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4 years ago

Bulletin Spring 2018

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  • Sclerosis
  • Neurological


DOES DIET PLAY A ROLE IN MS DISEASE PROGRESSION? DR LUCINDA BLACK, MSWA FUNDED POSTDOCTORAL RESEARCH FELLOW, SCHOOL OF PUBLIC HEALTH, CURTIN UNIVERSITY Around 40% of people with multiple sclerosis (MS) make dietary changes after their diagnosis 1 sometimes to lose weight and sometimes with the goal of reducing disease progression. However, there is very little consistency in the types of dietary changes people make – these range from healthy changes, such as increasing fruit and vegetable intake, to unhealthy changes, such as eating more convenience or snack foods. People newly diagnosed with MS often feel that they are not given sufficient dietary advice by their health care professionals. 2 This may partly be due to the fact that research on diet and MS disease progression has been limited and often poor quality; as a result, there are no evidence-based dietary recommendations specifically for people with MS. However, interest in this area of MS is growing rapidly, and many studies are under way that will help to answer some of the outstanding questions. Let’s have a look at the literature to date. Omega-3 fatty acids are very important for brain function, particularly the active forms of omega-3, known as EPA and DHA. These are the healthy fats we get from oily fish, fish oil supplements and cod liver oil. We do get omega-3 fatty acids from linseed, but only a small portion is converted in our body to the active forms, so linseed is not the best source of omega-3. Research on omega-3 and MS dates back to the 1970s, but trial quality was often poor and results were inconclusive. Two studies were conducted recently that assessed whether fish oil supplements might be effective in reducing MS disease progression. 3,4 Both studies randomly allocated participants with relapsing-remitting (RRMS) to two groups (treatment and control group). Participants in the treatment group were given a fish oil supplement, while participants in the control group were given a placebo supplement with no active constituent. After one to two years, researchers reported no beneficial effects of the fish oil supplements on MS disease activity. However, one study did show reduced inflammation in the treatment group compared with the control group. We know that inflammation is an important factor in MS disease progression, so reducing inflammation is a helpful outcome. These studies were considered ‘pilot’ studies, and included only a small number of participants (

Oily fish (eg salmon, tuna, mackerel, sardines) is the best dietary source of omega-3 and vitamin D and eating two serves of oily fish per week is recommended. Try to eat a variety of oily fish: it doesn’t have to be fresh, tinned fish will still contain these important nutrients. Avoid processed meats, which contain unhealthy additives, and limit your intake of other processed foods, including biscuits, cakes, confectionery, pastries, pies, commercial burgers, pizza, fried foods, potato chips, crisps and other savoury snacks, sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, energy and sports drinks. These are considered ‘discretionary’ foods and should be eaten only sometimes and in small amounts. MSWA now has two practicing dietitians on board, who would be happy to help you make healthy dietary changes, simply phone 9365 4888. 1 Russell RD et al. (2018) Reported changes in dietary behaviour following a first clinical diagnosis of central nervous system demyelination Front Neurol 9:161. 2 Russell RD et al. (2018) Dietary responses to a multiple sclerosis diagnosis: a qualitative study Eur J Clin Nutr (in press) 3 Torkildsen et al (2012) n-3 fatty acid treatment in multiple sclerosis (OFAMS Study): a randomized, double-blind, placebo-controlled trial Arch Neurol 69:1044-51 4 Ramirez-Ramirez et al (2013) Efficacy of fish oil on serum of TNF α, IL-1 β, and IL-6 oxidative stress markers in multiple sclerosis treated with interferon beta-1b Oxid Med Cell Longev 709493. 5 Yadav et al (2016) Low-fat, plant-based diet in multiple sclerosis: A randomized controlled trial Mult Scler Relat Disord 9:80-90. ANTIOXIDANTS KAREN HUMPHRIES AND KATELYN CLEMENTS, MSWA DIETITIANS We hear antioxidants mentioned frequently but do we understand what they are, and the potential benefits may be? Here we provide an overview for Members and a delicious recipe. What are Antioxidants? Antioxidants are molecules that help to defend our body’s cells against oxidative damage from free radicals. Oxidative damage is associated with the risk of several health conditions including cancers, heart disease, and macular degeneration. By protecting our cells from damage, antioxidants also help to slow the body’s aging process. Some of the antioxidants that we can get from our diet include: vitamin C, vitamin E, beta carotene, selenium, zinc. manganese, copper, flavonoids, carotenoids, phytochemicals, and several enzymes. Where do antioxidants come from? There are many different antioxidants. Some we make in our body, while others come from food, drinks (like tea and wine) or supplements. In general, antioxidants are better taken in the form of food, especially vegetables and fruits. Eating a variety of different fruits and vegetables not only supplies our bodies with plenty of antioxidants, but also lots of fibre, vitamins, and minerals. Cooking with herbs and spices will also help to boost your antioxidant intake. Including plenty of fruit and vegetables in your diet will provide you with the protective effects of antioxidants. Eat the rainbow! Be sure to include a wide variety of coloured fruits and vegetables as they provide different kinds of antioxidants. The stronger and more vibrant the colour the better. Try to include reds, oranges, yellows, greens, browns and blues/purples. See below for a list of some nutritious vegetables and fruits that are in season in spring. Vegetables Beetroot Asparagus Avocado Chilli Red onion Carrot Peas/snow peas Rhubarb Fruits & Berries Orange Grapefruit Lemon Lime Mandarin Mango Paw paw Silverbeet Tomato Sweet potato Broccoli Zucchini Spinach Herbs Blackberries Blueberries Raspberries Strawberries Apple Plum Boysenberries Capsicum Brussels Sprouts Broad beans String Beans Squash Pumpkin Eggplant Honeydew melon Passionfruit Persimmon Watermelon Peach Banana Rockmelon Crunchy Green Salad Ingredients: • 15 punnet sugar snaps • 120g rocket leaves • 1 small head of broccoli • 1 medium zucchini • 15 green beans • 1 avocado • 2 sprigs of mint • 3 alfalfa sprouts • 2 tbs olive oil • 1 tbs lemon juice • Black pepper • Salt Method Top and tail the zucchini. Using a peeler, peel the zucchini lengthways to make long thin strips. Top and tail the green beans and cut the broccoli into small florets. Steam the beans and broccoli for 2 minutes and refresh in cold water. De-string the sugar snaps and keep whole or cut in half if large. Slice the avocado. On a flat platter or large bowl, arrange the rocket and mint leaves. Add zucchini ribbons, broccoli, green beans, sugar snaps, and avocado; then top with alfalfa sprouts. Drizzle olive oil and lemon juice over the salad and season with salt and pepper. MSWA BULLETIN SPRING 2018 | 21