Print This PostAs we approach Motor Neuron Disease (MND) awareness week I think its important to look at this condition with a wide lens. Similar to something like Alzheimer’s, MND is an illness where only a fraction of cases can be purely attributed to genetics. So called ‘familial MND’ i.e. cases where the disease is genetically inherited only accounts for 1 in 10 patients. This is more than the 1 in 100 for Alzheimer’s but it leaves us with a very similar burning question. What is driving the other 90% of cases?
If you’re familiar with my blogs or podcasts here, it will be no surprise to you that I am asking this question. I am fascinated with the influence of environmental factors on our neurological health. I am becoming increasingly convinced that the food we put on our plates and the lifestyle we lead is a very significant contributor to how well our brains age. If you pull up a map showing the occurrence of ‘Westernised diets’ and compare it to a heatmap of dementia cases the result is at the very least, compelling. Correlation is not causation, but it does appear as if anywhere where you find less processed burgers and hotdogs and more consumption of fresh, healthy food (and a lot of plants), people age better. The big hot spots seem to be the USA and Western Europe and there is no denying that our diets are nowhere near as healthy as in South America, South East Asia etc. We are addicted to highly processed foods and try our best to ignore the impact they have on our health.
The evidence for diet in AD is becoming increasingly clear and we now have the MIND diet as a recommendation to reduce our risk. It consists of mostly plant based foods with the added consumption of fish and multiple studies appear to show benefits of it in relation to cognitive health. This leads me to my question. Can diet also reduce the risk of developing MND? If so, which diet and how sound is the data? Depending on what blogger or influencer you follow, you could get told to go keto, paleo, vegan, carnivore (please don’t this is catastrophic) or Mediterranean. So does any evidence stack up behind them? Well… I’ve done a deep dive into this so you don’t have to. Let’s jump in one by one!
The Carnivore Diet
This one is by far the most controversial. Eating only animal products that are high in fat seems hugely antithetical to promoting neuronal health. Saturated fats, cholesterol, dietary glutamate… they all have studies suggesting they act contrary to brain health. You are never going to convince me that a carnivore diet is going to do a healthy person any good whatsoever. Your body needs DIVERSE nutrients and packing your colon with meat 3 times a day seems to be a recipe for colon cancer. However, there is a very strange phenomenon that has been reported in a few studies but it is hotly debated so take it with a pinch of salt.
Some studies suggest that, once a patient is diagnosed with MND, an increased consumption in saturated fats could improve the survival rates of MND patients. Getting enough calories into a patient with MND can be challenging and a carnivore diet could potentially help to stabilise body weight. Furthermore, some studies suggest that the high amounts of fat could improve mitochondrial function and slow the disease progression. Having said that, there are better ways to increase fat consumption if that is what’s needed. The next diet for example…
The Ketogenic Diet
The ketogenic diet is essentially carnivore plus some low carbohydrate plants. The idea is to promote ketogenesis where the body switches to using ketones for energy. Again, studies that show benefits link it to mitochondrial function. It is purported that ketone metabolism is neuroprotective and reduces oxidative stress and mitochondrial damage which is, in turn, beneficial to MND patients. However, other studies say the opposite, showing that high-fat diets increase oxidative stress and the long term effects are not fully understood.
The Paleo Diet
This diet is built on the theory that modern humans are still genetically wired to the diet of Palaeolithic ancestors. They didn’t mill flour to make bread or add things like polysorbate 80 and carboxymethylcellulose to their foods. They ate what was available through hunter gathering with large consumptions of lean meats, seafood, nuts, fruits, seeds and vegetables. In relation to MND, it is reported in some studies that this dietary approach may inhibit the NF-kB pathway which could be beneficial to preventing MND. The diet is also high in Omega-3 fatty acids which could decrease pro-inflammatory cytokine expression and the diet may also lower cholesterol levels. However, these theories are lacking in quantity of hard evidence in relation to MND with may focussing on other effects. More needs to be done here.
The Mediterranean Diet
The Mediterranean diet is often heralded as one of the world’s healthiest diets. It involves the consumption of high amounts of extra virgin olive oil, vegetables, fresh fruit, dairy products, fish, and poultry, alongside moderate consumption of eggs, red meat, and red wine. It is a very ‘fresh’ diet that boasts high amounts of antioxidants, fibre, omega-3’s etc and these all may help protect against age-related cognitive decline. There are a lot more studies about this diet in comparison to the previous three and many demonstrate that it can reduce oxidative stress related to neuron death in MND. In vivo studies have demonstrated the neuroprotective effects of things like extra virgin olive oil and human studies suggest potential benefits in improving multiple health markers in MND patients. However, not everyone is in agreement and more rigorous studies (preferably double blind) are needed.
The Vegan Diet
Finally, we have the vegan diet. This focusses on consuming only plant-based foods – fruits, vegetables, seeds, grains, nuts, legumes etc. These foods are rich in antioxidants and anti-inflammatory components. We already know that eating lots of plants is good for us and can reduce the risk of developing something like Alzheimer’s (similar data exists for the mediterranean diet). However, high consumption of plants has also been linked to a statistically significant reduction in MND risk. The diet reduces levels of inflammatory markers like C-reactive protein (CRP) suggestion a reduction in chronic inflammation. In addition, omega-3 polyunsaturated fatty acids (PUFAs) found in plant-based sources like flaxseeds have been associated with neuroprotection and reduced MND risk. However, it is far too easy to say you are vegan and just consume highly processed meat replacements. This will not reduce your risk of anything. Furthermore, some studies show that there isn’t a significant difference in inflammatory markers between vegans and omnivores. This makes me wonder if the main thing is just to make your diet as fresh as possible. I am vegan and it has helped me overcome chronic illness but maybe the removal of processed foods is the most important thing here?
In summary, like with AD diet may play a potential role in managing and/or preventing MND, with various dietary patterns showing promise in reducing oxidative stress and inflammation. However, conflicting evidence and methodological limitations necessitate further research to clarify these diets’ efficacy and safety in MND management. Understanding individual variability and dietary impacts will be crucial in developing personalized nutritional strategies for MND patients. It’s definitely a ‘watch this space’ scenario.
Dr Sam Moxon
Author
Dr Sam Moxon is a Research Fellow at the University of Birmingham. His expertise falls on the interface between biology and engineering. His PhD focussed on regenerative medicine and he now works on trying to develop 3D bioprinting techniques with human stem cells, so that we better understand and treat degenerative diseases. Outside of the lab he hikes through the Lake District and is an expert on all things Disney.
Dr Jodi Watt
Dementia Researcher
Yasmin Bonsu
