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A Gut Reaction

21 October 2015

If you read my last post on food, you may well either have adopted a diet that is less varied than that of a Buddhist monk, or be cowering in fear that you are on the road to nutrition perdition. In any case, rest assured, this post may settle your nerves (although if you are the squeamish sort I can’t promise it will be easier to stomach – yes I know, those puns just keep on coming). While science strongly indicates that environmental conditions can influence MS disease activity and progression, it hasn’t yet provided conclusive evidence on what those factors are. Hypotheses abound and give rise to many other plausible explanations that may involve dietary influences but in a less direct way. In this post, I explore a fairly new theory that is generating interest and gathering momentum within the scientific community, that of the role of the gut and our intestinal flora in MS and other autoimmune conditions.

When we make dietary modifications, we impact not only ourselves, but the trillions of bacteria that we play to host to in our digestive tract. As human beings have evolved, so has the ecosystem living inside of us and it is constantly changing, even on a day to day basis. Your gut reaction (another pun!) to this news may be along the lines of that of my 7 year old – gross! – but do be open-minded here as studies indicate that the vast majority of these microbes are beneficial, particularly if we treat them well. It turns out that our intestinal passengers are extremely sensitive to the room service we, as proprietors, provide, responding promptly to changes in diet, stress and medications. Furthermore, our microbial profiles differ between intestinal segments, with some critters camping out closer to the stomach and others showing preference for locations further downstream. Finally, there are also significant variations between individuals that are influenced by age and genetics.

Friend or foe?Figure 1: Friend or foe? Hard to know.

This may account for the multiple anecdotal yet often contradictory success stories of dietary interventions on MS symptoms and outcomes. Perhaps typical “Western” diets result in a gutful (literally) of unhealthy bacteria that promote dysregulated immune responses and favour disease progression. If this is true, it may pave the way for targeting the gut and its guests as promising new therapies. The possibilities here range from a probiotics approach (i.e. introducing beneficial bacteria to re-establish a healthy composition of gut flora) to the more radical regimen of faecal transplantation. Eeshk, I hear you say and I have to agree that this is far less appetising than popping probiotics to fix flawed flora.  

While this particular theory is still in it’s infancy, it’s worth bearing in mind when making food selections. While totally eliminating particular foods might make us feel like we are improving our prognosis (and overall health), and it’s then easy to extrapolate from that and arrive at the conclusion that ingesting any morsel of these foods will be bad. However, science is rarely that black and white, which is why there is very little current consensus on what is best practice. And let’s face it, where’s the fun in life when trying to follow impossibly rigid food rules? Perhaps a highly varied approach to food selection (aka the “everything in moderation” approach) is just fine after all, so long as that you choose enough foods to keep the good microbes happy and starve out the bad guys.

So my readers, what is your gut reaction to this hypothesis? 

Comments (16)

Just curious if anyone with MS has seen this? I have definitely changed the way I eat! http://www.youtube.com/watch?v=KLjgBLwH3Wc&sns=em

Another fascinating post Sarah. I agree it's promising, but when will we get hard science about the best microbiome for MS I wonder? That's what I want most. Some science I can sink my teeth into! Given your very funny post about what to eat and what not to eat, I guess you are familiar with Swank's work. As you know, his theories about saturated fat being causative in MS have not been proven, and his work has not been replicated. I have some issues with his methods too, but I often wondered that if his observations were completely accurate, just how much his success owed to an altered microbiome through altered diet? Of course, new research is showing that the majority of the immune system resides in the gut, and when you throw in crucial nutrient metabolism in the gastrointestinal tract (especially B group vitamins), and the 'old friends' hypothesis relating to intestinal parasites, it is an egg that is well worth unscrambling...

Unfortunately science progresses with glacial slowness in most cases I think Lawrie. I know we've already discussed the differences between mice and men, but there are so many other limitations of most studies. Agreed though that it's an important area for further investigation...

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Very interesting topic Sarah, it is a subject that will continue to confound us probably till the end of time. Great blog. Thanks.

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I have read lots of research on this as I also have autoimmunity though not MS. Rheumatologist and Gastroenterologists in Dunedin have joined forces to study this further. You also might want to look into "leaky gut syndrome" and bowel candidiasis which essentially if treated offer a relief of symptoms. I have seen a functional medicine Dr alongside western specialists to make sure my bowel health and nutrient support is the best it can possibly be. Your immune system can't work optimally if it isn't getting the right nutrients due to dodgy guts.

Thanks Jaclyn! I will definitely look into the Dunedin research and your other suggestions. I also agree it's worth shopping around to get a whole lot of opinions. Sometimes the conventional answer isn't always spot on...

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