Diet and Multiple Sclerosis: Scoping Review of Web-Based Recommendations (Preprint)

BACKGROUND There is currently no scientific evidence supporting the use of specific diets in the management of multiple sclerosis (MS); the strongest dietary associations are observed with vitamin D and omega-3 fatty acid supplementation. Despite this, there are many websites that provide advice or suggestions about using various dietary approaches to control symptoms or disease progression. OBJECTIVE The objective of this study was to assess the dietary advice for the symptomatic management of MS available on the internet. METHODS This study was a systematic review of webpages that provided dietary advice for the management of MS. Webpages were selected from an internet search conducted in November 2016 using Google, Yahoo, and Bing search engines and the search term “MS diet.” The first two pages of results from each search engine were included for the initial assessment. Duplicates were removed. Data extracted from websites included specific advice relating to diet and its rationale and the citation of supporting scientific literature. Authorship and credential information were reviewed to assess webpage quality. RESULTS We included 32 webpages in the final assessment. The webpages made a wide variety of specific recommendations regarding dietary patterns and individual foods to help manage MS. The most common dietary pattern advised on these webpages was the low-fat, high-fiber balanced diet, followed by the low-saturated fat diet, near-vegetarian Swank diet, and the Paleo diet. The main categories of individual foods or nutrients suggested for addition to the diet were: supplements (especially omega-3 and vitamin D), fruits, vegetables, and lean protein. In contrast, the most commonly recommended for removal were saturated fats, dairy, gluten-containing grains, and refined sugar. These recommendations were often accompanied by rationale relating to how the particular food or nutrient may affect the development, prevalence and symptoms of MS; however, very little of this information is supported by the current scientific evidence between diet and MS. Only 9 webpages provided full authorship including credential information. CONCLUSIONS There is a wide variety of Web-based dietary advice, which in some cases is contradictory. In most cases, this advice is the result of peoples’ individual experiences and has not been scientifically tested. How people living with MS use this information is not known. These findings highlight the important role health professionals can play in assisting people living with MS in their health information-seeking behaviors.

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Supplementation and therapeutic use of vitamin D in patients with multiple sclerosis: Consensus of the Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20130252 ◽

2014 ◽

Vol 72 (2) ◽

pp. 152-156 ◽

Cited By ~ 5

Author(s):

Doralina Guimarães Brum ◽

Elizabeth Regina Comini-Frota ◽

Claúdia Cristina F. Vasconcelos ◽

Elza Dias-Tosta

Keyword(s):

Multiple Sclerosis ◽

Clinical Trial ◽

Vitamin D ◽

Environmental Factors ◽

Scientific Evidence ◽

Hypovitaminosis D ◽

Central Nervous System Disease ◽

Keywords Multiple Sclerosis ◽

System Disease ◽

Genetic And Environmental Factors

Multiple sclerosis (MS) is an inflammatory, autoimmune, demyelinating, and degenerative central nervous system disease. Even though the etiology of MS has not yet been fully elucidated, there is evidence that genetic and environmental factors interact to cause the disease. Among the main environmental factors studied, those more likely associated with MS include certain viruses, smoking, and hypovitaminosis D. This review aimed to determine whether there is evidence to recommend the use of vitamin D as monotherapy or as adjunct therapy in patients with MS. We searched PUBMED, EMBASE, COCHRANNE, and LILACS databases for studies published until September 9 th , 2013, using the keywords “multiple sclerosis”, “vitamin D”, and “clinical trial”. There is no scientific evidence up to the production of this consensus for the use of vitamin D as monotherapy for MS in clinical practice.

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Nutritional Intervention as an Essential Part of Multiple Sclerosis Treatment?

Physiological Research ◽

10.33549/physiolres.933694 ◽

2018 ◽

pp. 521-533 ◽

Cited By ~ 6

Author(s):

A. PENESOVÁ ◽

Z. DEAN ◽

B. KOLLÁR ◽

A. HAVRANOVÁ ◽

R. IMRICH ◽

...

Keyword(s):

Multiple Sclerosis ◽

Fatty Acids ◽

Polyunsaturated Fatty Acids ◽

Dietary Intervention ◽

Dietary Habits ◽

Clinical Status ◽

Saturated Fat ◽

Well Being ◽

Omega 3 ◽

Inflammatory Status

Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease of the central nervous system. In addition to the genetic, epigenetic and immunological components, various other factors, e.g. unhealthy dietary habits, play a role in the MS pathogenesis. Dietary intervention is a highly appealing approach, as it presents a simple and relatively low risk method to potentially improve outcomes in patients with brain disorders in order to achieve remission and improvement of clinical status, well-being and life expectancy of patients with MS. The importance of saturated fat intake restriction for the clinical status improvement of MS patients was pointed for the first time in 1950s. Recently, decreased risk of first clinical diagnosis of CNS demyelination associated with higher intake of omega-3 polyunsaturated fatty acids particularly originating from fish was reported. Only few clinical trials have been performed to address the question of the role of dietary intervention, such is e.g. low saturated fat diet in MS treatment. This review summarizes current knowledge about the effect of different dietary approaches (diets low in saturated fat and dietary supplements such as fish oil, lipoic acid, omega-3 polyunsaturated fatty acids, seeds oils, high fiber diet, vitamin D, etc.) on neurological signs, patient’s well-being, physical and inflammatory status. So far the results are not conclusive, therefore much more research is needed to confirm and to understand the effectiveness of these dietary interventions in the long term and well defined studies.

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General Public’s Information-Seeking Patterns of Topics Related to Obesity: Google Trends Analysis (Preprint)

10.2196/preprints.20923 ◽

2020 ◽

Author(s):

Aditya S Pawar ◽

Sajan Nagpal ◽

Neha Pawar ◽

Lilach O Lerman ◽

Alfonso Eirin

Keyword(s):

Weight Loss ◽

Information Seeking ◽

Google Trends ◽

Search Term ◽

Web Based ◽

Entire Study ◽

Awareness Campaigns ◽

Prevalence Of Obesity ◽

The Mean ◽

Over Time

BACKGROUND Obesity is a major public health challenge, and recent literature sheds light on the concept of “normalization” of obesity. OBJECTIVE We aimed to study the worldwide pattern of web-based information seeking by public on obesity and on its related terms and topics using Google Trends. METHODS We compared the relative frequency of obesity-related search terms and topics between 2004 and 2019 on Google Trends. The mean relative interest scores for these terms over the 4-year quartiles were compared. RESULTS The mean relative interest score of the search term “obesity” consistently decreased with time in all four quartiles (2004-2019), whereas the relative interest scores of the search topics “weight loss” and “abdominal obesity” increased. The topic “weight loss” was popular during the month of January, and its median relative interest score for January was higher than that for other months for the entire study period (<i>P</i><.001). The relative interest score for the search term “obese” decreased over time, whereas those scores for the terms “body positivity” and “self-love” increased after 2013. CONCLUSIONS Despite a worldwide increase in the prevalence of obesity, its popularity as an internet search term diminished over time. The reason for peaks in months should be explored and applied to the awareness campaigns for better effectiveness. These patterns suggest normalization of obesity in society and a rise of public curiosity about image-related obesity rather than its medical implications and harm.

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Metabotyping for the development of tailored dietary advice solutions in a European population: the Food4Me study

British Journal Of Nutrition ◽

10.1017/s0007114517002069 ◽

2017 ◽

Vol 118 (8) ◽

pp. 561-569 ◽

Cited By ~ 13

Author(s):

Clare B. O’Donovan ◽

Marianne C. Walsh ◽

Clara Woolhead ◽

Hannah Forster ◽

Carlos Celis-Morales ◽

...

Keyword(s):

Saturated Fat ◽

Population Group ◽

Healthcare Setting ◽

European Population ◽

Dietary Advice ◽

Omega 3 ◽

Metabolic Markers ◽

Personalised Nutrition ◽

Individual Level ◽

Using Data

AbstractTraditionally, personalised nutrition was delivered at an individual level. However, the concept of delivering tailored dietary advice at a group level through the identification of metabotypes or groups of metabolically similar individuals has emerged. Although this approach to personalised nutrition looks promising, further work is needed to examine this concept across a wider population group. Therefore, the objectives of this study are to: (1) identify metabotypes in a European population and (2) develop targeted dietary advice solutions for these metabotypes. Using data from the Food4Me study (n 1607), k-means cluster analysis revealed the presence of three metabolically distinct clusters based on twenty-seven metabolic markers including cholesterol, individual fatty acids and carotenoids. Cluster 2 was identified as a metabolically healthy metabotype as these individuals had the highest Omega-3 Index (6·56 (sd 1·29) %), carotenoids (2·15 (sd 0·71) µm) and lowest total saturated fat levels. On the basis of its fatty acid profile, cluster 1 was characterised as a metabolically unhealthy cluster. Targeted dietary advice solutions were developed per cluster using a decision tree approach. Testing of the approach was performed by comparison with the personalised dietary advice, delivered by nutritionists to Food4Me study participants (n 180). Excellent agreement was observed between the targeted and individualised approaches with an average match of 82 % at the level of delivery of the same dietary message. Future work should ascertain whether this proposed method could be utilised in a healthcare setting, for the rapid and efficient delivery of tailored dietary advice solutions.

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Placing a Well-Designed Vegan Diet for Slovenes

Nutrients ◽

10.3390/nu13124545 ◽

2021 ◽

Vol 13 (12) ◽

pp. 4545

Author(s):

Boštjan Jakše

Keyword(s):

Vitamin D ◽

Vitamin B12 ◽

Healthy Lifestyle ◽

Scientific Evidence ◽

Adult Population ◽

Scientific Data ◽

Vegan Diet ◽

Omega 3 ◽

New Findings ◽

Calcium Iron

Interest in vegan diets has increased globally as well as in Slovenia. The quantity of new scientific data requires a thorough synthesis of new findings and considerations about the current reserved position of the vegan diet in Slovenia. There is frequently confusion about the benefits of vegetarian diets that are often uncritically passed on to vegan diets and vice versa. This narrative review aims to serve as a framework for a well-designed vegan diet. We present advice on how to maximize the benefits and minimize the risks associated with the vegan diet and lifestyle. We highlight the proper terminology, present the health effects of a vegan diet and emphasize the nutrients of concern. In addition, we provide guidance for implementing a well-designed vegan diet in daily life. We conducted a PubMed search, up to November 2021, for studies on key nutrients (proteins, vitamin B12, vitamin D, omega-3 long chain polyunsaturated fatty acids (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)), calcium, iron, zinc, iodine and selenium) in vegan diets. Given the limited amount of scientific evidence, we focus primarily on the general adult population. A well-designed vegan diet that includes a wide variety of plant foods and supplementation of vitamin B12, vitamin D in the winter months and potentially EPA/DHA is safe and nutritionally adequate. It has the potential to maintain and/or to improve health. For physically active adult populations, athletes or individuals with fast-paced lifestyles, there is room for further appropriate supplementation of a conventional vegan diet according to individuals’ health status, needs and goals without compromising their health. A healthy vegan lifestyle, as included in government guidelines for a healthy lifestyle, includes regular physical activity, avoidance of smoking, restriction of alcohol and appropriate sleep hygiene.

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Implications of Vitamin D in Multiple Sclerosis and Other Neurodegenerative Processes: Bibliometric Analysis and Systematic Review

CNS & Neurological Disorders - Drug Targets ◽

10.2174/1871527318666190703102330 ◽

2019 ◽

Vol 18 (6) ◽

pp. 478-490 ◽

Cited By ~ 1

Author(s):

Javier Caballero-Villarraso ◽

María J. Jiménez-Jiménez ◽

Begoña M. Escribano ◽

Eduardo Agüera ◽

Abel Santamaría ◽

...

Keyword(s):

Multiple Sclerosis ◽

Systematic Review ◽

Vitamin D ◽

Neurodegenerative Diseases ◽

Bibliometric Analysis ◽

Scientific Evidence ◽

Future Trend ◽

Clinical Severity ◽

Double Blind ◽

Parkinson’S Diseases

: In recent years, numerous investigations focused on the pleiotropic actions of vitamin D have been carried out. These actions include the participation of this molecule in neurophysiological and neuropathological processes. As a consequence, abundant scientific literature on the role of this vitamin in neurodegenerative entities has emerged, even concerning clinical studies. To identify the level of scientific evidence concerning the relation between vitamin D and neurodegenerative diseases, from a quantitative and qualitative perspective. To describe, by means of a bibliometric analysis, the scientific production and its evolution through time in quantitative terms, regarding the implications of vitamin D in neurodegeneration. To analyse and present the degree of evidence in the aforementioned field of study, a systematic review of the literature focused on the most prevalent neurodegenerative diseases was carried out. We retrieved 848 articles in the bibliometric analysis, the majority of which were dated between the years 2010-2017. The most studied metabolite was the 25(OH)D3 and the most cited disease was multiple sclerosis. In the systematic review, we found studies about Alzheimer’s and Parkinson’s diseases and again, about multiple sclerosis prominently (in number and quality), with 12 randomised double-blind clinical trials. The research about vitamin D and its relations with neurodegenerative diseases shows a growing evolution over the last decade. More studies are needed to find correlations between the clinical severity of these diseases and the specific status of vitamin D and the genotypes related with them, which seems to be a future trend.

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NUTRITIONAL STRATEGIES OF SLOVENIAN NATIONAL JUNIOR SWIMMING TEAM

Annales Kinesiologiae ◽

10.35469/ak.2018.158 ◽

2018 ◽

Vol 9 (1) ◽

pp. 15-34

Author(s):

Vesna Simič ◽

Nina Mohorko

Keyword(s):

Vitamin D ◽

Saturated Fat ◽

Sports Nutrition ◽

Fat Intake ◽

Iron Intake ◽

Omega 3 ◽

Supplement Use ◽

Vitamin D Intake ◽

Nutritional Strategies ◽

Competitive Swimmers

Purpose: The purpose of our study was to assess the nutritional strategies of Slovenian national junior swimming team and compare them with recommendations of clinical sports nutrition. Competitive young swimmers namely have increased energy and nutrient needs compared to general adolescents due to frequent and intense training. Despite some physiological differences from adults, adult sports nutrition recommendations for macronutrients apply to them. Further, literature reports iron, calcium, and vitamin D intake as frequently inadequate.Methods: Nutritional strategies of 19 members of Slovenian national junior swimming team were assessed retrospectively through 3-day food and activity diaries, questionnaires, anthropometric data including bioimpedance analysis. Energy availability (EA), macronutrient intake and timing, iron, calcium and vitamin D intakes, hydration, consumption of sports food and dietary supplement use were evaluated.Results: EA in some of male swimmers and in majority of female swimmers was lower than recommended. Carbohydrate intake was adequate in male swimmers and two thirds of female swimmers. Although average protein intake exceeded the upper recommended limit, some female swimmers did not meet the lower recommended intake limit. Total fat intake was lower than recommended, with saturated fat intake on the upper recommended level. Calcium and iron intake in male swimmers exceeded recommended values, while female swimmers had lower calcium intake than recommended and some had lower iron intake, too. Vitamin D intake was low in all swimmers. Meal timing was adequate in majority of swimmers, who often reached for dietary supplements, mostly omega 3 fatty acids, multivitamins, and magnesium.Conclusions: Low EA in young competitive swimmers is of concern. More successful, personalised nutrition strategies for young competitive swimmers, focusing on higher energy intake and healthy food choices, would contribute to the preservation of their health and development into top performers.

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Nutrientes y alimentos en la esclerosis múltiple

Archivos Latinoamericanos de Nutrición ◽

10.37527/2020.70.1.007 ◽

2020 ◽

Vol 70 (1) ◽

pp. 60-74

Author(s):

Virginia Sedeño Monge ◽

Eduardo A Fabre Palacios ◽

Cristina López García ◽

María de L Meza Jiménez

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Scientific Evidence ◽

Short Chain Fatty Acids ◽

Vitamina D ◽

Esclerosis Múltiple ◽

Increased Risk ◽

Inflammatory Processes ◽

The Central Nervous System

La alimentación influye en la mejora de la sintomatología de cualquier enfermedad, incluida la esclerosis múltiple (EM),la cual, se caracteriza por un proceso inflamatorio crónico, autoinmune del sistema nervioso central generando situaciones como inflamación, alteraciones; digestivas y mentales, discapacidad, y fatiga. El propósito de la presente revisión fue identificar la evidencia científica sobre los aspectos nutricionales que mejoran la progresión de EM. La metodología consistió en la búsqueda de literatura, en bases de datos electrónicas, referente a nutrición y esclerosis múltiple, principalmente entre los años 2015-2020. Entre los resultados de los aspectos nutricionales que mostraron eficacia en mejorar la progresión de EM, se encuentran el zinc, vitamina D, fibra, probióticos, aceite de pescado y de oliva, cacao, cúrcuma, y salmón. Existen evidencias del papel inmunomodulador del Zn y de la vitamina D en la inhibición de la producción de citocinas proinflamatorias. Niveles bajos de ambos componentes se asocian con mayor riesgo de padecer EM. Otros componentes de interés nutricional son la fibra y probióticos; producen ácidos grasos de cadena corta, con propiedades antiinflamatorias. La primera se conoce por su papel en la motilidad gastrointestinal y los segundos por su acción celular y molecular en procesos inflamatorios, y modulación del microbioma, por mencionar algunos. Los aspectos nutricionales antes mencionados pueden contribuir a modular la inflamación y mejorar la fatiga. Finalmente, este documento genera un panorama importante para continuar con la investigación referente a la influencia de la alimentación en pacientes con EM. Diet influences the improvement of the symptoms of any disease, including multiple sclerosis (MS), which is characterized by a chronic, autoimmune inflammatory process of the central nervous system generating situations such as inflammation, mental and digestive alterations, disability and fatigue. The aim of this review was to identify the scientific evidence on the nutritional aspects that improve the progression of MS. The methodology consisted of searching literature, in electronic databases, referring to nutrition and multiple sclerosis, mainly between the years 2015-2020. The results of the nutritional aspects that showed effectiveness in improving the progression of MS, are zinc, vitamin D, fiber, probiotics, fish oil and olive oil, cocoa, turmeric and salmon. There is evidence of the immunomodulatory role of Zn and vitamin D in inhibiting the production of proinflammatory citokines. Low levels of both components are associated with an increased risk of MS. Other components of nutritional interest are fiber and probiotics; they produce short chain fatty acids, with anti-inflammatory properties. The first is known for its role in gastrointestinal motility and the second one for its cellular and molecular actions in inflammatory processes and the microbiome modulation, to name a few. The nutrition aspects mentioned above, can contribute to modulate inflammation and improve fatigue. Finally, this paper creates an important perspective to continue the investigation concerning the influence of diet in MS patients.

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General Public’s Information-Seeking Patterns of Topics Related to Obesity: Google Trends Analysis

JMIR Public Health and Surveillance ◽

10.2196/20923 ◽

2020 ◽

Vol 6 (3) ◽

pp. e20923 ◽

Cited By ~ 1

Author(s):

Aditya S Pawar ◽

Sajan Nagpal ◽

Neha Pawar ◽

Lilach O Lerman ◽

Alfonso Eirin

Keyword(s):

Weight Loss ◽

Information Seeking ◽

Google Trends ◽

Search Term ◽

Web Based ◽

Entire Study ◽

Awareness Campaigns ◽

Prevalence Of Obesity ◽

The Mean ◽

Over Time

Background Obesity is a major public health challenge, and recent literature sheds light on the concept of “normalization” of obesity. Objective We aimed to study the worldwide pattern of web-based information seeking by public on obesity and on its related terms and topics using Google Trends. Methods We compared the relative frequency of obesity-related search terms and topics between 2004 and 2019 on Google Trends. The mean relative interest scores for these terms over the 4-year quartiles were compared. Results The mean relative interest score of the search term “obesity” consistently decreased with time in all four quartiles (2004-2019), whereas the relative interest scores of the search topics “weight loss” and “abdominal obesity” increased. The topic “weight loss” was popular during the month of January, and its median relative interest score for January was higher than that for other months for the entire study period (P<.001). The relative interest score for the search term “obese” decreased over time, whereas those scores for the terms “body positivity” and “self-love” increased after 2013. Conclusions Despite a worldwide increase in the prevalence of obesity, its popularity as an internet search term diminished over time. The reason for peaks in months should be explored and applied to the awareness campaigns for better effectiveness. These patterns suggest normalization of obesity in society and a rise of public curiosity about image-related obesity rather than its medical implications and harm.

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Multiple sclerosis and nutrition

Multiple Sclerosis Journal ◽

10.1191/1352458505ms1119oa ◽

2005 ◽

Vol 11 (1) ◽

pp. 24-32 ◽

Cited By ~ 72

Author(s):

Stefan Schwarz ◽

Hans Leweling

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Unsaturated Fatty Acids ◽

Early Stage ◽

Meta Analysis ◽

Saturated Fat ◽

Epidemiological Studies ◽

Linoleic Acid Intake ◽

Positive Effect

Benefits from any particular diet in multiple sclerosis (MS) have not yet been proven. It is, however, frequent that malnutrition may potentially exacerbate the symptoms of MS. There is some evidence that a high intake of saturated fat increases the incidence of MS. Epidemiological studies imply that unsaturated fatty acids may have a positive effect on the course of MS. However, the results of controlled studies are ambiguous. A meta-analysis of three small controlled clinical trials suggests a benefit from linoleic acid. Intake of Vitamin D is associated with a lower incidence of MS. In MS, the risk of osteoporosis is high, and prophylactic vitamin D and calcium should be considered at an early stage. The role of minerals, trace elements, antioxidants, vitamins or fish oil is unclear. The possible relationships between diet and MS have not been subjected to adequate study. It seems possible that in the future, diets or dietary supplements may become recommended forms of treatment for MS.

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