By Jack Challem
Copyright 1998 by Jack Challem, The Nutrition Reporter™
All rights reserved. This article originally appeared in Let's Live magazine.

Lynn needs a walker to get around her apartment. Teri tools around the office in a motorized cart. Robert suffers from numbness and has days of overwhelming fatigueIncredible as it might sound, multiple sclerosis has emerged as the "polio" of the 1990s. This disabling disease now affects an estimated 300,000 Americans, most of whom are diagnosed between the ages of 20 and 40, a time when they should be at their healthiest.

But check in with the national Multiple Sclerosis Society, which pumps millions of dollars into MS research, and you'll hear the official chant: there is no known cause, and there is no cure. Ignoring this official sense of resignation, many people have turned to alternative therapies to treat their MS.

Take the case of Matt Embry, now 22 and a film student in Calgary, Canada. In June 1995, he suddenly developed severe leg twitches, problems with balance, and an extreme sensitivity to temperature on his left side. One month later, a magnetic resonance imaging scan identified a dozen lesions in this brain and spinal column. The diagnosis was unmistakable. Matt envisioned life in a wheelchair-and "almost shut down and gave up," he said.

Matt's dad, Ashton, a geologist, started reading everything about MS that he could get hold of-in books, in medical journals, on the internet. He quickly realized that few researchers and physicians had seriously considered the roles of diet and alternative treatments in controlling MS. Yet such treatments held far more promise than drug treatments ridden with side effects.

Ashton suggested two therapies to Matt, who was initially skeptical. First came acupuncture. Amazingly, after 10 acupuncture treatments, Matt's MS symptoms completely cleared-as did headaches, night sweats, and allergies he had suffered with for years. Although acupuncture, long a component of Chinese medicine, has made inroads into Western medicine, no one really understands how or why it works. But work it did.

Ashton also realized that diet had a profound affect on the progression of MS. He read about Roy L. Swank, M.D., Ph.D., of Portland, Ore., who had years before developed a low-saturated-fat diet to treat MS. He also learned that food sensitivities-allergy-like reactions-could aggravate MS symptoms, and he put Matt on a "paleolithic," or cave-man, diet consisting of simple and unprocessed foods, such as fruits, vegetables, fish, skinless chicken breasts, and a little rice, and avoiding all dairy, gluten, legumes, fried foods, and yeast. In addition, Matt began taking a variety of supplements, including vitamins, minerals, and such "good fats" as salmon oil and evening primrose oil.

For the past three years, Matt has remained completely free of MS symptoms. "I stick with the diet religiously," he said. "It was rough for the first six months, but then it became easy. Sure, the foods aren't real exciting, but I would rather use my hand to bring these foods to my mouth than not to be able to use my hand at all.

"Actually, this is the best thing that ever happened to me," Matt added. "It changed my whole perspective. I don't take as many things for granted.

The Nature of MS

MS is generally considered an auto-immune disease, an allergic reaction to oneself that eats away at the myelin sheaths wrapped around nerve fibers. Sclerosis is the medical term for lesion, and in MS multiple lesions form on the myelin, which is akin to the plastic insulation surrounding electrical wires. The myelin becomes inflamed and literally begins to fray, short-circuiting nerve signals and leading to the disease's physical and neurological symptoms.

More women than men suffer from MS, and there is a higher incidence of the disease in extreme northern and southern climates. People of Scottish descent seem particularly vulnerable. According to a study at the University of California, San Francisco, the stress of daily hassles and major life events can exacerbate MS symptoms.

What makes the immune system turn against its host? Many researchers and physicians believe a bacterial or viral infection sets the stage for MS, often years before symptoms appear. In fact, a form of the herpes virus known as "human herpes virus 6" seems to promote MS flare ups, though most people harbor the virus without developing the disease.

It's not that a germ attacks and damages the myelin. Rather, myelin gets destroyed by an immune system gone haywire and incapable of turning itself off, similar to what happens in rheumatoid arthritis or lupus erythematosis. Various types of immune cells migrate to myelin and attack it, triggering a variety of neurological and muscular symptoms, including numbness, impaired vision, and weakness.

In fact, the nerve damage characteristic of MS may be far greater than previously thought. In a study published in the January 19, 1998, New England Journal of Medicine, Bruce D. Trapp, Ph.D., and his colleagues at the Cleveland Clinic showed that the disease process actually severs nerve fibers in the brain, suggesting that late-stage MS may not be reversible.

Fats: Too Much of the Wrong Kinds

In his own review of MS research, Ashton Embry stumbled across something most MS experts have overlooked: that the modern diet, with a lopsided intake of dietary fats, particularly highly refined fats and oils, may set the stage for inflammation-and, in some people, MS. Restoring a balance of fats, such as through a low-or balanced-fat diet, reduces inflammation.

Why fats? Myelin is rich in polyunsaturated fatty acids, such as the omega-6 and omega-3 fatty acids, which are essential for brain and nerve development and function.

In the 1940s, Swank theorized that people with MS had been consuming far too much saturated fat (found in meat). Later, as chairman of the department of neurology at Oregon Health Sciences University, Portland, and head of his own MS clinic, he carefully tracked the health of patients for 34 years. He found that those eating low-fat diets (less than 20 grams daily) suffered only "slight" myelin deterioration and 95 percent survived the study. In contrast, 80 percent of the patients eating moderate to high-fat diets (25 to 41 grams daily) had a serious progression of their MS symptoms, with only 20 percent living through the end of the study.

As significant as his findings were, however, Swank may have overlooked the larger dietary picture of fats and oils. According to S. Boyd Eaton, M.D., of Emory University, Atlanta, the ratios of modern dietary fats bear little resemblance to evolutionary patterns of fat intake, to which our genes are accustomed. The domestication of cattle has skewed fatty acid ratios in beef, so there's more saturated fat; game meats have a fat profile resembling that of salmon. In addition, the modern ratio of omega-6 to omega-3 fatty acids is about 11:1. In the paleolithic diet, which people and primates evolved on, the ratio ranged from 4:1 to 1:1, according to Artemis Simopoulos, M.D., and Jo Robinson, authors of The Omega Plan (HarperCollins, 1998).

Both families of fats are essential for health and, in addition to their roles in brain and nerve function, are needed to produce a variety of immune compounds, such as the hormone-like eicosanoids and cytokines. Their effects, though, are almost diametrically opposed. High intake of the omega-6s, such as through the consumption of fried foods and salad dressings, promote production of inflammatory eicosanoids and cytokines. In contrast, the omega-3s form anti-inflammatory eicosanoids and cytokines-and have been useful in other autoimmune disorders, such as rheumatoid arthritis. Another group of fatty acids, the omega-9s (found in olive and canola oils), also have an antiinflammatory effect.

In a recent article in the journal Neurology , Klaus Lauer, M.D., of Darmstadt, Germany, noted that large amounts (20-25 grams daily) of omega-6 fatty acids have been found to reduce the severity of MS in newly diagnosed cases, but had no affect on long-established cases. In one study, adding 2-3 grams of omega-3 fatty acids (from fish oils) as well helped ease symptoms a bit more, according to Lauer.

Part of the problem, according to David Horrobin, Ph.D., M.B., a fatty acid researcher and editor of the journal Medical Hypothesis, is that the modern diet is flooded with poor quality omega-6 fatty acids (in the form of cooking or frying oils), which seem to overwhelm delta-6-desaturase, a crucial enzyme. Inadequate delta-6-desaturase activity limits the conversion of linoleic acid, found in vegetable oils, to gamma-linolenic acid (GLA), a highly beneficial and antiinflammatory omega-6 fatty acid. To leapfrog this problem, Horrobin often recommends that people take evening primrose oil supplements, which are rich in GLA and sidestep the sluggish enzyme. Fish or flaxseed oil capsules, which contain the omega-3 fatty acids, might also help.

Vitamins May Protect, Rebuild Tissue

The omega-6 and omega-3 fatty acids, like most fats and oils, are highly susceptible to free radicals, unbalanced molecules that oxidize and damage cells. Free radicals are produced during inflammatory reactions-they destroy bacteria and, by activating "adhesion molecules," maintain inflammation. However, chronic or severe inflammation breaks down normal tissues, such as myelin, and several studies have found MS patients to have elevated levels of free radical damage.

While antioxidant nutrients are well established for their ability to quench free radicals, few studies have actually scientifically tested the use of antioxidants in MS patients. One, described in Biological Trace Element Research found that a combination of antioxidants (6 mg selenium, 2 grams vitamin C, and 480 mg vitamin E) did increase levels of glutathione peroxidase, a key antioxidant enzyme.

There's other promising, though indirect, research indicating that antioxidant nutrients should help ease MS symptoms. Vitamins C and E, flavonoids (e.g., Pycnogenol®), and vitamin-like alpha-lipoic acid-all antioxidants-quench free radicals and are well established for their antiinflammatory properties.

Other vitamins, particularly those of the B complex, may also help maintain or rebuild myelin in MS patients. Several years ago, E H. Reynolds, M.D., of King's College Hospital, London, measured B12 levels among many MS patients. Nearly all were deficient in the vitamin, though they did not exhibit signs of pernicious anemia. Other studies and clinical experiences reinforce the importance of vitamin B12. In one study, researchers found that low B12 levels were associated with the early onset of MS, particularly in patients under age 18.

While vitamin B12 has not become a common therapy for MS, it may be helpful. Several years ago, researchers at Kyushu University, Fukuoka, Japan, noted B12 abnormalities in 24 MS patients and injected six of them with massive doses (60 mg, not mcg) of the vitamin daily for six months. Visual and auditory symptoms improved, but muscle function did not.

Folic acid, another B vitamin, might also help in MS. Swiss doctors have theorized that incomplete breakdown of dietary sugar, particularly fructose, may yield formaldehyde, a toxic compound that attacks myelin. Folic acid might block this damage. The apparent association of low B12 and folic acid with MS touches on another possible intriguing cause of the disease: inefficient methylation.

Methylation, which donates carbon and hydrogen molecules to chemical reactions, is a key process in the building of new molecules, particularly deoxyribonucleic acid (DNA), and new cells. Vitamins B12 and folic acid play essential roles in methylation and DNA synthesis and the production of new cells. Inadequate levels of these vitamins, or defects in the body's use of them, could impair the growth of myelin and nerve cells.

According to a team of researchers at the Baylor Research Institute, Dallas, Texas, S-adenosyl-methionine (SAM) might also be helpful, because it regulates methylation and helps regenerate myelin. Deficiencies of B12 and folic acid lower SAM production. Because SAM is an expensive supplement, it may be better trying extra B12 and folic acid before SAM. In addition, betaine, also known as trimethylglycine, can boost SAM levels in the body.

Diet/Geography Link

Even the geographical pattern of MS may have some dietary links.

MS researchers have long recognized that the incidence of MS generally increases farther north and south from the equator, correlating to less sunlight. Sunlight activates the body's production of vitamin D, and people living farther from the equator would, over the course of a year, make less vitamin D.

This relationship doesn't confirm that a lack of vitamin D increases the risk of MS. But there's other tantalizing data. According to a report by C. E. Hayes, Ph.D., and his colleagues at the University of Wisconsin, Madison, vitamin D can prevent experimental autoimmune encephalomyelitis, the mouse version of human MS.

Another variable appears to be the amount of fish consumed, particularly by people living at extreme latitudes. For example, along the coast of Norway and throughout Japan, the incidence of MS is less than expected, based on latitude. Fish, rich in the antiinflammatory omega-3 fatty acids, is a major dietary constituent in these areas and may be protective. In fact, the high incidence of MS among people of Scottish descent might reflect an interaction between a genetic propensity toward the disease and a modern diet containing less fish.

For the most part, nutrition research on MS languishes in medical libraries. Most MS research dollars are earmarked for identifying the molecular causes of the disease and developing new drugs. Yet it's clear that diet is a powerful influence on the development and progression of MS. A cure for MS is far from being at hand. However, effective, safe, and inexpensive treatments do exist.

The information provided by Jack Challem and The Nutrition Reporter newsletter is strictly educational and not intended as medical advice. For diagnosis and treatment, consult your physician.

copyright © 2000 The Nutrition Reporter™ - updated 11/25/00