The very fact that you are reading this likely means that you have heard about and/or are interested in the role of lifestyle interventions as a way of managing MS.
Dating back to the pioneering research of Prof. Roy Swank in the 1940’s on the role of fats in MS progression, corroborated by more recent large-scale studies from around the globe, not to mention Prof. Jelinek’s vital work at the NEU, we know that diet and lifestyle play an enormous part in the prevention and the progression of this condition.
Further papers, published in the past two years have begun to unpick the key mechanisms behind diet quality, fasting, obesity and blood lipid levels and their effects on MS relapse rates and disability progression.
But yet, there is still much work to be done. There is conflicting evidence on which, if any, dietary strategy works best to prevent and treat MS, and doctors generally remain extremely sceptical of lifestyle-based interventions. One of the issues is that the fundamental mechanisms underpinning this disease still evade us, and it can sometimes feel (from the outside at least) like scientists are feeling around for that elusive key in the dark.
Perhaps though, they have now found one?
A team of researchers from McGill University, Canada, have just published a paper demonstrating a potential pathway for the essential amino acid (meaning it cannot be made by the body, but rather must be consumed in our diet) methionine in the management of MS.
Methionine is a key building block of many proteins in the body and is known have a significant role in regulation of the immune system (an important clue!). T-cells (a type of white blood cell known to be involved in the immune attack of myelin in MS) require high levels of the amino acid to activate and to change into the types of cell that then seek out and attack a target. The theory then would be that reducing consumption will reduce the levels of methionine in the blood available for T-cells, which in turn would reduce the inflammatory response.
“Ok, makes sense,” I hear you say, "but will it actually work?"
Well we already know that restricting the dietary intake of methionine increases the life-span of a variety of animals, delays the ageing process and prevents metabolic disease in mice. It has also recently been shown to have a potential additional benefit as a cancer treatment.
In this research, the team found that if mice were methionine restricted, they were significantly less likely to develop EAE (mouse MS) when it was medically induced, compared with control animals, and significantly delayed the onset of EAE in the mice that did develop EAE, as well as the number of mice that developed symptoms. Of course, more work needs to be done, and larger studies in humans will be vital, but nevertheless this is a potentially extremely important discovery.
“So this sounds promising, but how do I restrict my methionine intake, and do I have to give up more foods that I like?!”
Well here is the good news. If you were to follow a methionine restricted diet, you would be avoiding animal products such as meat, dairy and eggs, and increasing consumption of plant-based sources of nutrition; sound familiar?!
This is all very promising so far, but as with nearly all medical research, the puzzle doesn’t fit together neatly. You see, methionine levels are also relatively high in fish. But before you tear up your favourite OMS salmon recipes, it is worth remembering that Prof. Jelinek’s research found additional benefits from regular fish consumption in people with MS, in all measures of quality of life, relapse rates and disability levels. It is extremely common to have seemingly mutually exclusive contradictions in the human body, and simply shows that further work needs to be done to fully understand an extremely complex pathway.
In the meantime, it is very encouraging that the body of evidence behind the OMS program continues to expand rapidly, but you can never have too much of a good thing when it comes to determining the very best way to live well with MS.
We will of course keep you posted on any future developments.
1) Roy D.G., Chen J., et al. Methionine Metabolism Shapes T Helper Cell Responses through Regulation of Epigenetic Reprogramming, Cell Metabolism, Volume 31, Issue 2, 2020, Pages 250-266.
2) Swank R.L., Dugan B.B., Effect of low saturated fat diet in early and late cases of multiple sclerosis, The Lancet, Volume 336, Issue 8706, 1990, Pages 37-39.
3) Hadgkiss E.J., Jelinek G.A., Weiland T.J., Pereira N.G., Marck C.H., van der Meer D.M. The association of diet with quality of life, disability, and relapse rate in an international sample of people with multiple sclerosis. Nutritional Neuroscience. 2015;18(3):125-136.
4) Fitzgerald K.C., Tyry T., Salter A., et al. Diet quality is associated with disability and symptom severity in multiple sclerosis. Neurology. 2018;90(1):e1-e11.
5) Gafson A.R., Thorne T., McKechnie C.I.J. et al. Lipoprotein markers associated with disability from multiple sclerosis. Sci Rep 8, 17026 (2018). https://doi.org/10.1038/s41598-018-35232-7
6) Black L.J., et al. A healthy dietary pattern associates with a lower risk of a first clinical diagnosis of central nervous system demyelination, Multiple Sclerosis Journal (2018)
7) Jakimovski D., Weinstock-Guttman B., Gandhi S. et al. J Neurol (2019) 266: 866.
8) Neumann B, Baror R, Zhao C, et al. Metformin Restores CNS Remyelination Capacity by Rejuvenating Aged Stem Cells. Cell Stem Cell. 2019;25(4):473-485.
9) Hoffman R.M., Clinical Studies of Methionine Restricted Diets for Cancer Patients, Methods Mol Biol. 2019;1866:95-105. doi: 10.1007/978-1-4939-8796-2_9.