Multiple sclerosis and intestinal health: what you know

Trillions of bacteria, fungi and other organisms live in your digestive system. Collectively known as your gut microbiome, these germs usually coexist peacefully, working together to maintain digestion, immunity and overall health. However, if something like a dramatic change in diet occurs, it can upset the balance of the gut microbiome and affect your health, putting you at risk of developing certain diseases, including multiple sclerosis (MS).

Studies have consistently found that people with MS have significantly different intestinal microbiomes than those without the disease, although what this means for people living with MS is not fully understood. Here’s what researchers know.

The link between gut health and MS

The relationship between the gut and MS is complex, according to J. William Lindsey, MD, director of the Department of Multiple Sclerosis and Neuroimmunology at the University of Texas Health Center in Houston. “This includes interactions between diet, nutritional status, gut bacteria and the activity of the immune system,” he explains.

How did all this intertwine?

For starters, “diet affects nutritional status and also changes the composition and activity of bacteria in the gut microbiome,” says Dr. Lindsey.

This disorder in intestinal bacteria can cause a chain reaction. “The microbiome can affect the activity of white blood cells in the gut, and these white blood cells can migrate to other parts of the body, including the brain,” explains Lindsay. “The microbiome also produces metabolites such as short-chain fatty acids and altered bile acids, which enter the bloodstream and affect the activity of the immune system.

Because MS is an autoimmune disease of the central nervous system, it is believed that these disorders, which lead to an increase in pro-inflammatory bacteria in the gut, affect the condition.

Can modifying the bacteria in the gut change the course of MS?

Maintaining a consistently healthy diet can affect the gut microbiome. And findings from various small studies in both humans and mice suggest that a healthy diet can reduce the activity of MS, especially in combination with disease-modifying therapy and other healthy lifestyle habits.

However, these are not definitive studies – more research is needed, consisting of larger studies, to clarify the role that diet plays in modifying the intestinal microbiome and managing MS.

Tips for a suitable diet for MS to promote intestinal health

Despite what we know – and still don’t know – about the link between the gut microbiome and MS, research shows that taking steps to a healthy diet is considered an important part of an overall MS management plan. “And a healthy diet can lead to a healthier microbiome,” Lindsay added. However, studies are limited by the focus on MS outcomes and there are not many analyzes that specifically look at the composition of the microbiome in response to diet.

Although there are no dietary guidelines specific to MS, the same diet plans that are known to support cardiovascular health and promote healthy aging – such as DASH and the Mediterranean diet – are also good for MS, Lindsey explains.

This means eating a diet focused on:

  • Fruits
  • Vegetables
  • Whole grains
  • Legumes
  • nuts
  • Seeds
  • Healthy fats

And limitation:

Can probiotics help?

The terms “gut health” and “probiotics” often go hand in hand. This is because increasing the intake of probiotics or “good” bacteria can help reduce inflammation in the gut. Uncontrolled inflammation is what triggers an overactive immune response.

Studies show that consuming probiotics can help prevent MS. And for people who develop MS, probiotics can help reduce its severity, slow its progression and improve some symptoms of MS. Although larger, more comprehensive research is needed on this topic as well.

Probiotics can be found in fermented foods such as:

  • Kefir
  • kimchi
  • Kombucha
  • Misho
  • Pickles
  • sour cabbage
  • Tempe
  • yoghurt

Probiotics are also available in the form of supplements for people who are not interested in the characteristic sour, yeasty taste of food sources. That said, only some strains of lactobacillus and Bifidobacteria have been shown to be useful for MS.

It is important to note that probiotic supplements are not regulated by the US Food and Drug Administration, so consult your doctor before stocking. Given that the relationship between the intestinal microbiome and MS is not yet fully understood, it is best to err on the side of caution. However, it’s probably a good idea to dine with all the kimchi and yogurt you like.

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