Medical Hypotheses Medical Hyporheses (1991) 34. 272 - 274 0 Longman Group UK Ltd 1991

Lipids and Neurological


B.H. MARSHALL 1 13 Walters Lane,

lB, Itasca,

IL 60 143,


Abstract - Neurological diseases, such as multiple sclerosis (MS), Sjogren-Larsson syndrome, Reye’s syndrome, and Refsum’s syndrome (herediopathica atactica polyneuroformis), and many others afflict millions of persons yearly and have no successful treatment available. A common aspect of these diseases appears to be a lipid imbalance involving the essential fatty acids (EFA), linoleic and linolenic, and trace fatty acids which result from faulty lipid metabolism. It is proposed that treatments for these diseases should be sought through diet and metabolic enzymes rather than drugs.

Introduction From the evidence of EFA deficiency found in many neurological diseases, such as multiple sclerosis (MS) (1) (which afflicts me), cystic fibrosis, Sjogren-Larsson syndrome, Reye’s syndrome (2), and Refsum’s syndrome (3) (herediopathica atactica polyneuroformis), it appears that many neurological diseases are deeply involved in faulty lipid metabolism and can be better treated by dietary means than by drugs. In Refsum’s syndrome, the symptoms, which are surprisingly like MS - ataxia, absence of deep neural responses, polyneuritis, etc. - can be almost entirely overcome in 1 - 4 years of a diet of less than 10 mg daily of phytanic acid (3, 7, 11, 15 tetramethylhexadecanoic acid), a branched chain FA. The normal amount is 0.1 mg/dl or less, but it can rise to 200 mg, with fatal results. Today, 40 years after the delineation of treatment, no one knows how the healthy body metabolizes phytanic acid. Date received Date accepted

Trace fatty acids (FA) seem to be involved in many neurological diseases. When EFA are not properly metabolized, a trace fatty acid partially makes up the lipid mass and tries to fulfill the functions of the missing EFA. These functions are maintenance of cell ‘fluidity’ (flexibility), skin condition, and serving as precursors of prostaglandins. Now that laboratories are routinely equipped with capillary gas chromatographs and mass spectrometers, it is easy to check serum of patients against the norms established by Phinney et al (4). Since trace FA seem to cause most of the problems, they can be detected by the newer, more sophisticated equipment. Nausieda (5) categorized these diseases into lipid storage disorders, myelin disorders, systemic toxins, etc. This categorization will help researchers find the causes of neurological diseases. As a patient, I am more interested in finding treatments, which appears to mean finding

18 July 1990 20 August 1990



the metabolic enzymes which are lacking or malfunctioning in these diseases. The EFA are linoleic (18: 2~6) and linolenic (18: 3~3). In this shorthand way of writing them, the first number indicates the number of carbon atoms; the second, the number of double bonds or unsaturation; and the third, the family or series to which it belongs. The EFA belong to either the omega 6 or omega 3 family and are not interchangeable in form or function. They cannot be made by the body and must be ingested. The omega 6 family comes mostly from seed oils such as corn, cottonseed, sunflower seeds, etc. Fish oils provide the best source of omega 3 acids, but they are found in small amounts in other oils such as walnut and soy. Omega 3 lipids are absolutely essential for building and maintaining a healthy neural system. FA’s compete for metabolic enzymes with omega 3 being strongest, omega 6 next, followed by the






other families (6). This shows the vital nature of omega 3 acids. With the help of metabolic enzymes, lipids are elongated and desaturated, leaving double bonds where hydrogen atoms existed before in the FA chain. In MS, Holman and Johnson (1) show very abnormal amounts of branched and oddchain FA. The EFA are present in highly reduced amounts, which suggests that metabolism of EFA is incorrectly accomplished, leaving an inadequate lipid pool from which the oligodendrocytes make faulty myelin subject to attack by some unknown element, possibly a virus (6). Treatment is the most important next step. Ebers (7) said the cost in the USA of MS in 1975 was $5 billion, plus the pain and suffering of both patients and their families. Upon receiving preliminary reports of Holman’s studies in 1982, and using Refsum’s syndrome diets as a guide to branched chain FA, I

for MS patients

Dai1.v 3 tsp soy oil

1 multiple vitamin, mineral tablet I capsule 400 IU Vitamin E Foods allo wed

Root vegetables Winter squash Peeled fruit canned or fresh without pith or seeds Spices: ginger, pepper Strained fruit juices such as cranberry, apple, orange grapefruit Sodas of all types Skim milk, either dairy skim or mixed from powdered milk .Jelly but not jam Eggs - 3 per week Angel food or sponge cake but not pound cake Potatoes: baked or boiled, mashed without butter or milk, except skim Rice - white, but not brown Sweet potatoes Skinless white meat of chicken or turkey Lean fish without skin, at least twice weekly Tofu White bread Shrimp, crab, lobster, boiled not fried or in sauce

Foods to avoid

Fatty foods, fried foods Beef Lamb Pork Milk fat in any form Lowfat cottage cheese Sherbet Ice cream Whipped cream Butter Herbs: oregano, tarragon, sage, etc. any leaves of plants Cheese Unstrained orange juice Bananas All green vegetables Skin: animal, vegetable or fruit Yogurt or buttermilk Coffee, tea Mayonnaise Aspartame (diet soda, etc) Chocolate Whole grains as bread or cereal Popcorn Corn meal Corn

274 devised a diet (Table) low in branched chain FA, plus anything I could identify as bothering me, such as paprika. The object was to avoid eating FA that the body could not handle. I started the diet in 1984, when my MS had deteriorated to the point that my husband had to feed me nightly. Within a week, I could feed myself, and all other symptoms improved. I now have greatly improved bladder control, stamina, handwriting, voice strength and clarity, etc. The diet is not quite right. It is virtually impossible to eliminate branched and odd-chain FA, because most tables of lipid analyses combine the trace FA under ‘others’ of l-2%. These ‘others’ are the problem in neurological diseases and must be better identified. My success with even an imperfect diet should lead research into dietary treatment . Conclusion

Holman and Johnson (1) state the MS body cannot elongate beyond C 18 FA. This abnormality of metabolism calls for research into metabolic enzymes. Whether the abnormal metabolic products are toxic or the lack of correct FA causes the disease, is still unknown. However, a different approach in research is indicated. Years of effort to



treat MS as an autoimmune disease have had no solid success (8). The time has come to step into a new territory of research to solve the abnormalities identified by Holman. References 1.



4. 5.

6. 7.


RT, Johnson SB. Deficiencies of polyunsaturated fatty acids in plasma lipids in multiple sclerosis. Proc. Nat1 Acad Sci USA, 86: 4720-4724, 1989. Holman RT, Johnson SB. Essential fatty acid deficiencies in man, in Dietary Fats and Health (EG Perkins, WJ Visek, eds) American Oil Chemistry Society, Champaign, IL 1983. Eldjarn L, Stokke 0, Try K. Biochemical aspects of Refsum’s disease and principles of the dietary treatment, in handbook of Clinical Neurology, Vol 36, Part 1 (PJ Vinken, GW Bruyn, eds) North Holland Publishing Co., Amsterdam, New York, Oxford, 1979. Phinney SD, Odin RS, Johnson SB, Holman RT. Am J Clin Nutr 1989, in press. Nausieda P. Presentation of metabolic diseases, in Diseases of the Nervous System, Vol 1 (AK Asbury, GM McKhan, WI McDonald, eds) W.B. Saunders Co., Philadelphia, 1986. Holman RT. Nutritional and metabolic relationships between fatty acids. Federation Proceedings, 23(5), 1964. Ebers GC. Multiple sclerosis and other demyelinating diseases. p 1268 in Diseases of the Nervous System, Vol. II (AK Asbury, GM McKhan, WI McDonald, eds) W.B. Saunders Co., Philadelphia, 1986. Ebers, lot. cit. p 1276. Holman

Lipids and neurological diseases.

Neurological diseases, such as multiple sclerosis (MS), Sjögren-Larsson syndrome, Reye's syndrome, and Refsum's syndrome (herediopathica atactica poly...
222KB Sizes 0 Downloads 0 Views