The lipid (fat) hypothesis in MS has been around for a long time. Ever since Swank postulated that people with MS were abnormally sensitive to animal fats, and showed in his 34 year study that avoidance of these fats kept people with MS well, evidence has been accumulating that the lipid profile of people with MS is altered and contributes to the development of disability.
There is too much evidence to present here, but we know that people with MS have more saturated fat in their cell membranes than people without MS, that the more saturated fat in these membranes, the more disabled people with MS get, and the worse the lipid profile (that is high cholesterol and ratio of good to bad fats) the worse the disability. Given how these factors also seem to be key drivers for heart and cardiovascular disease in general, it seems reasonable to assume that vascular disease may be at least partly an underlying factor in the development and progression of MS, and recent data has shown that the more vascular disease a person with MS has, the more rapid the progression of disability.
Now a new hypothesis has emerged that ties much of this information together, arguing that MS is not a disease of the immune system at all, but rather a disorder of lipid metabolism that in many respects parallels cardiovascular disease. Publishing in the journal Quarterly Review of Biology, Dr Angelique Corthals, a forensic anthropologist, has argued that the formation of plaques on the walls of arteries (atherosclerosis or hardening of the arteries) is remarkably similar to the formation of plaques in the central nervous system in people with MS. Corthals argues that MS is really what happens predominantly to women who have disordered fat metabolism and atherosclerosis is what happens to men, while neither is excluded from getting the other disease. She argues that this theory certainly explains more of the findings about MS than the immune hypothesis.
It is interesting of course to note that if she is right, then the factors that improve heart disease should also improve MS: interestingly, these are a low saturated fat diet, stopping smoking, omega 3 supplements, vitamin D supplements, exercise, stress management techniques, and so on, indeed all the things we advocate on this website. This also fits well with other recently published research from Del Boccio et al in Italy who have found a marker in the blood of people with MS that signals disordered phospholipid metabolism, and the recent research showing that nicotinic acid (vitamin B3) may be of benefit in MS as it is in heart disease.
Corthals’ paper should stimulate neuroscientists everywhere to more closely examine the lipid theory of MS causation and develop more appropriate therapies. In the meantime, the paper is strong support for the OMS Recovery Program, and highlights the long term potential of this lifestyle approach in enabling people with MS to live long, healthy and happy lives.