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Multiple Sclerosis Self-Management Program|
Many studies have demonstrated a reduced capacity to detoxify free radicals in patients with MS. The key factor appears to be a reduced activity of the antioxidant enzyme glutathione peroxidase (GSH-Px). [V.K.S. Shukla, G.E. Jensen, and J. Clausen, "Erythrocyte Glutathione Peroxide Deficiency in Multiple Sclerosis," Acta Neurol Scand 56 (1977):542-50.] Since GSH-Px is intricately involved in the protection of cells from free-radical damage, decreased activity level would leave the myelin sheath particularly sensitive to damage. In response to free-radical exposure, lipid peroxides are formed.
GSH-Px is found in two forms: a selenium-dependant enzyme and a non-selenium-dependant enzyme. Since low selenium areas often overlap with high-frequency-rate areas for MS, it is natural to speculate that a link might exist between selenium levels, GSH-Px activity, and MS. Studies linking MS to selenium levels have given conflicting results. Initial studies supported the link between MS and selenium levels [Wilkstrom, Westermarck, et al. "Selenium, Vitamin E and Copper in Multiple Sclerosis," European Neurology v.22. 1983. 442-446], but a subsequent study, found that reduced GSH-Px activity was independent of selenium [Szeinberg, et al. "Decreased Erythrocyte Glutathione Proxide Activity in Multiple Sclerosis," Acta Neurology Scandanavia v.60 1980 61-67].
This conflict doesn't mean that selenium supplementation is a dead end; it could have resulted because cofactor antioxidant nutrients (vitamin E and copper) were present in the successful link study and were not included in the study that found no correlation. Also, individual genetic factors play a major role in both low GSH-Px and selenium absorption. One could logically conclude that many individuals may benefit from selenium and cofactor nutrient supplementation, but that others may not have noticeable improvements.
Because of the established malabsorption patterns of MS, the proven association of certain nutrients to certain body functions and to MS therapy, the improvements found from the Swank program, and the absence of risky side effects, it is logical to conclude that nutrient supplementation is a therapeutic option for MS.
A diet including mostly vegetables, eggs, fruits, whole grains, raw nuts and seeds, and cold-pressed vegetable oils (no Crisco, Sun, or other common hydrogenated grocery store vegetable oils).
Limit saturated fats and animal , since the processing of saturated fats uses up EFAs and thereby result in a lower available quantity for neural myelin support.
Drink at least eight 8-oz glasses of water daily to prevent toxic buildup in the muscles.
Eliminate alcohol, caffeine, fried foods, highly seasoned foods, meat, oats, refined foods, last spices, sugar, and tobacco.
Get tested for possible food allergies.
Avoid stress and anxiety by performing relaxation exercises (deep breathing, meditation, prayer, visualization).
Avoid exposure to heat, such as hot baths, showers, sunbathing, and overly warm surroundings, and avoid becoming overheated when working or exercising.
Utilize massage, get regular exercise, and keep mentally active. These are extremely valuable in maintaining muscle function and bringing about remission of symptoms. Swimming is the best activity, or other exercises in the cool water, because increased body temperatures can decrease the function of hate nerves involved and make symptoms worse.
Dr. Roy Swank began successfully treating patients with his lowfat diet in 1948. His research and clinical work as Professor of Neurology at the University of Oregon Medical School, provides convincing evidence that his dietary suggestions over a long period of time tends to retard the disease process of MS and reduce the number of attacks [Swank, "Multiple Sclerosis: Twenty Years on Low Fat Diet." Archives of Neurology v.23 (1970) p.460-474]. Dr. Swank recommends: a saturated fat intake of no more than 10 grams per day; a daily intake of 40 to 50 grams of polyunsaturated oils per day (margarine, shortening, and hydrogenated oils are not allowed);at least 1 tsp of cod liver oil per day; a normal allowance of protein; Consumption of fish three or more times per week.
A diet low in saturated fats significantly restricts many animal sources of protein or would require very lean sources of animal protein (i.e. baked chicken breast). The patient should derive protein from other sources (legumes, grains, and vegetables). While meat consumption is advised, cold-water fish (mackeral, salmon, herring) are one of the best sources because of the protein content and also the beneficial omega-3 oils they contain.
Swank's diet was originally thought to help patients with MS by overcoming an essential fatty acid deficiency. Currently, it is thought that the beneficial effects are probably a result of (1) decreasing platelet aggregation, (2) decreasing an autoimmune response, and (3) normalizing the decreased essential-fatty-acid levels found in serum, erythrocytes, and, perhaps most importantly, the cerebrospinal fluid in patients with MS.
Swank's diet significantly reduces the platelet adhesiveness and aggregation that is observed in atherosclerosis as well as in multiple sclerosis. Excessive platelet aggregation and very small clumps of platelets are thought to result in the following abnormalities observed in MS: damage to the blood-brain barrier, alterations in the microcirculation of the central nervous system, and reduced blood flow to the brain.
MS patients have been shown to have an abnormal blood-brain barrier, presumably as a result of excessive platelet adhesiveness and aggregation. Damage to the blood-brain barrier may allow the passage of blood components that are toxic to myelin into the cerebral spinal fluid. These components include bacteria, viruses, antibodies, toxic chemicals, and other compounds. Reduced blood flow may also be a contributing factor in demyelination, by promoting both cellular death and the release of self-destructing enzymes.
Medical Options and Precautions
The effect of diet on platelets is important in MS, but probably more important is the effect that fatty acids have on the activity of the immune system. Immune-suppressing drugs such as adrenal steroids, cyclophosphamide, and methotrexate yield good short-term benefits, but are of limited value in the long run due to their high risk side effects and lack of demonstrable long-run effectiveness. The idea behind using drugs which suppress the immune system in MS is based upon the theory that MS is an autoimmune condition where the immune system is attacking and destroying the myelin sheath. Currently, new immune-suppressing drugs are being tested for use in treating MS. However, considering the lack of toxicity and long-run effectiveness, Swank's dietary approach with stepped up nutritional supplementation to secure adequate nutrient coverage and possibly yield quicker improvements appears to be more appropriate and safer ways of modulating the immune response.
Concerned individuals should become knowledgeable about the side effects of any drugs they are taking and with that awareness establish with their health care practitioner a comprehensive treatment program with the lowest possible risk.
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