Department of Internal Medicine, University of Iowa, Iowa City, IA 52242, USA.
Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA.
Nutrients. 2019 Mar 1;11(3):537. doi: 10.3390/nu11030537.
Multiple sclerosis (MS) is a demyelinating disease that attacks the central nervous system. Evidence-based dietary guidelines do not exist for MS; the default advice is to follow the Dietary Guidelines for Americans (DGA). A modified Paleolithic Wahls Elimination (WahlsElim) diet promoted for MS excludes grains and dairy and encourages 9+ cups fruits and vegetables (F/V) and saturated fat for cooking. This study evaluated the nutritional adequacy of seven-day menus and modeled them with varying amounts of F/V for comparison with the DGA Healthy US-Style Eating Pattern (HEP) for ages 31⁻50 years. WahlsElim menus had low added sugar and glycemic index. Nutritional adequacy of the menus and modeled versions were similar to HEP for 17 vitamins and minerals (mean adequacy ratio ≥92%). Nutrient shortfalls for the modeled diet with 60% F/V were identical to HEP for vitamin D, iron (females), magnesium (marginally males), choline and potassium; this modeled diet was also low in dietary fiber and calcium but met vitamin E requirements while HEP did not. WahlsElim-prescribed supplements corrected vitamin D and magnesium shortfalls; careful selection of foods are needed to meet requirements of other shortfall nutrients and reduce saturated fat and sodium. Doctors should monitor nutritional status, supplement doses, and possible contraindications to high vitamin K intake in individuals following the WahlsElim diet.
多发性硬化症 (MS) 是一种脱髓鞘疾病,攻击中枢神经系统。目前尚不存在针对 MS 的循证饮食指南;默认的建议是遵循《美国人饮食指南》(DGA)。为 MS 推荐的改良原始人沃尔希饮食 (WahlsElim) 禁止食用谷物和奶制品,并鼓励食用 9 杯以上水果和蔬菜 (F/V) 以及用于烹饪的饱和脂肪。本研究评估了 7 天菜单的营养充足性,并对其进行了不同数量 F/V 的建模,以与 31⁻50 岁年龄段的 DGA 健康美国饮食模式 (HEP) 进行比较。WahlsElim 菜单的添加糖和血糖指数较低。菜单和模型版本的营养充足性与 HEP 相似,有 17 种维生素和矿物质(平均充足率≥92%)。在 F/V 占 60%的模型饮食中,维生素 D、铁(女性)、镁(男性边缘)、胆碱和钾的摄入量与 HEP 相同;这种模型饮食还缺乏膳食纤维和钙,但满足了维生素 E 的需求,而 HEP 则没有。WahlsElim 规定的补充剂纠正了维生素 D 和镁的不足;需要仔细选择食物,以满足其他不足营养素的需求,并减少饱和脂肪和钠的摄入。医生应监测遵循 WahlsElim 饮食的个体的营养状况、补充剂量和可能存在的高维生素 K 摄入的禁忌症。