Dieting.

D

I think I just wrote that I wouldnot write anything about diets, but I have been challenged You said “I know diet is seen as quackery on this blog. However it seams to be actually showing evidence of neuroprotection more than any of the drugs trialed so far”. I would argue not at all, ProfG may have talked about them, indeed he has just sent me a book on diets as has DoctorLove.

However, I have stayed clear because I know nothing about them, don’t and haven’t paid attention to the data and am not making any suggestions. Mice get pellets. I have other things I want to think about, I am not hollistic I am narrow-minded and focussed.

We all know a balanced lifesytle has health benefits, but it may nessesarily not be the same as saying this is better than a drug, which is clearly doing something. However Andrea from the group may do a post on this. I prefer to stick to the hard-core science. I am not going to be making life-style recommendations….ever.

But as the guantlet was thrown down, I thought I would have a look and a paper on ketogenic diet and neurofilaments. First one I looked at was in Neurology2019. I wont give the reference so there is no link to my comments but it says ketogenic diet “(n = 17), we found a significant decrease in the sNfL level from 8.5 at baseline (no dietary intervention) to 7.1 pg/mL (mean difference -1.307; 95% CI -2.256 to -0.357; p < 0.05) at the end of the study after 6 months. So there you have it significant benefit. So then I asked what does a potent MS drug do. The first report out of Google it said “Exposure to ocrelizumab resulted in a lowering of NfL levels to comparable to 118 healthy donors which established NfL ranges of 5.5—9.8 pg/mL for blood serum and 4.3–7.9 pg/mL for blood plasma”.

So go back to paper on diet it could mean that on the diet the people went from a normal Nfl level to a normal NFl level.. This is harder to get excited about. The paper also say”We found a significant association between sNfL and age (r = 0.347, p < 0.05)”, etc. I dont consider r=0.3 to be a biologically meaningful association in terms of prediction, such that I could know what my Nfl level would be if I were a certain age.

But a paper has just been reported on Intermitant fasting. This sparked my attention as intermittant fasting has been reported to promote a repairing environment in animals that can be chemically-mimicked. But before you can say “metformin”, we have a study looking at caloric restriction. It seems that caloric restriction can influence T cell numbers (see below). However, one has to say this (5%) is not in the same league as the reduction seen with potent disease modifying treatments (95% with alemtuzumab). Whether or not this influenced repair is not the subject matter of the paper. What did it do to B cells, which would raise my personal interest more? I dont know that either.:-)

Intermittent calorie restriction alters T cell subsets and metabolic markers in people with multiple sclerosis Kathryn C. Fitzgerald, Pavan Bhargava, Matthew D. Smith, Diane Vizthum, Bobbie Henry-Barron, Michael D. Kornberg, Sandra D. Cassard, Dimitrios Kapogiannis, Patrick Sullivan, David J. Baer, Peter A. Calabresi, Ellen M. Mowry. medRxiv 2022.01.11.22269094; doi: https://doi.org/10.1101/2022.01.11.22269094

Background: Intermittent fasting or calorie restriction (CR) diets provide anti-inflammatory and neuroprotective advantages in models of multiple sclerosis (MS); data in humans are sparse.

Methods: We conducted a randomized-controlled feeding study of different CR diets in 36 people with MS over 8 weeks. Patients were randomized to receive either: a daily CR diet (22% reduction in calories, 7 days/week), an intermittent CR diet (75% reduction, 2 days/week; 100%, 5 days/week), or a weight-stable diet (100%, 7 days/week). Untargeted metabolomics was performed on plasma samples at weeks 0, 4 and 8 at Metabolon Inc (Durham, NC). Flow cytometry of cryopreserved peripheral blood mononuclear cells at weeks 0 and 8 were used to identify CD4+ and CD8+ T cell subsets including effector memory, central memory, and naïve cells.

Results: 31 (86%) completed the trial. Over time, individuals randomized to intermittent CR had significant reductions in CD4+Central Memory [CM] -4.87%; 95%CI: -8.59%, -1.15%; p=0.01), CD4+Effector Memory [EM] (-3.82%; 95%CI: -7.44, -0.21; p=0.04), and CD8+EM (-6.96%; 95%CI: -11.96, -1.97; p=0.006) with proportional increases in naïve subsets (CD4+Naïve: 5.81%; 95%CI: -0.01, 11.63%; p=0.05; CD8+Naïve: 10.11%; 95%CI: 3.30, 16.92%; p=0.006). No changes were observed for daily CR or weight-stable diets. Larger within-person changes in lysophospholipid and lysoplasmalogen metabolites in intermittent CR were associated with larger reductions in memory T cell subsets and larger increases in naïve T cell subsets.

Conclusions: In people with MS, an intermittent CR diet was associated with reduction in memory T cell subsets. The observed changes may be mediated by changes in specific classes of lipid metabolites. Trial Registration: This study is registered on Clinicaltrials.gov with identifier NCT02647502

COI None

Disclaimer: These are opinions of the author and do not represent any institutional view

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MouseDoctor

24 comments

  • Hi, for those of us with so called “SPMS” and no access to DMTs – would it be worth a try? If nothing else it might shift the lock-down weight gain

    • I have read the book by doctor Terry Whal (The Wahl protocol) and how she desribes how she had tried all kinds of drugs given her by neurologists for her MS. She worked as a doctor in a hospital, in charge of a department, but her disease made it more and more impossible to work full time and she ended in a wheelchair and thought her carriere was soon over. She took matters in her own hands, used what she had learned at University combined with studies (holistic views) and startet to change life and diet. After 2-3 years she came out of the wheelchair and back on her bike and later climbing mountains. Mind my mitokondria she says in her book. And since I read about other research – one in Norway where they say that MS patients lack a protein that cause neuro celles not to renew themselves, and they say the protein(s) is connected to minerals and vitamins, it might make sence that food is important (organic ecological food, vegetables minly, but fish and grasseating animals).
      I think it is now common knowledge that some food trigger inflammation and important not to eat that, and too much omega 6 compared to omega 3 will give inflamamtion etc etc.

      And physitians work with low carb diets and change the health on people of other diseases (also autoimmune og diseases with inflamamtion cause) and people can stop using drugs as induline, bloodpressure, cholesterol, they write books about it. And i read a book about gut bacteria written by a physitian in USA and how he desribed the influence on brain healt… i mean- there is so much new information on how gut bacteria influence the general health, so i beleive what we eat will at least reduse the symptomes and maybe reduse the agressivness of the disease.
      I know people among the MS sosiety in Norway that say they got another life after lifstyle changes and different (lowcarb, low inflammation food, keto diets), got more energy, managed to go back to exercising, participating in laife more than before…
      excuse my english which is not perfect….

  • I am no expert in the affect diet can have on our disease but I am 100% sure it helps with symptom management. My most debilitating symptoms are in my intestines’ and bowel which tweaking my diet has improved massively, giving me some of my freedom back. As a result the number of migraines I suffer from has also reduced significantly. It may or may not help in the long-term outcome but it definitely improved the quality of my day to day life.

  • If you put the bad guys on some kind of diet will they become good guys?

    Response: Maybe

    Now if you kill the bad guys (and friendly fire ,also the good guys in the process)..What will happen?

    Yep you get a response 🙂

    Mouse doc like to say response to treatment

    🙂

    Nice work

    • well you know that diet works for mental diseases, so you might be right 🙂

      Book by Doctor MD Emeran Mayer, The MIND-GUT connection.

  • Also macrophages

    The b-hydroxybutyrate receptor HCA2 activates
    a neuroprotective subset of macrophages

    https://www.nature.com/articles/ncomms4944

    and b cells

    Thus, the number of naïve B cells was gradually restored until 48 h after refeeding. In contrast, the recovery of GC B cells and IgA+ B cells was much slower than that of naïve B cells because these cells readily underwent apoptosis in response to fasting. As a consequence, GC B cells were eliminated from lymphoid follicles of PPs, whereas naïve B cells were restored after fasting-refeeding. Give that a subset of GC B cells differentiates into memory B cells, the elimination of GC B cells from PPs in fasted mice may lead to the loss of immune memory for oral antigens. Indeed, fasted mice failed to generate antigen-specific IgA, IgM, and IgG upon repeated oral immunization with ovalbumin.

    Dietary Intervention Impacts Immune Cell Functions and Dynamics by Inducing Metabolic Rewiring

    https://www.frontiersin.org/articles/10.3389/fimmu.2020.623989/full

    • eat the burger if from ecological cows eating grass, skip the bread or make breds without wheat 🙂 i saw an english documentary that told us that previously before -ah..what it is called the powder from soya etc- when the highland cattle ate at highland fields – they ate herbs with omega3 which is good for fighting inflammation. Our food lacks diversity – for eksample we hav few wheat varieties bacuse of BIG COMPANIES and monopolies,, the animals eat soya and not their normal food (take farmed salmon that have more OMEGA 6 than omega 3 which is not good and the natural salmond has twice the amount of omega3 than farmed salmon), our way og making food by adding stuff for faster production (add extra gluten to bread ), pestecides, etc etc ofcourse affects us. I am convinced, and i feel it on my arthrosis if i eat sugar, and i gain weight if i eat bread with wheat.

  • Thanks for looking, it’s so annoying to know that there’s not a ‘neuro protective’ drug. Other than the anti inflammatory drugs.

    Lifestyle factors seam to have the edge at the moment. But the thing is do people stick to them long term, probably not. Maybe if it’s proven lifestyle factors are neuro protective they will, as of now it seams our best bet after immune suppression.

    Thanks again

      • I know, possibly not, the trials will never have millions pumped into them like drugs do

        However diet and exercise as so far looking more neuro protective than drugs trialed to be neuro protective.

        However taking the highest efficacy drug available should be the first choice along side good lifestyle choices

  • Dear PR, Please dont be offended but if the post does not have a clear link to the post then it is not going to get launched or it will be launched and quickly removed, as I do not have time to work what the messaging is about and linking to other sites hastens the removal.

    • Have long history of taking flak from offence-taking community, and also multifactorially time-challenged, so I can unite with that!

  • I saw a program from Russia where they for years have treated arthritis patient in hospital wards with fasting for 6 weeks under supervision of health workers. Thei inflammation improved and the pain dissapared and lastet for almost one year, but then they had to come back for new treatment.

    before insuline shots i read that one treated diabetics with low carb diets (but now they give them insuline and high carb inflammation diets)

  • Being lighter puts less strain on knees etc.

    ps surprised that you didn’t put up a tribute to your rock hero and doppelgänger Meatloaf who sadly passed away.

  • Knowing how difficult it has been for MD trying not to respond to some of the comments, there probably won’t be another diet-related article for a while 🙂

  • Was it Swank?

    Flash back- MS in 1989. Swank diet, (no bee stings), & (1995) intravenous steroids within 3 days of exacerbations. Betaseron (new) also added in ’95 (till 2019). Wheelchair use in ’95. By ’99, cousin also diagnosed (no other family history). Me smoker, she not. In ‘05, though, hiking several miles thru the “pine barrens” forest in NJ (US) looking for antique bottles like I was a kid. Could you call it “hiking”? Now I’m 64 and slowly approaching the end. Some slow, non-active SPMS symptoms (20 yrs no change MRIs). Non- DMT cousin appears about the same. Nothing MS wise to make me cry. It was harder for people I had to deal with, than for me. That was the biggest problem. Sucks?, yes. Crying?, no. (Although I did cry a few times.) Could have been much worse.

    Bottom line? Only thing I know for sure is I’m lucky (so far). Why? I don’t know. “Swank-ish” for 25 years? Diet is sugar free (SF), no added sugar and lower sugar fruit, aspartame. Always look for sugar content & compare. Lots of fish/salmon, vegs, sweet potato, salad. 1 slice bread daily & skim milk. No fried or processed. SF Hershey, SF deserts every night. Sat. eve is celebration night- meat (pork or beef) 2 x mo, sometimes a pizza or spag. w/grated cheese. You can still have quite a bit of fun with all that.

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