Dr.
Michelle Leary-Chang was the guest speaker for a MS/Cancer conference call that
focused on patients with Multiple Sclerosis (MS) and nutrition, including
vitamin D. She is studying family medicine at Eastside Integrated Primary Care
in Bellevue, WA, and works part-time as a research associate at the Institute
of Functional Medicine. The following are highlights from her talk.
I
have MS. What should I do?
1.
Choose an eating plan that is nutrient dense
and anti-inflammatory. The Mediterranean diet is the best researched and most
practical for most individuals wanting to improve their diet.
2.
Talk to your doctor about making sure you are
sufficiently complete in Vitamin D.
3.
Assess your need to fix your gut. Common leaky
gut symptoms often match up with the clinical syndrome, Irritable Bowel
Syndrome. Make sure you have bowel movements daily.
4.
Get some form of physical activity daily, if
possible. This can be seated exercise, standing with a balance support, or
high-level activity.
5.
Consider talking to an integrative health
care provider about ways to support your health goals.
6.
If you decide to buy supplements on your own,
select high quality brands. Brands matter.
Mediterranean Diet
- ·
Relatively easy to follow versus restrictive diets
- ·
High intake of anti-inflammatory foods including olive oil, garlic,
onions, and fish.
- ·
Lots of anti-oxidants in the diet through fresh vegetables and fruits
The
following are factors patients with MS should consider in regard to their health.
Why
MS and inflammation matters
- ·
Reduction of white blood cells and
proinflammatory molecules crossing the blood brain barrier to potentially
activate an immune response in the brain and spinal cord against myelin.
- ·
Reduction in risk factors of other chronic
illness such as heart disease and cancer.
- ·
Improvement in quality of life.
Anti-inflammatory foods
- ·
Tomatoes.
- ·
Olive oil.
- ·
Green leafy vegetables, such as spinach,
kale, and collards.
- ·
Nuts like almonds and walnuts.
- ·
Fatty fish like salmon, mackerel, tuna, and
sardines.
- · Fruits
such as strawberries, blueberries, cherries, and oranges.
Immunomodulation
·
When our cells become educated in our lymphoid tissue, which includes
the lymph nodes and gut associated lymphoid tissue in our digestive tract, sometimes
the immune system gets mis-educated about what tissue of our body is our own,
and what tissue is a threat.
·
An immunomodulator is a therapeutic, an example being vitamin D, which
can help the immune system make better, more educated choices about what cells
are our own (and thus should not be attacked) and what cells are true invaders
or threats.
·
It is not the same as an immunosuppressant, which reduces the immune
system reactivity to a specific agent, which can have a role in the treatment
of MS and other autoimmune diseases.
Environment
Your
environment is not only your home and physical environment, although this does
play a role.
- ·
Consider your lifestyle environment.
- · Evaluate your stress, nutrition,
movement, and smoking.
Nutrient Density
Nutrient density compares the amount of nutrients
in food (vitamins, minerals, antioxidants) to the calorie content in food.
Vitamin D
Vitamin D work as an Immune Modulator. Essentially
Vitamin D helps to tell immune cells that are associated with proinflammatory
reactions to make better educated decisions about who it should go after. It
also tells the T cells responsible for educating our immune system about our
own self-proteins to make sure the immune cells don’t attack them, according to
Dr. Leary-Chang.
An ideal level of Vitamin D3 translates to a level of minimum of 40ng/mL.
Foods
high in Vitamin D
- ·
Fatty fish, like tuna, mackerel, and salmon.
- ·
Foods fortified with vitamin D, like some dairy products, orange juice,
soy milk, and cereals.
- ·
Beef liver
- ·
Cheese
- · Egg yolks
Magnesium
in MS
Potential therapeutic roles of magnesium for
people with MS include:
- ·
Spasticity: Gives adjunctive support, does
not affect the neurological signal that creates spasticity in MS patients.
- ·
Constipation treatment: Magnesium citrate powder
with 12 to 16 ounces of water, 250 to1000 mg at night.
- · Fatigue
Foods
high in magnesium
- ·
Dark leafy greens
- ·
Nuts
- ·
Seeds
- ·
Fish
- ·
Beans
- ·
Whole grains
- ·
Avocados
- ·
Yogurt
- ·
Bananas
- ·
Dried fruit
- ·
Dark chocolate
Calcium
How do you know if you are deficient in
calcium? Unfortunately, it is not simple. While calcium can be measured in the
blood, it is intentionally maintained at a very precise level in the blood and
uses bone calcium to maintain that careful balance
Foods high in calcium
- ·
Dairy foods
- ·
Sardines
- ·
Tofu
- ·
Pink salmon
- ·
Collard greens
- ·
Spinach
- ·
Kale
Dr. Leary-Chang’s recommendation for persons without
osteoporosis is no more than 600 mg daily of supplemental calcium unless you
and your doctor have discussed other reasons for higher. Get a DEXA (bone
mineral density) scan.
Vitamin
B12
Dr. Michelle Leary-Chang stated that patients
with chronic immune reactions or recurrent myelin repair processes might
increase the demand for vitamin B12.
Foods high in Vitamin B12
- · Shellfish
- · Liver
- · Fish
- · Crab
- · Fortified soy products (tofu, soymilk)
- · Fortified cereals
- · Red meat
- · Low-fat dairy
- · Cheese
- ·
Eggs.
Guidelines
for selecting supplements
- ·
GMP (Good Manufacturing Practices) Certified
(FDA Code of Federal Regulations, Title 21, Part 111)
- ·
GMP Registered by NSF International, a
respected independent certification organization
- ·
Therapeutic Goods Administration (TGA),
Australian Government Department of Health and Aging for regulation of
pharmaceuticals and drug products.
Dr. Michelle Leary-Chang is a graduate of Bastyr University's
Naturopathic Medical Doctoral Program. In fall 2016, she participated in the MS
Society's advanced mentorship program, allow for 160 hours of advanced
post-doctoral training in northwest MS centers with MS trained neurologists. She
is studying family medicine at Eastside Integrated Primary Care in Bellevue,
WA, and works part-time as a research associate at the Institute of Functional
Medicine. Dr. Leary-Chang has a bachelor's degree in exercise physiology and
prior to attending medical school was the wellness director of a cardiovascular
and medical rehabilitation center in Maple Valley, WA. She is passionate about
integrative care for MS patients and hopes to specialize in working with MS in
the future, following her family medicine training.