Diet and MS: Part 3
So, aside from feeling confused, where does this leave us? What is a patient with MS to do with regards to diet? First of all, let me say that I think the vast majority of patients with MS have relatively healthy diets to begin with. With a few exceptions, most of my patients are young, fit people who exercise often and don’t appear to get the majority of their meals from fast food restaurants.
When a patient asks me what they should do about diet, I tell them that my suggestions are no different from anyone who does not have MS. They should not eat too much, they should eat plenty of fruits and vegetables, and they should try to lay off the junk food (though I know how hard this can be!). Even if this does not impact their MS, it will help their waistline as well their cardiovascular fitness. Generally, I tell patients that they should enjoy food like anyone else. It is, after all, one of life’s great pleasures.
I give similar advice when it comes to supplements. Many patients I see take numerous supplements and vitamins daily. Based on the available evidence, I cannot advise them that any of these supplements offer any particular benefit, though I am optimistic that further studies will support a role for vitamin D.
Additionally, I am concerned that taking large doses of certain supplements and vitamins may have unforeseen adverse side effects. Many patients feel safe because they feel they are taking something “natural.” Most likely, such supplements will be excreted harmlessly in the urine. However, I think it is a mistake to say that just because something is “natural” it must be harmless and without side effects. Few people would eat random berries and mushrooms they found in a forest simply because these were “natural.” Additionally, almost anything—if taken in a high enough dose—can have serious adverse health effects. There is a saying in medicine that “the dose determines the poison” and there have been cases of people dying from drinking too much water!
Another consequence of patients taking large quantities of vitamins and supplements is that some of them can be quite expensive. Few of my patients have money to burn, and I suspect that their money can often be put to better use. So, other than suggesting that patients take vitamin D, I recommend that patients save their money until further evidence emerges that any of the supplements are helpful.
Clearly, more research is needed to determine the role of diet and nutrition in MS.
I am available via e-mail at firstname.lastname@example.org and will try to answer all questions.