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Nutrition and Multiple Sclerosis
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Nutrition and Multiple Sclerosis

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Lipids".

Deadline for manuscript submissions: closed (30 April 2022) | Viewed by 20112

Special Issue Editor

Prof. Dr. Halina Bartosik-Psujek

E-Mail Website
Guest Editor
Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University，Warzywna 1A, 35-310 Rzeszów, Poland
Interests: multiple sclerosis; immunomodulatory therapy; vitamin D; nutrients in multiple sclerosis

Special Issue Information

Dear Colleagues,

Multiple sclerosis (MS) is the most common immune-mediated inflammatory, demyelinating disease of the central nervous system, which primarily affects young adults. The exact cause of the disease is unknown, but environmental factors are considered. In particular, associations between lifestyle and food intake in people with MS are of increasing global interest.

In recent years, many studies have been conducted to assess the effects of various dietary components on the immune and clinical parameters in MS patients. Some works suggest that dietary factors may exacerbate or ameliorate MS symptoms by modulating the inflammatory status of the disease both in relapsing–remitting MS and in primary–progressive MS. This is achieved by controlling both the metabolic and inflammatory pathways in the human cell and the composition of commensal gut microbiota. However, the data about a nutritional intervention with anti-inflammatory food and dietary supplements are inconclusive, and there is no specific diet designed for MS patients. Nonetheless, this is the basic question of patients after a diagnosis of MS is made. Patients expect disease-modifying therapy to affect the natural course of the disease and accurate guidance on diet and lifestyle. Approved treatments for MS work by regulating the immune system. There is interest in whether dietary interventions, such as specific diets or dietary supplements may influence on MS activity or side effects of immunomodulatory therapy. Therefore, from the point of view of nutrition sciences, it is particularly interesting to learn about the role of dietary programs and other dietary supplements in managing patients with multiple sclerosis.

This Special Issue will welcome works covering various areas of research on the role of diet and dietary supplements in MS patients, with a particular focus on treatment of the disease. We welcome different types of submissions including original research articles, systematic reviews, and meta-analyses.

Prof. Dr. Halina Bartosik-Psujek
Guest Editor

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • multiple sclerosis
  • nutrients in multiple sclerosis
  • dietary supplements
  • nutrition
  • MS therapy
  • diet–immune system interactions
  • gut microbiota
  • vitamin D

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Published Papers (4 papers)

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Research

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10 pages, 615 KiB  
Article
Diet Quality Assessment in Wheelchair Users with Multiple Sclerosis
by Stephanie L. Silveira, Brenda Jeng, Gary Cutter and Robert W. Motl
Nutrients 2021, 13(12), 4352; https://doi.org/10.3390/nu13124352 - 3 Dec 2021
Cited by 5 | Viewed by 2919
Abstract
Background: Diet quality has not been distinctively examined in wheelchair users with multiple sclerosis (MS). Methods: This cross-sectional study examined the Diet History Questionnaire (DHQ) III and the Automated Self-Administered 24-h (ASA24) Dietary Assessment Tool in 128 wheelchair users with MS. Participants were [...] Read more.
Background: Diet quality has not been distinctively examined in wheelchair users with multiple sclerosis (MS). Methods: This cross-sectional study examined the Diet History Questionnaire (DHQ) III and the Automated Self-Administered 24-h (ASA24) Dietary Assessment Tool in 128 wheelchair users with MS. Participants were prompted to complete the DHQ-III and 3 ASA24 recalls during a seven-day data collection period. Healthy Eating Index (HEI)-2015 scores were calculated for DHQ-III and ASA24, and scores were compared with normative values. Spearman’s correlation analyses (rs) estimated the associations between DHQ-III and ASA24 HEI-2015 total and component scores with supportive paired sample t-tests. Results: HEI-2015 scores for DHQ-III and ASA24 were significantly higher than normative values for total score, total protein foods, and added sugar. Correlations between HEI-2015 scores generated using ASA24 and DHQ-III were all statistically significant (range rs = 0.23–0.69); however, significant differences between ASA24 and DHQ-III values were noted for HEI-2015 total score, total fruits, whole fruit, total vegetable, greens and beans, whole grains, seafood and plant protein, refined grains, and saturated fats. Conclusion: This study provided a novel description of diet quality in wheelchair users with MS for guiding future research promoting healthy eating in this population. Full article
(This article belongs to the Special Issue Nutrition and Multiple Sclerosis)
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17 pages, 692 KiB  
Article
The Effects of Specific Omega-3 and Omega-6 Polyunsaturated Fatty Acids and Antioxidant Vitamins on Gait and Functional Capacity Parameters in Patients with Relapsing-Remitting Multiple Sclerosis
by Panayiotis Aristotelous, Manos Stefanakis, Marios Pantzaris, Constantinos S. Pattichis, Philip C. Calder, Ioannis S. Patrikios, Giorgos K. Sakkas and Christoforos D. Giannaki
Nutrients 2021, 13(10), 3661; https://doi.org/10.3390/nu13103661 - 19 Oct 2021
Cited by 17 | Viewed by 6774
Abstract
Patients with multiple sclerosis (MS) are characterized by, among other symptoms, impaired functional capacity and walking difficulties. Polyunsaturated fatty acids (PUFAs) have been found to improve MS patients’ clinical outcomes; however, their effect on other parameters associated with daily living activities need further [...] Read more.
Patients with multiple sclerosis (MS) are characterized by, among other symptoms, impaired functional capacity and walking difficulties. Polyunsaturated fatty acids (PUFAs) have been found to improve MS patients’ clinical outcomes; however, their effect on other parameters associated with daily living activities need further investigation. The current study aimed to examine the effect of a 24-month supplementation with a cocktail dietary supplement formula, the NeuroaspisTM PLP10, containing specific omega-3 and omega-6 PUFAs and specific antioxidant vitamins on gait and functional capacity parameters of patients with MS. Fifty-one relapsing-remitting MS (RRMS) patients with low disability scores (age: 38.4 ± 7.1 years; 30 female) were randomized 1:1 to receive either a 20 mL daily dose of the dietary formula containing a mixture of omega-3 and omega-6 PUFAs (12,150 mg), vitamin A (0.6 mg), vitamin E (22 mg), and γ-tocopherol (760 mg), the OMEGA group (n = 27; age: 39 ± 8.3 years), or 20 mL placebo containing virgin olive oil, the placebo group (n = 24; age: 37.8 ± 5.3 years). The mean ± SD (standard deviation) Expanded Disability Status Scale (EDSS) score for the placebo group was 2.36 and for the OMEGA group 2.22. All enrolled patients in the study were on Interferon-β treatment. Spatiotemporal gait parameters and gait deviation index (GDI) were assessed using a motion capture system. Functional capacity was examined using various functional tests such as the six-minute walk test (6MWT), two sit-to-stand tests (STS-5 and STS-60), and the Timed Up and Go test (TUG). Isometric handgrip strength was assessed by a dynamometer. Leg strength was assessed using an isokinetic dynamometer. All assessments were performed at baseline and at 12 and 24 months of supplementation. A total of 36 patients completed the study (18 from each group). Six patients from the placebo group and 9 patients from the OMEGA group dropped out from the study or were lost to follow-up. The dietary supplement significantly improved the single support time and the step and stride time (p < 0.05), both spatiotemporal gait parameters. In addition, while GDI of the placebo group decreased by about 10% at 24 months, it increased by about 4% in the OMEGA group (p < 0.05). Moreover, performance in the STS-60 test improved in the OMEGA group (p < 0.05) and there was a tendency for improvement in the 6MWT and TUG tests. Long-term supplementation with high dosages of omega-3 and omega-6 PUFAs (compared to previous published clinical studies using PUFAs) and specific antioxidant vitamins improved some functional capacity and gait parameters in RRMS patients. Full article
(This article belongs to the Special Issue Nutrition and Multiple Sclerosis)
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13 pages, 397 KiB  
Article
Change in Micronutrient Intake among People with Relapsing-Remitting Multiple Sclerosis Adapting the Swank and Wahls Diets: An Analysis of Weighed Food Records
by Tyler J. Titcomb, Lisa Brooks, Karen L. Smith, Patrick Ten Eyck, Linda M. Rubenstein, Terry L. Wahls and Linda G. Snetselaar
Nutrients 2021, 13(10), 3507; https://doi.org/10.3390/nu13103507 - 5 Oct 2021
Cited by 16 | Viewed by 4145
Abstract
The low-saturated fat (Swank) and modified Paleolithic elimination (Wahls) diets have shown promise for MS symptoms; however, due to their restriction of specific foods, inadequate intake of micronutrients is concerning. Therefore, as part of a randomized trial, weighed food records were collected on [...] Read more.
The low-saturated fat (Swank) and modified Paleolithic elimination (Wahls) diets have shown promise for MS symptoms; however, due to their restriction of specific foods, inadequate intake of micronutrients is concerning. Therefore, as part of a randomized trial, weighed food records were collected on three consecutive days and were used to evaluate the intake of micronutrients among people with relapsing remitting MS adapting these diets. After randomization to either the Swank or Wahls diets, diet education and support was provided by registered dietitians at baseline and throughout the first 12 weeks of the intervention. Usual intake of each micronutrient was estimated and then evaluated with the EAR-cut point method. At 12 weeks, the Swank group had significant reductions in the proportion with inadequate intake from food for vitamins C, D, and E, while the Wahls group had significant reductions for magnesium and vitamins A, C, D, and E. However, the proportion with inadequate intake significantly increased for calcium, thiamin, and vitamin B12 in the Wahls group and for vitamin A in the Swank group. Inclusion of intake from supplements reduced the proportion with inadequate intake for all micronutrients except calcium among the Wahls group but increased the proportion with excessive intake for vitamin D and niacin among both groups and magnesium among the Swank group. Both diets, especially when including intake from supplements, are associated with reduced inadequate intake compared to the normal diet of people with relapsing remitting MS. Full article
(This article belongs to the Special Issue Nutrition and Multiple Sclerosis)
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Review

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22 pages, 21062 KiB  
Review
Involvement of the Intestinal Microbiota in the Appearance of Multiple Sclerosis: Aloe vera and Citrus bergamia as Potential Candidates for Intestinal Health
by Jessica Maiuolo, Vincenzo Musolino, Micaela Gliozzi, Cristina Carresi, Federica Scarano, Saverio Nucera, Miriam Scicchitano, Francesca Oppedisano, Francesca Bosco, Roberta Macri, Ernesto Palma, Carolina Muscoli and Vincenzo Mollace
Nutrients 2022, 14(13), 2711; https://doi.org/10.3390/nu14132711 - 29 Jun 2022
Cited by 13 | Viewed by 5110
Abstract
Multiple sclerosis (MS) is a neurological and inflammatory autoimmune disease of the Central Nervous System in which selective activation of T and B lymphocytes prompts a reaction against myelin, inducing demyelination and axonal loss. Although MS is recognized to be an autoimmune pathology, [...] Read more.
Multiple sclerosis (MS) is a neurological and inflammatory autoimmune disease of the Central Nervous System in which selective activation of T and B lymphocytes prompts a reaction against myelin, inducing demyelination and axonal loss. Although MS is recognized to be an autoimmune pathology, the specific causes are many; thus, to date, it has been considered a disorder resulting from environmental factors in genetically susceptible individuals. Among the environmental factors hypothetically involved in MS, nutrition seems to be well related, although the role of nutritional factors is still unclear. The gut of mammals is home to a bacterial community of about 2000 species known as the “microbiota”, whose composition changes throughout the life of each individual. There are five bacterial phylas that make up the microbiota in healthy adults: Firmicutes (79.4%), Bacteroidetes (16.9%), Actinobacteria (2.5%), Proteobacteria (1%) and Verrucomicrobia (0.1%). The diversity and abundance of microbial populations justifies a condition known as eubiosis. On the contrary, the state of dysbiosis refers to altered diversity and abundance of the microbiota. Many studies carried out in the last few years have demonstrated that there is a relationship between the intestinal microflora and the progression of multiple sclerosis. This correlation was also demonstrated by the discovery that patients with MS, treated with specific prebiotics and probiotics, have greatly increased bacterial diversity in the intestinal microbiota, which might be otherwise reduced or absent. In particular, natural extracts of Aloe vera and bergamot fruits, rich in polyphenols and with a high percentage of polysaccharides (mostly found in indigestible and fermentable fibers), appear to be potential candidates to re-equilibrate the gut microbiota in MS patients. The present review article aims to assess the pathophysiological mechanisms that reveal the role of the microbiota in the development of MS. In addition, the potential for supplementing patients undergoing early stages of MS with Aloe vera as well as bergamot fibers, on top of conventional drug treatments, is discussed. Full article
(This article belongs to the Special Issue Nutrition and Multiple Sclerosis)
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