Multiple Sclerosis Newsletter

Multiple Sclerosis Newsletter
Northern Colorado Edition

February - March 2004

Research Updates

RESEARCHERS REPORT POSSIBLE LINK BETWEEN VITAMIN D INTAKE AND REDUCED RISK OF MS
NMSS Research Bulletin (1/16/04)

Summary: A new study in nurses suggests that those with higher vitamin D intake may have had a reduced risk of developing multiple sclerosis.

Details:A new study in nurses suggests that those with higher vitamin D intake may have had a reduced risk of developing multiple sclerosis. Kassandra Munger, MSc, and colleagues (Harvard School of Public Health, University of California at Irvine) report their findings in the January 13, 2004 issue of Neurology.

Background: The cause of multiple sclerosis, which involves immune attacks against the body's own brain and spinal cord tissues, is unknown. Worldwide, MS occurs with much less frequency in lower latitudes closer to the equator, than in higher latitudes, further away from the equator. It is thought that there may be genetic, infectious, and environmental factors that increase or decrease an individual's risk of developing MS.
One of several possible "protective" factors at work in lower latitudes which are being explored is the increased sunlight exposure in these areas and the resulting increase in the body's production of Vitamin D. Vitamin D is available not only through sun exposure but also from nutritional sources and vitamin supplementation.
In general, Vitamin D helps the body use calcium. In addition, immune cells have been shown to be influenced by vitamin D, and preliminary research suggests that vitamin D can alter immune attacks in mice with MS-like disease.

Study: To investigate the relation between vitamin D levels and the risk for developing MS, Dr. Munger's team used the database from the Nurses' Health Study I and Nurses Health Study II, which regularly surveys female registered nurses about their history of disease and lifestyles. For this study, the investigators focused on dietary assessments from 187,563 of the participants. The study included 173 women diagnosed with probable or definite MS after their enrollment in the Study (between the ages of 30-55 for NHS I or 25-42 for NHS II). Vitamin D intake was determined through the Nurses' Health Study questionnaire and four one-week diet records, which included queries about diet and use of dietary supplements. Blood levels of vitamin D were examined, and analyses were performed to determine other factors that might affect the results, such as latitude of the subject's birth place and smoking (members of this research group reported an increased risk of MS among nurses who smoked in the October 28, 2003 issue of Neurology.)

Results:Women whose intake of vitamin D was greater than or equal to about 400 IU/day (the amount usually contained in multivitamin supplements), from either supplements - mostly multivitamins - and food, or from supplements alone, had a 40% lower risk of developing MS than those women who did not take vitamin D supplements. No reduced risks were found for vitamin D intake from food alone. Further analyses of smoking habits and birthplace did not affect these results. There is no information information in this study to determine whether vitamin D affects the course of MS once it has begun.

Importantly, vitamin D intake was strongly associated with intake of other components of multivitamins, including vitamins A and E and folic acid. Therefore, it was not possible for the group to analyze the effects of vitamin D intake independently from these other vitamins. The authors note that the strongest evidence to date implicates vitamin D, and suggest that this vitamin seems to be the most likely candidate for association with reduced risk of MS.

Conclusion: This study adds new information to ongoing research focused on a possible role for vitamin D in reducing the risk of developing MS. Further research is necessary to clarify these findings, for example: What is the role of vitamin D versus other vitamins? Do these findings apply to men as well? Can vitamin D alter the course of existing MS?

The National MS Society is funding several researchers investigating the possible association of sunlight exposure, vitamin D and the risk of MS, including:
* Alberto Ascherio, MD DrPH (a member of this Harvard team), who is testing whether higher vitamin D concentrations in the blood are associated with a lower risk of MS
* Anthony J. McMichael, MBBS, PhD (The Australian National University, Canberra), who is investigating whether increased sunlight exposure and consequent increased production of vitamin D reduces the risk of developing MS
* Colleen E. Hayes, PhD (University of Wisconsin-Madison), who is examining how a hormone the body produces from vitamin D, called calcitriol, impacts an MS-like disease in mice

EXERCISE YOUR MS MIND!
Linda Irwin, MS Active Source (12/1/03)

Just like your muscles, your brain needs exercise too. Just like your legs, your brain can get flabby. Just like your arms, your brain needs to be kept active.

You don't have to do 25 repetitions of trigonometry, solve The New York Times' Sunday crossword puzzle, or memorize the names of all our nation's presidents in order. Brain exercises are not complicated; they're enjoyable and can make a real difference. Here are some suggestions to consider:

1. Read the newspaper - the weekly and daily editions. The last time I checked the statistics, newspapers were written on a 7th grade level. You can handle that! (Note: If the negative news gets you down, only read the positive sections. Enjoy the comics, advice column, recipes, and home section.)

2. Read a book. I know that sounds like a rather simple suggestion, but that book will help you with memory and sequencing and you might even learn something in the process. A book is good company. It takes you into the lives and times of its characters and entertains you. You can lie down to read, too. Books on tape are even easier to "read"!

3. Buy an easy, jumbo print crossword puzzle book. It isn't important to test your vocabulary skills as much as it is to keep the ability to recall everyday words. For those of you who don't like to cook, the answer to "part of a stove" is "oven"'; for the sports fan, "a skater's jump" is "axel"; and, for those with little ones or little "grand" ones, "baby's seat" is "lap"! Keep the books easy and have fun! (P.S. If you really get stuck, the answers are in the back of the book.)

4. Haul out that old flute or set of drums or dust off the piano and stat playing again. You can hit those notes when no one is home, behind the door of a soundproof room, or hope your family really loves you as you play in the living room. Keep it simple, take it easy, and remember that if music helps increase a child's reading and math skills, it can help you too.

5. Attend plays and concerts. They stimulate your senses, get you out of the house, and provide afternoons or evenings of enjoyment.

6. Turn off the television! Television is not an interactive device. You can become a vegetable, sitting in front of the tube for hours at a time. Perhaps the home decorating channel will spur you to do something about the awful color of your bathroom. I guess that's OK. There are a few other channels with redeeming qualities, but be careful!

7. Become other-person centered. Other people have problems too. There are people in our town or on your block that would love a phone call, a note, or a silly little card from you. This gesture can brighten their day and, in turn, brighten yours.

8. Keep a journal or diary. You can type it on the computer, write in a notebook (the ones with wideruled lines), or record it on tape. Oh, and be sure to write or say the date. This helps you remember too. Be sure to mention positive thoughts, such as the beautiful weather, the delicious meal your husband cooked, and the "good days" you've had.

9. Observe the world around you. Note the leaves on the trees, the way the sun lights up the corner of your house, or how the birds are already changing color in preparation for winter.

10. Remember this sage advice: You only live once. But if you work it right, once is enough." - Joe E. Lewis

SUNSHINE MAY PROTECT AGAINST MULTIPLE SCLEROSIS
British Medical Journal 2004 Jan 13

Sunshine may protect against the development of multiple sclerosis, suggests a study in the Journal of Epidemiology and Community Health.

The exact causes of MS are unknown, but it becomes more common the further away from the equator people live in both the southern and northern hemispheres.

To test their theory that sunshine may itself be an important factor, the authors analyzed data from hospital records and death certificates to assess the prevalence of skin cancer a proxy for prolonged exposure to sunshine in the former English health service region of Oxford.

Records spanning over 30 years from 1963 up to 1999 of people with MS and other autoimmune or neurological diseases were included in the study.

The results showed that rates of cancer in general were not especially low among the 5000 people with MS. If anything, they were slightly higher than would be expected, based on comparative figures for the general population.

Cancer rates among the 430,000 patient with other immune related or neurological diseases were as would be expected for the general population. But the prevalence of skin cancers in people with MS was significantly lower than average. This deficit was greater for skin cancer than melanoma. Melanoma is the deadliest form of skin cancer, and the one most likely to occur as a result of intense but brief periods of exposure to very hot sun. Other skin cancers are more closely associated with prolonged, continuous exposure to sunshine. A minimum level of exposer throughout the year might therefore be important in conferring protection, suggest the authors.

The body's immune system acts against nerve cells during the development of MS. And the authors conclude that sunshine might protect against the development of MS by beneficially influencing the immune system response, possibly through changes to the production of vitamin D and melatonin, the substance involved in acquiring a tan.

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*This material is provided as general medical information and is not intended as advice for individual patients;
please contact your physician for specific recommendations.

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