Multiple Sclerosis: Is Diet A Magic Bullet?
A few months ago I was giving a talk about the role of nutrition in multiple sclerosis. Afterwards a very nice lady came up to to offer some feedback. “I really liked your talk but I also really hated it.” She went on to explain that she was really hoping to hear about how diet would be a magic bullet that would heal her MS and was disappointed to hear that no such bullet exists.
Her comment has lived in my head for a while now for a few reasons. First and foremost I think it has a lot to do with the fact that so many of us can identify with her desire for a magic bullet, right? I mean who among us has not had that wish in some form at some time?
Eat this, avoid that and be healed! If only…
Another reason her comment has stuck with me is because it shines a light on a problem that I encounter every day: having multiple sclerosis is scary and Dr Google knows it.
This Is Us
It is important to know that Dr Google and his associates are keenly aware of our desire for a magic bullet and are all to ready to sell it to us. They know this about us because their marketing teams have researched us and targeted us with endless information, products and services that promise to deliver exactly what we want (need?) to hear.
These promises are typically made using vague and confusing language. Sometimes they cite sketchy research or anecdotal evidence. In any case, it is almost always difficult to know what we can reliably expect from products, dietary guidelines, programs, etc. In the end, the only one who truly benefits from the transaction is Dr Google’s bottom line. An unfortunate truth which makes it our responsibility to do a little bit of digging and verify health claims before we make dramatic changes to our diet, spend thousands of dollars on detox programs or make supplement pills our primary source of nutrients.
Who is us? Us is anyone who is living with an awful disease that has no known cause and no known cure. We are a marketing target and should not forget that.
Something To Think About…
I am not sure when we became convinced that in order to be effective, a dietary intervention must be complicated, restrictive, expensive, competitive….and so on. The truth is that eating well does not have to be hard. In fact the most impactful diet interventions are not flashy, exotic, expensive or restrictive. And they are not secret… it just feels like they are hidden in plain sight behind all of the headlines and clickbait. This may be because it lacks an advertising budget and the only beneficiary will be YOU!
- Colorful Vegetables and Fruits
- Lean Proteins
- Beans, Legumes, Nuts and Seeds
- Whole Grains
- Healthy Fats
- Low-fat Calcium Foods
- While limiting: saturated fats, sodium, added sugars, highly refined foods
- And avoiding: trans fats entirely
Should I Eat Differently Because Of MS?
- Maybe… It depends!
- How are you eating now? Does it look anything like the list above?
- What changes are you considering and why?
Doctor prescribed dietary interventions take the problem→intervention→outcome approach. This helps to make sure that the intervention will actually impact the problem and result in better health outcomes.
Multiple sclerosis is an awful disease that serves up hellish symptoms that everyone experiences differently. While food choices can play a significant role in managing some common MS symptoms it is unlikely that a single intervention will address everything in the same way for everyone.
Before changing your diet dramatically or adding lots of supplements to your daily routine why not subject them to a quick test by answering these questions:
- What is the specific problem being targeted?
- What is the specific intervention? In other words, how will you modify your diet?
- What is the expected outcome? Is this a realistic expectation?
- Has this intervention been shown to impact the problem?
This example might help illustrate the idea:
- Specific Problem: Hypertension
- Intervention: Reduced sodium dietary pattern
- Expected Outcome: improved blood pressure
- Has a reduced sodium diet been shown to impact hypertension? Yes.
- Is it realistic to expect improved blood pressure with a reduced sodium diet? Yes.
Many of the recommendations made by Dr Google and his associates fail to provide any of the specifics used in the problem→ intervention →outcome approach described above. With one exception… the interventions are often very specific. Often they involve complicated food rules, restrictive eating patterns, require copious supplements, and…..
Now consider this example:
- Specific Problem: Multiple Sclerosis
- Intervention: Very specific and exacting food rules including things like removing entire food groups from the diet, taking copious supplements (presumably to replace nutrients no longer provided from food)
- Expected Outcome: Heal, beat or reverse MS
- Has this intervention been shown to impact the MS disease course? No.
- Is it realistic to expect that modifying your diet in this way will heal, beat, or reverse MS? No, not in any clinical sense. These language used here is intentionally vague so it is difficult to know what they even mean in the context of a disease with no known cause and no known cure.
*This example was complied from several products/diets/protocols/detoxes that are currently floating around on the internet and beyond.
So, No Magic Bullet?
As someone who has been living with multiple sclerosis for almost 10 years, nobody would welcome a magic bullet more that me. But I am afraid not…or at least not in the way you may have been hoping for. Researchers continue to investigate a variety of ways that nutrition might impact multiple sclerosis but at this time no diet has been shown to alter the MS disease course. And research, especially nutrition research involving humans, is very expensive and takes a lot of time. But there is plenty you can do to live well with MS while the researchers continue to look for a cure.
As I have mentioned before there is increasing evidence to suggest that having a comorbid chronic health condition along with MS is associated with an increase in disability and decrease in quality of life.
Each of the chronic comorbid health conditions listed above has a doctor prescribed dietary intervention that is associated with improved health outcomes.
So if you have one of these conditions along with MS, following the doctor prescribed dietary guidelines that result in improved health outcomes is a really good idea. In other words Improved: glucose control, blood fats, triglycerides, blood pressure, bone health all contribute to feeling better and living better with MS.
If you do not have any of these conditions then adopting sustainable and healthy habits (including a balanced diet) that will reduce your risk for adding one of these conditions to your health record is also a really good idea.
Maybe Wellness Is The Magic Bullet?
Maybe. I am not sure. But as I reflect on the “I really liked your talk but I also really hated it” conundrum I am reminded that research suggests maintaining good overall health is a really important part of living well with MS. There are a few other things that I am sure of as well:
- MS remains a disease with no known cause and no known cure.
- MS is a disease with a poorly understood diversity of outcomes. Comorbid chronic health conditions may help to explain this.
- A balanced, nutrient-dense diet along with other important daily habits like exercise, sleep, attending to anxiety/depression,… CAN improve your overall health and quality of life with MS.
- The human body prefers to get nutrients from food.
- Removing entire food groups from your diet does not make you healthier.
- MS is difficult and expensive enough to navigate without adding complicated and costly food/ supplement interventions that are of questionable benefit and in fact may have significant unintended consequences.
- Supplements are not regulated. So in my best Forest Gump voice… you never know what you’re gonna get. Seriously. Whenever supplements are warranted, I recommend the NatureMade brand (or other USP verified products). They are widely available and most importantly sport the USP label, which means that they are third party verified as to their contents. Another resource for this is consumerlab.com.
- It is very important to make sure that your doctors are aware of all of the vitamins, minerals and or herbal supplements you are taking.
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