Fueling the Fight: Nutrition's Role in Multiple Sclerosis Physiotherapy Sessions.

M.? Are you here? I know for some "That's As Bad As Listening To The Beatles Without Earmuffs."

James Bond in Goldfinger (1964)

But regardless, I wanted to have a heart-to-heart convo about something that often gets pushed to the back burner when we discuss Multiple Sclerosis (MS) - and that's nutrition. Believe it or not, the food choices we make can have a big impact, especially when dealing with a condition like MS[1].

As a neuro physio I always look for my patients to do well.

Remember you know, you eat, you do.

Let's break it down, shall we?

Your Nutritional Status and MS

First things first, most of our MS buddies have a pretty standard BMI. But, I've come across quite a few who might be carrying a bit more weight than they'd like. And on the flip side, some even face the challenge of malnutrition, especially when MS gets more advanced. Things like difficulty swallowing, feeling blue, fatigue, and not being as active can play a part in this[2]. It's essential to keep tabs on this, and together, we can tackle it.

What's on Your Plate?

Here's something interesting: many with MS eat pretty much like everyone else. But, I've met some who are experimenting with special diets, hoping it might give them an edge with their MS. And often, they're venturing into this without any professional guidance[3]. If you're thinking about shaking things up diet-wise, let's chat first with an experienced professional. It might be a case that there are other factors that cause malnutrition or gastric problems. Recently one of my MS cases discovered helicobacter pylori ( the prize bug of all time with a Nobel Prize in 2005 thanks to Barry Marshall and Robin Warren). According to the mentioned study published in 2022, researchers "confirm that the infection of H. pylori is a significant one among many environmental factors which lead to many types of autoimmune diseases." [9] and the infection itself can lead to malnutrition and additional health problems.

Nutrition Bits That Might Impact MS

- Vitamin D: There's been some chatter about vitamin D. Turns out, low levels might be linked to a higher risk of getting MS and even more intense symptoms[4]. Some folks are popping supplements, but we're still figuring out the best amount to take.

- Good Fats (PUFAs): There's a hint that foods high in PUFAs might be a game-changer for MS, but the data's a bit mixed[5].

- Eating Patterns: Some food for thought - munching on more fruits, veggies, beans, and fish might be a good move when it comes to MS. But again, we're still connecting the dots here[6].

Some Friendly Advice

1. Eat Balanced: It's super important to eat a balanced diet and keep an eye on our weight. This isn't just about looking good but feeling good and having the energy for our rehab exercises.

2. Regular Check-ins: As MS progresses, it's a smart move to have regular check-ups to see how our nutrition is doing[7].

3. Vitamin D: If you're running low on vitamin D, it might be worth considering a supplement[8]. But let's discuss the right amount for you.

4. Diet Experiments: I know there's a ton of info out there about special diets for MS. But always remember, everyone's journey is unique. Let's chat if you're thinking of trying something new.

Why Nutrition Matters in Your Rehab

Here's the deal: rehab, including physio sessions, is a big part of the MS journey. And good nutrition? Think of it as the fuel that powers this journey. When our body is well-nourished, it's like giving it a turbo boost. It responds better to treatment, bounces back faster, and is more resilient against MS symptoms.

A Little Note From Me to you

I wanted to share this with you because it's all part of the bigger picture. Nutrition is a piece of the puzzle that can supercharge our physiotherapy efforts. But always remember, everyone's different. For a detailed plan, it might be a good idea to chat with a clinical dietitian. They're the nutrition wizards who can tailor things just for you.

Stay strong, and remember, we're covered this now - no more excuses Mrs MA!

Sources:

[1]: [ESPEN guideline on clinical nutrition in neurology](https://www.espen.org/files/ESPEN-Guidelines/ESPEN-guideline_clinical_nutrition_in_neurology.pdf)

[2]: Smith, T.J., et al. "Dietary habits and metabolic health in a population of overweight and obese MS patients." Neurology Research International, 2018.

[3]: Schwarz, S., & Leweling, H. "Multiple sclerosis and nutrition." Multiple Sclerosis Journal, 2005.

[4]: Munger, K.L., et al. "Vitamin D intake and incidence of multiple sclerosis." Neurology, 2004.

[5]: Hoare, S., et al. "Higher intake of omega-3 polyunsaturated fatty acids is associated with a decreased risk of a first clinical diagnosis of central nervous system demyelination." Multiple Sclerosis Journal, 2016.

[6]: Fitzgerald, K.C., et al. "Diet quality is associated with disability and symptom severity in multiple sclerosis." Neurology, 2018.

[7]: Penesova, A., et al. "Nutritional intervention as an essential part of multiple sclerosis treatment?" Physiological Research, 2018.

[8]: Mowry, E.M., et al. "Vitamin D status predicts new brain magnetic resonance imaging activity in multiple sclerosis." Annals of Neurology, 2012.

[9]: Wang L, Cao ZM, Zhang LL, Dai XC, Liu ZJ, Zeng YX, Li XY, Wu QJ, Lv WL. Helicobacter Pylori and Autoimmune Diseases: Involving Multiple Systems. Front Immunol. 2022 Feb 10;13:833424. doi: 10.3389/fimmu.2022.833424. PMID: 35222423; PMCID: PMC8866759.