Diet and Multiple Sclerosis: Scoping Review of Web-Based Recommendations

Abstract

BackgroundThere is currently no scientific evidence supporting the use of specific diets in the management of multiple sclerosis (MS); the strongest dietary associations are observed with vitamin D and omega-3 fatty acid supplementation. Despite this, there are many websites that provide advice or suggestions about using various dietary approaches to control symptoms or disease progression.ObjectiveThe objective of this study was to assess the dietary advice for the symptomatic management of MS available on the internet.MethodsThis study was a systematic review of webpages that provided dietary advice for the management of MS. Webpages were selected from an internet search conducted in November 2016 using Google, Yahoo, and Bing search engines and the search term “MS diet.” The first two pages of results from each search engine were included for the initial assessment. Duplicates were removed. Data extracted from websites included specific advice relating to diet and its rationale and the citation of supporting scientific literature. Authorship and credential information were reviewed to assess webpage quality.ResultsWe included 32 webpages in the final assessment. The webpages made a wide variety of specific recommendations regarding dietary patterns and individual foods to help manage MS. The most common dietary pattern advised on these webpages was the low-fat, high-fiber balanced diet, followed by the low-saturated fat diet, near-vegetarian Swank diet, and the Paleo diet. The main categories of individual foods or nutrients suggested for addition to the diet were: supplements (especially omega-3 and vitamin D), fruits, vegetables, and lean protein. In contrast, the most commonly recommended for removal were saturated fats, dairy, gluten-containing grains, and refined sugar. These recommendations were often accompanied by rationale relating to how the particular food or nutrient may affect the development, prevalence and symptoms of MS; however, very little of this information is supported by the current scientific evidence between diet and MS. Only 9 webpages provided full authorship including credential information.ConclusionsThere is a wide variety of Web-based dietary advice, which in some cases is contradictory. In most cases, this advice is the result of peoples’ individual experiences and has not been scientifically tested. How people living with MS use this information is not known. These findings highlight the important role health professionals can play in assisting people living with MS in their health information-seeking behaviors.

A Review of Various Antioxidant Compounds and their Potential Utility as Complementary Therapy in Multiple Sclerosis

“…Currently, there are 32 websites that provide advice or suggestions about using various dietary approaches to control the symptoms or progression of MS. The most recommended diets are a healthy balanced diet (low-fat, high-fiber diet with whole grains and fish), Swank diet (rich in low saturated fat), and modified Paleolithic diet (based on raw food, gluten-free, and lactose-free products), which primarily reduce fatigue and reduce the symptoms of MS [133]. The specific dietary patterns used by MS patients are generally characterized by diets that are low in saturated fat, processed meats, and refined sugars, and are rich in vegetables, fruits, nuts, and fish.…”

Current Evidence on the Efficacy of Gluten-Free Diets in Multiple Sclerosis, Psoriasis, Type 1 Diabetes and Autoimmune Thyroid Diseases

“…Multiple sclerosis (MS) is an autoimmune, yet incurable, disease of the central nervous system [ 28 ] and one of the leading causes of disability among young adults. A recent publication reports that 31% (10/32) of websites providing MS-specific dietary advice recommend patients with MS to abstain from “grains (gluten)” [ 29 ]. Despite a high interest in the use of dietary modifications to ameliorate the course of the disease [ 30 ], MS-specific, evidence-based dietary guidelines have not been developed yet.…”

Selenization of S. cerevisiae increases its protective potential in experimental autoimmune encephalomyelitis by triggering an intestinal immunomodulatory loop

“…Roy Swank proposed a low saturated fat diet to treat MS around 1950 [12][13][14] and diet supplementation with organic, gluten-free and allergen-free ingredients have been beneficial to MS patients 15 . A review containing scientifically unproven data sustains the use of specific diets in the management of MS, suggesting a relationship between them and disease progression 16 . The immunomodulatory properties of CAM have been studied and their effectiveness in MS has been investigated.…”