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Monday, September 4, 2017

Current Evidence about Diet and MS

     By:Pavan Bhargava, MD

Introduction Multiple Sclerosis is a chronic immune-mediated demyelinating disorder that affects the central nervous system (CNS). In MS, inflammatory cells of the immune system (including T cells, B cells and others) are believed to target cells and tissues within the CNS, causing inflammation and damage to myelin, nerve fibers and the cells that make myelin. Several genetic and environmental factors that influence the risk for developing MS have now been identified. Perhaps the most significant dietary factor that has been linked with the occurrence of MS and its disease course is vitamin D. 1,2 Another recent dietary factor associated with autoimmunity is high salt intake. 3 Ongoing research is also demonstrating a link between the gut microbiota (bacteria in our gut) and MS. 4 Diet plays an important role in shaping our gut microbiota and is also implicated in multiple other chronic diseases (type 2 diabetes, obesity, hypertension). There is increasing interest in the possible role of diet in autoimmunity and in the role of dietary interventions in diseases such as MS.

Possible mechanisms by which diet may have an effect on MS -

1. Direct effects on the immune system: 
Recent immunological research has shown that metabolism plays an important role in the function of several types of immune cells. Additionally several immune cells have receptors (surface structures that allow cells to connect and communicate with other cells) for various types of dietary metabolites (vitamin D, fatty acids). Thus intake of certain types of fats has been linked to greater inflammation while intake of polyunsaturated fatty acids (PUFAs) has the opposite effect.

Indirect effects through modulation of the gut flora:
The gut bacteria metabolize certain components of the diet into short chain fatty acids that, besides helping in colonic health, can also act on immune cells and make T cells more regulatory.
 Additionally diet can lead to alterations in the gut bacterial composition that can shift the immune system towards a pro- or antiinflammatory state.

 Effects on components of the central nervous system: 
As mentioned above, since altered metabolism may play a role in the adaptation of the nervous system to damage, various experimental foods and diets are being studied for

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