Weight Loss to Treat MS

Obesity may raise the risk for multiple sclerosis for some people — and weight loss to treat MS may potentially help prevent the disease. Learn more here.

Multiple sclerosis (MS) is a chronic, inflammatory disease that affects the central nervous system. MS damages nerves in the brain and spinal cord, as well as the optic nerves, causing neurological symptoms and, with the progressive type, disability. Although a direct cause of MS hasn’t been uncovered, researchers believe it’s an autoimmune disease.

They’ve developed several treatments that can help relieve symptoms of the condition and, in some cases, slow disease progression. What’s more, scientists have also found some factors, including excess weight, that can play a role in the development, exacerbation, or improvement of MS.

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For example, people who smoke are more likely to develop the disease and generally have more brain shrinkage and lesions than non-smokers with MS. On the other hand, those with high levels of vitamin D tend to have less severe MS and fewer relapses, according to the National Institute of Neurological Disorders and Strokes. Now researchers are studying how weight can impact MS progression, and how weight loss to treat MS might be a possibility.

A MS weight connection begins in puberty

More than 40 percent of American adults are now obese, the Centers for Disease Control and Prevention notes, and the problem of obesity is also affecting kids. In fact, more than 20 percent of 12- to 19-year-old U.S. adolescents are also significantly overweight, a fact that may be putting some young people at an elevated risk for MS.

Past studies have linked entering puberty at a younger-than-average age with developing MS. But when researchers from McGill University in Montreal looked at the age when puberty began for about 14,802 people with MS and 26,703 people who did not have the disease, they found something surprising.

Their study, published in Neurology, found puberty at a younger-than-normal age was an MS risk factor ― but primarily only in those with an elevated body mass index (BMI), a measure of body fat based on height and weight.

If youngsters are overweight when the changes of adolescence kick in early, they may be more likely to develop MS eventually than their normal weight counterparts, the researchers concluded.

Does that mean making sure children have a healthy, normal weight as they hit puberty could help prevent MS?  

"More research is needed to determine whether decreasing rates of obesity could help to reduce the prevalence of MS," said the lead author of the study, J. Brent Richards, MD, associate professor of human genetics, epidemiology, and biostatistics at McGill. "If so, this could be another important reason for public health initiatives to focus on lowering obesity rates."

Excess weight may cause MS-linked damage

We know that overeating can increase MS symptoms, such as fatigue, stress on joints, demand on the heart and lungs, and the risk of other illnesses.

Neuroscientists at the City University of New York (CUNY), working in collaboration with clinicians at the Icahn School of Medicine at Mount Sinai, are unravelling more connections between MS, weight, and diet.

They’ve found an important clue: Fat molecules in the blood (lipids) go through changes in people who are significantly overweight or obese. Because these lipids are involved in many cellular processes, including immune system function, the altered fat molecules may affect MS and the course of the disease in people with higher than normal BMIs.

To test this idea, for two years the research team studied 54 patients with relapsing-remitting MS between the ages 18 to 60. Half of the research subjects were normal weight, the other half overweight. The researchers used MRIs (magnetic resonance imaging) to look for signs of brain damage in the patients, conducting exams to document weight, disabilities, and other vital information. They took blood samples from the research subjects to measure types of circulating lipids and white blood cells.

For validation, the researchers also compared their findings with another group of 91 MS patients from the National Institute of Health and a group of healthy individuals who were in the same BMI range but didn’t have MS.

The findings showed overweight or obese patients tended to have greater MS disease activity, more progressive disability, and more brain lesions on MRI scans on follow-up.

The researchers discovered something else that might explain the weight and MS progression link: MS patients with excess weight had significantly higher levels of fat molecules called ceramides than normal-weight patients.

Ceramides can have several effects on cells in the body, and the researchers found the excess fat molecules in the overweight MS patients altered the gene activity of a type of white blood cells, monocytes, causing them to proliferate far more than normal.

Monocytes are a type of white blood cell that fights off bacteria, viruses, and fungi, which helps protect health. But in recent years, scientists found monocytes can travel into the brain in reaction to brain injuries, promoting inflammation and damaging nerve fibers. That raises the possibility people with MS who are overweight have bodies with excessive fat molecules triggering the over-production of monocytes that enter the brain, causing damage and triggering disease progression.

Weight loss to treat MS isn’t far-fetched

The results of the research strengthen the likelihood lifestyle factors, like diet and weight control, can help treat MS. It's important, however, that additional studies evaluate dietary interventions ― with an emphasis on reducing specific types of saturated fats to potentially reduce plasma ceramide levels ― to see if lifestyle changes are an effective way to alter the course of MS, the researchers noted.

According to the research team, their findings back the validity of nutri-epigenomics, the concept that food can alter the way genetic information is interpreted on a cellular level.

“This study gives us a much-needed view into the environmental influences that can affect and change the behavior of cells in an individual’s body,” said, Kamilah Castro, a neuroscience PhD student at CUNY and the study’s first author. “Our findings suggest that increased levels of saturated fat as a result of dietary habits are one likely cause of the epigenetic changes that advance MS, which gives us a starting point for a potential intervention.”

Bottom line: Dietary intervention and weight loss to treat MS may be effective ways to alter the course of the disease.

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