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Paleolithic diet

The Paleolithic diet is a dietary regime which some people believe to be effective in treating multiple sclerosis. The diet was first popularised by film writer Roger MacDougall. MacDougall was diagnosed with MS in 1953. His condition progressed steadily until he changed his diet to one which is essentially the same as what is now called the Paleolithic diet.

At the nadir of his disability, MacDougall was "was unable to use my legs, eyes, and fingers ... even my voice was affected, and I was quite unable to stand erect, even for a few seconds". By 1975, after several years on the diet, a neurologist pronounced his reflexes, muscle control, gait, and movements to be normal and could only detect a slight nystagmus in one eye.

The Diet

The broad basis of MacDougall's diet is:

MacDougall emphasises that everyone is different and that it's not necessarily the case that what works for one person will work for everyone. He advocates finding out what works for you.

He also states that you have to follow the diet for a while before results can be seen.

Clearly, MacDougall's diet is radically different to a typical Western diet. It's important to have a balanced diet and you must take care to ensure that you're getting all the basic foodstuffs that you need. Many people have developed recipes that adhere to MacDougall's diet. Perhaps the best place to start if you're looking for culinary ideas is Ashton Embry's MS-Direct web site. Embry is the father of a person with MS and has spent a great deal of time researching dietary strategies to fight this disease.

The Theory behind the diet

MacDougall's diet has become known as the "Paleolithic Diet", and is based around a theoretical framework which derives from evolutionary biology.

In essence, the theory goes as follows:

Whether or not one ascribes any validity to the evolutionary tenets of the argument, it is still possible to maintain that diet may very well play a role in the cause or treatment of multiple sclerosis. It is known that dietary elements are involved in other autoimmune diseases (for example, type 1 diabetes and celiac disease), so it is not absurd to postulate that the same may be true of MS. There is some solid evidence that certain proteins found in wheat and dairy produce could play a part in the etiology and/or pathogenesis of multiple sclerosis.

Gluten

Neuropathic Coeliac Disease (CD) is a manifestation of gluten intolerance that can present with central nervous system white matter abnormalities not altogether dissimilar to the lesions caused by multiple sclerosis [Kieslich et al, 2001]. In some individuals, these abnormalities are observed without the digestive problems that are typical of the disease.

Recent research has shown genetic similarities between people with CD and some other autoimmune diseases including multiple sclerosis [Ref]. It is also possible that a proportion of people with multiple sclerosis represent a misdiagnosed group of people with CD.

Whey Proteins

There is some good evidence that the incidence of multiple sclerosis is higher in areas of high cow's milk consumption [Malosse and Perron, 1993], [Malosse et al, 1994], [Sepcic et al, 1993], [Butcher, 1986] and [Butcher, 1992].

More recently, detailed immunological studies have been carried out by Michael Dosch's team in Ontario, Canada. They have looked at potential triggers for multiple sclerosis and type-1 diabetes focusing on dairy proteins especially those in whey [Dosch et al, 2001] and [Dosch et al, 2001]. One particular milk protein, butyrophilin, has been presented as a potential antigen which may be similar enough to Myelin Oligodendrocyte Glycoprotein (MOG) to spur the immune system to attack myelin in a process known as molecular or epitopic mimicy. Independent studies by a group in Germany have reached similar conclusions [Stefferl, Schubart et al, 2001].

Interestingly, the German group have used heavy doses of butyrophilin on mice with an experimental model for multiple sclerosis called EAE. They have found that this strategy, called immune tolerance, reduces the effects of the disease.

Studies

Ashton Embry's Direct MS organisation is funding a very small study of the Paleolithic diet to begin next year (2002). As I understand it, limited funds will restrict the study population to 12 people with relapsing-remitting multiple sclerosis. It will be hard to draw many firm conclusions from a study of this size. However it is to be hoped that they will achieve positive results and spur larger, richer organisations to fund larger research projects.

One of the difficulties in analysing the Paleolithic diet is that it is a very broad based diet involving several foodstuffs. Even if Embry's group do find the diet therapeutic, it will be hard to know which elements of the diet were beneficial and which were superfluous. Even if the study does not achieve positive results, that does not mean that diet has no bearing on the disease.

What is urgently required are some well-designed, large population studies on the dietary intake of individual proteins such as butyrophilin. For some reason and in the face of pressures from many people with MS and a few researchers, diet has largely been ignored by those who fund research into the disease. This is perhaps understandable in the case of pharmaceutical companies but it rather a perverse line for the NMSS to take given that they claim to be representing the interests of people with MS.

As things stand, no one knows the cause of MS except that it involves the interaction between a person's genes and one or more unknown environmental factors. It is as reasonable a hypothesis as any that one or more dietary elements might be among those factors.

Paleolithic diet links:
My Fight Against Multiple Sclerosis, by Roger MacDougall
DIRECT-MS
MS Dietary Home Page
MS-Diet Support Group
Campaign for Research into Diet and Multiple Sclerosis


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