The molecular basis of nutritional intervention in multiple sclerosis: A narrative review

Complementary Therapies in Medicine
Volume 19, Issue 4, August 2011, Pages 228­237


The molecular basis of nutritional intervention in multiple sclerosis: A narrative review
P. Riccio
Dipartimento di Biologia D.B.A.F., University of Basilicata, Potenza, Italy
National Institute of Biostructure & Biosystems (INBB), Roma, Italy


Summary


It is commonly accepted that nutrition is one of the possible environmental factors involved in the pathogenesis of multiple sclerosis (MS), but its role as complementary MS treatment is unclear and largely disregarded. At present, MS therapy is not associated to a particular diet, probably due to lack of information on the effects of nutrition on the disease. To overcome the distrust of the usefulness of dietary control in MS and to encourage nutritional interventions in the course of the disease, it is necessary to assess the nature and the role of bioactive dietary molecules and their targets, and establish how a dietary control can influence cell metabolism and improve the wellness of MS patients.


The aim of this review is to provide a rationale for a nutritional intervention in MS by evaluating at the molecular level the effects of dietary molecules on the inflammatory and autoimmune processes involved in the disease. Present data reveal that healthy dietary molecules have a pleiotropic role and are able to change cell metabolism from anabolism to catabolism and down-regulate inflammation by interacting with enzymes, nuclear receptors and transcriptional factors. The control of gut dysbiosis and the combination of hypo-caloric, low-fat diets with specific vitamins, oligoelements and dietary integrators, including fish oil and polyphenols, may slow-down the progression of the disease and ameliorate the wellness of MS patients.


http://www.sciencedirect.com/science/article/pii/S0965229911000860



Excerpts:


"Studies on the relationship between diet and MS are very few, and diets available to the MS patient are often lacking a scientific basis. At present, MS therapy is not associated to a particular diet. There is, however, an apparently great need to apply non-conventional therapies, and the majority of MS patients often use complementary or alternative treatments without informing the physician."


"inflammation, autoimmunity, oxidative stress, and angiogenesis associated with MS, and for this reason they are considered as 'healthy' molecules that can improve the wellness of MS patients. Among them, the most important are polyphenols and carotenoids from vegetables, omega-3 (n-3) long-chain polyunsaturated fatty acids (PUFA) from fish, and vitamins as vitamin D and niacin."


"Statements of principal findings reported in this review article are based on careful, although not systematic, search of the literature and on our own experiments."


"The most important limitation for the evaluation of the impact of nutrition on the wellness of MS patients can be ascribed to the very limited number of clinical studies in this field. This is a bit like biting the tail, because the limited number of clinical evidences, the restricted types of dietary molecules used in clinical trials, or the limited number of patients enrolled in the studies, did not allow so far to achieve the scientific validity required for the approval of nutritional interventions in MS and this, on the other hand, make it difficult to perform other clinical studies."


"This review article introduces for the first time two important claims: (1) the link between diet, gut dysbiosis, inflammation and MS; (2) the molecular basis for the planning of nutritional interventions as complementary treatments of MS, based on combinations of both hypocaloric, low-fat diets and specific dietary supplements, including vitamins D3 and niacin, oligoelements, polyphenols and fish oil, together with sunshine and physical exercise."