Eating well for healthy living: Examining
the role of supplements
By Deanna Groetzinger and Josée Poirier
from
MS Canada,
May 2005, pp. 14-15
Healthy living with MS includes a healthy diet. Questions that
sometimes arise are: what foods are best to stay healthy and
do I need extra vitamins or food supplements?
Over the years,
a wide variety of nutritional approaches have been suggested – some
with little or no evidence that they do any good. However, it
makes sense that a healthy approach to eating can keep the body
in the best shape possible to facilitate repair and replacement
of injured tissue, whether it is a “broken leg or damaged
myelin”, pointed out Dr. Brenda Banwell, director of the
Pediatric MS Clinic, Hospital for Sick Children, Toronto.
So
what does this mean in practical terms when you go shopping?
Many nutritionists recommend an overall diet that is high in
vegetables and fruit, whole wheat grain products, lowfat dairy
products, lean meats, poultry and fish. Foods that are high in
animal fats and sugars should be avoided.
A healthy diet for
people with MS is very much what is recommended by the Canada
Food Guide with one exception. Increasingly, some nutritionists
recommend that people with MS may want to include oily fish (tuna,
salmon, sardines, mackerel) because they have high amounts of
omega-3 oils. Vegetable oils (sunflower, safflower or soya oils),
are also seen to be beneficial to overall health. They are naturally
high in linoleic acid, a type of omega-6 oil.
The reasoning behind
including these oils is that there is some indication they may
be useful in slowing down the progression of MS, although this
has not been confirmed.
Another question that arises frequently
is whether food supplements or vitamins are useful in maintaining
overall health or whether they might even have an effect on MS
signs and symptoms.
Tips
for using vitamins, food supplements
and herbal remedies
Don’t take any product
that stimulates your immune system.
Try only one new product at a time. If you haven’t
experienced
a change for the better after using it for four weeks,
stop taking it.
Be careful about buying products over the Internet.
Be sure to tell your family doctor, neurologist and
pharmacist what products you’re using.
Remember that there’s no such thing as a miracle
drug.
Eat properly – if you eat enough fruits and vegetables,
you shouldn’t need vitamins and food supplements.
If you do try a supplement, respect the recommended
dosage.
Adapted from “Be
careful with food supplements”, by Josée Poirier, R.N.,
in MS Quebec, December 2004.
Certainly food supplements are everywhere
these days. You can’t turn on the TV or the radio without
being bombarded by ads describing the spectacular effects of
one product or another. But you have to be careful with both
food supplements and vitamins.
“It’s important to
remember that ‘natural or herbal’ does not mean without
side effects,” said Dr. Banwell. Some products actually
stimulate the immune system which could become a problem in MS,
which results because of a misdirected immune attack on myelin
within the central nervous system. In addition, they can conflict
with other medications and, it is also important to remember
that food supplements are not regulated by Health Canada.
Following
are some examples of common vitamins, supplements and herbal
therapies and their pros and cons.
Vitamin D
Vitamin
D has been recognized by MS researchers as possibly being helpful
in preventing MS. Many physicians now suggest that people with
MS themselves might benefit from taking vitamin D. The current
official Canadian recommendation is 400 IU of vitamin D daily.
Many MS specialists suggest that a daily intake of 800 – 1,000
IU of vitamin D is safe – because some people with MS may
be vitamin D deficient.
Coenzyme Q10 or ubiquinone
Q10
is an antioxidant that may have a neuroprotective effect, which
could be beneficial for MS. On the other hand, Q10 also stimulates
the immune system, which represents a risk for people with MS.
Echinacea
Echinacea purpurea or purple coneflower is
used by many people to treat colds and flu, however, it should
be avoided by people with MS since it stimulates the immune system,
which is risky. In addition, echinacea may reduce the effects
of the disease modifying drugs such as the interferons and glatiramer
acetate and may increase the risk of high levels of liver enzymes
(hepatotoxicity) if combined with methotrexate (an immune suppressing
drug) or the interferons.
Noni juice
This juice is from
the fruit of a Polynesian plant (Morinda citrifolia). While ads
claim it is effective in treating MS, no scientific studies have
confirmed this. In addition noni juice contains polysaccharides
that some studies have shown to have a stimulating effect on
the immune system – again this is a risk for people with
MS. It can also reduce the effectiveness of the immunesuppressing
drugs or the disease modifying therapies.
St. John’s wort
A
widely available herbal medicine, St. John’s wort (Hypericum
perforatum) appears to be effective at treating mild to moderate
depression. However, people with MS should note that it has sedative
properties that may aggravate fatigue or increase the sedative
effect of drugs used to treat spasticity such as baclofen, Zanaflex
(tizanidine) and amitriptyline. St. John’s wort can also
interact with antidepressants, anticonvulsants and birth control
pills. It should be avoided by anyone who is already taking an
antidepressant and by pregnant women and nursing mothers. People
with MS who are thinking about trying a food supplement, vitamin
or herbal remedy, should always talk to their physician or pharmacist
before trying a new product. It is vital to ensure there is no
interaction with any medication you are already taking.
Tips for healthy eating
Choose low-fat dairy products, such as low-fat yogurt
and semi-skimmed milk.
Eat oily fish, such as tuna, salmon or mackerel,
two or three times weekly.
Choose chicken, turkey and leaner cuts of red meat.
Grill, bake, steam or poach foods instead of frying.
Use omega-6 vegetable oil or spreads in moderate
amounts. These include sunflower, safflower and soya
products.
Avoid the animal fats contained in pastry, pies,
cakes, chocolate and cream.
Eat whole grain bread and cereals.
Eat at least five portions of fruit and vegetables
daily.
Drink two litres or more of sugar-free fluids daily.
Adapted from “Making nutritional choices”,
MS in Focus, Healthy Living, Issue 5, 2005, published by
MS International Federation. Available at www.msif.org
At the time of this article (May 2005) Deanna Groetzinger was
National Vice-President, Communications, MS Society of Canada;
Josée Poirier was Coordinator, MS Clinic, Notre Dame Hospital,
Montreal.
Additional resources
Healthy
Eating, available from
MS Society of Canada offices
or at www.mssociety.ca.
Dietary Supplements
and Multiple Sclerosis: A Health
Professional’s Guide by Allen
C. Bowling, M.D., Ph.D., and
Thomas M. Stewart, I.D.,
P.A.C.; Demos Medical
Publishing. (Available at
www.demosmedpub.com or
check your local bookstore.)
Canada Food Guide, available
at www.hc-sc.gc.ca under
Healthy Living/Food and
Nutrition; or call Health Canada
at (613) 954-5995.
