[The efficacy of dietetic intervention in multiple sclerosis]

The involvement of nutritional factors in the etiopathogenesis of multiple sclerosis is currently being investigated. Notwithstanding the huge amount of data present in the literature, the possible etiological or protective role of nutrients with regard to the disease remain debatable. The epidemiological data suggest an association between multiple sclerosis and nutrition; the populations that take in a higher quantity of foods of animal origin (meat p<0.0001 and dairy products p<0.01) seem to be the most affected. A role of saturated fatty acids in the etiopathogenesis of myelinic damage has been hypothesised. Case control studies have identified certain foods that act as risk factors and others as protection in the onset of the disease. Some case control studies point to a time-cause relationship between the intake of total calories (O.R. 2.03) and saturated fats (O.R. 1.88) and the incidence of multiple sclerosis; other prospective studies failed to confirm this hypothesis, negating the protective effect of a diet rich in anti-oxidant vitamins and polyunsaturated fatty acids. Intervention studies are discordant with respect to the effects of polyunsaturated fatty acid supplements on the course of the disease. In patients with a progressive chronic form of the disease, polyunsaturated fatty acids did not demonstrate any effect on the progression of the invalidating lesions. Interventions on patients suffering from an acute and remittent form have pointed to the significant effect of treatment with polyunsaturated fatty acids in slowing down the progression of lesions only in cases with a slight initial degree of disability or no disability (p=0.001) at all. They do, however, seem to confirm the hypothesis of an association between the gravity of the disease and consumption of saturated fats (p<0.05) and show an improvement trend in patients treated with polyunsaturated fatty acids, although the data are not statistically significant.