Nutrition articles in "Nature Clinical Practice Neurology" (January & February 2009)

Because I work on a Neuroscience unit, I periodically scan the online neurology and neurosurgery literature for nutrition content. Recently I found these free, full-text articles in Nature Clinical Practice Neurology:

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• Food for thought    HTML   PDF

This editorial reminds us nutritional supplements "have real pharmacological effects, not all of which are desirable."  True, too much of a good thing (a nutrient) can be bad thing (work against other medications). I appreciate the editor's closing statement: "It is, of course, understandable that patients will want to pursue all available options for the treatment of their condition, but they need to be provided with realistic expectations of the benefits, as well as being informed of any potential risks."

Application to practice: Be empathetic to people's needs but truthful about what the best evidence tells us.

• The ketogenic diet, four score and seven years later   HTML  PDF   

This commentary discusses the findings of randomized controlled trials.

Application to practice: "The ketogenic diet should be considered in the treatment of children with refractory epilepsy, and not only as a last resort.

• Polyunsaturated fatty acids and their potential therapeutic role in multiple sclerosis  HTML  PDF 

Key points from this article:

■ Epidemiological studies demonstrate an association between saturated fat intake and the incidence of multiple sclerosis (MS)
■ In vivo studies demonstrate that polyunsaturated fatty acids (PUFAs) can exert anti-inflammatory effects through multiple, complex mechanisms
■ Controlled and noncontrolled trials have produced mixed results regarding the efficacy of PUFAs in MS; however, these trials have several limitations that could partially explain the lack of a treatment effect
■ Despite the lack of definitive evidence that PUFAs can be beneficial in MS, the anti-inflammatory potential of these agents is intriguing
■ The potential role of PUFAs as a treatment for MS should be further explored in proof-of-concept studies that use MRI-based outcome measures

Application to practice: Because these researchers believe more, better designed research should be conducted, I cannot discourage MS patients from modifying their diets or hoping some day we may find a nutrient or food that may make a difference in their disease progression, symptom management and/or quality of life; I would support them in making the healthiest fat choices by providing education.