What do studies tell us about diet and managing MS?

We often write about – and emphasize in our own practice’s recommendations - the importance of maintaining a healthy diet and the impact on disease progression. Now, new studies point to how specific foods as well as nutritional approaches can make a difference in patient outcomes.

One recent investigation explored the link between cow’s milk proteins and the prevalence of multiple sclerosis (MS). The environmental influences involved in the pathophysiology of autoimmune diseases like MS includes the very things we eat, drink, and are exposed to on a regular basis.We’ve long thought that milk from cows, which contains the protein casein and derivative products, has been shown to negatively affect MS patients.1 
 
In this new study, the scientists also looked at the role of antibodies and how these could exacerbate symptoms in a subset of patients. Their findings demonstrated that “a high percentage of MS patients harbor antibodies to bovine casein but also that antibody cross-reactivity between cow’s milk and CNS antigens can exacerbate demyelination.” 
 
Additionally, the authors stated a belief that consuming cow’s milk in some patients who have previously experienced a loss of tolerance to bovine casein could indeed aggravate the disease. They concluded that the data suggest these patients with antibodies to the cow’s milk protein could benefit from restricting dairy consumption and also expand clinician’s understanding of how diet influences MS in order to identify the most individualized and beneficial diet plans along with disease-modifying treatments (DMTs).
 
In addition to dairy, we often recommend our MS patients limit or avoid altogether foods containing gluten, just some of which include:
 

• Breads (e.g., wheat, rye, white, sourdough, etc.) 
• Cereals and many grains (e.g. barley, most commercial oatmeal)
• Wheat or semolina pastas
• Crackers, cookies (any prepared or baked goods that use flours other than rice or another acceptable gluten-free starch)
• Processed foods (soups, frozen meals, etc.) – become a label reader!
• Beer

 
We know – the list can be long! But there is a great deal of research that shows how gluten can incite inflammation in autoimmune disease and may be a factor in MS.
 
There also are studies that have provided preclinical data suggesting that a keto diet (KD), which restricts foods that typically contain gluten, and a fasting diet (FD) may “modulate immunity, reduce disease severity, promote remyelination” as observed in studies using mice models.3 And as reported in MS News Today, a recent small study found that short-term ketogenic diet resulted in significant improvements in people with relapsing-remitting multiple sclerosis (RRMS). 
 
You can find additional related reading in our blog archives about the role of diet in MS as well as other neurodegenerative diseases, including:
 
https://www.suzannegazdamd.com/blog---ms-in-the-news/intermittent-fasting-and-dietary-restriction-for-ms
 
https://www.suzannegazdamd.com/blog/new-study-shows-lower-risk-of-ms-relapse-with-the-prudent-diet
 
Or let us know if you have any questions or need to schedule a visit – we’re always here to help!
 
In hope and healing,
Dr. Suzanne Gazda 
 
References:
 
1 Malosse, D & Hervé, Perron & Sasco, Annie & Seigneurin, J. (1992). Correlation between Milk and Dairy Product Consumption and Multiple Sclerosis Prevalence: A Worldwide Study. Neuroepidemiology. 11. 304-12. 10.1159/000110946.
 
2 Chunder, R., Weier, A., Mäurer, H., Luber, N. et al. Antibody cross-reactivity between casein and myelin-associated glycoprotein results in central nervous system demyelination. (2022) Proceedings of the National Academy of Sciences (PNAS).https://doi.org/10.1073/pnas.2117034119
https://multiplesclerosisnewstoday.com/news-posts/2022/03/08/immune-response-casein-cow-milk-protein-may-explain-ms-diary-link/
 
3 Bahr LS, Bock M, Liebscher D, et al. Ketogenic diet and fasting diet as Nutritional Approaches in Multiple Sclerosis (NAMS): protocol of a randomized controlled study. Trials. 2020;21(1):3. Published 2020 Jan 2. doi:10.1186/s13063-019-3928-9