• MS_Navigators Jul 01, 2014 9:45 AM

    July Discussion of the Month - Diet & Nutrition

    Maintaining good health is very important for people with multiple sclerosis. A well-balanced and planned diet can help achieve this goal, but with so many to choose from, and differing opinions on which are most effective, it can be a challenge to know where to start, let alone how to stick with one long enough to know if it’s helping.

    Join us for a conversation about diet and nutrition. Share your thoughts, tips and questions below. And then check back later this month as we chat with Denise Nowack, RD, and Ellen Mowry, MD, about your burning questions.

     

    ** Scroll down to see responses from Dr. Mowry and Ms. Nowack, and read their blog interviews here. **

     

  • cahill54
    cahill54 Jul 01, 2014 2:14 PM

    RE:July Discussion of the Month - Diet & Nutrition

    I have tried to find a diet specifically for MS, all i hear is to eat right, eat healthy...well if i knew what worked, i would give it a try. I'm on a limited income, no food stamps or government assistance, so organic is out of my income level. Any help?

  • travisgreen
    travisgreen Jul 01, 2014 3:00 PM

    RE:July Discussion of the Month - Diet & Nutrition

    I've been dealing with a new symptom lately(spasticity) and it's got me changing a number of things and one being diet. My wife gave me the book "the Wahls Protocol" which seems to suggest a no gluten diet.... Has anyone else read this? And if so how's it working?

  • AuntieB
    AuntieB Jul 01, 2014 4:54 PM

    RE:July Discussion of the Month - Diet & Nutrition

    I tried this diet. After attending an MS society exercise program for 12 weeks, the scale didn't budge. I decided to try a gluten free, (mostly) dairy free diet, knowing that I probably wouldn't be able to maintain it for an extended amount of time. I managed to lose about 10 lbs in 3 weeks. Felt pretty good and was actually sleeping better, which is one of my major problems. Then came my birthday, other celebrations, and blew the gluten free thing (I like cake lol!). I'm hoping to try it again after the 4th of July barbecues are over. The full-on Wahl's diet includes no gluten, no grains of any kind, no dairy, and wants you to eat organ meats (liver and heart - yuck!). I think one of the premises of the Wahl's book is that there is no real option for "cheating". The author implies that she loses all accumulated benefits if she cheats a bit. I think it (the gluten free option) might be something I can do for a while, but it isn't really going to be a permanent thing for me. The idea of permanently eliminating grains and dairy for my diet just doesn't seem feasible. Could this be an unhealthy "fad" diet? Sure, but I'm willing to give it a shot knowing that if my body needs grains or dairy, I will probably crave it. I'm not going to permanently deny myself any food group, but figure if I use it as a weight loss kick start, it won't hurt me.

  • christinerlb
    christinerlb Jul 01, 2014 7:37 PM

    RE:July Discussion of the Month - Diet & Nutrition

    Since being diagnosed my fiance's doctor told him to go gluten free, dairy free, and red meat free.  This has allowed to him to lose over 50 pounds within 4 months and has made a world of the difference in how he feels.  He also now takes Metanx, daily multivitamin, Vitamin D, and fish oil.  We are reading the Wahls Protocol now, she has an amazing Ted Talk about her experience, and all the additional reading we have done suggest a Paleo Diet.  The doctor has said he is doing so well that he might be able to lower the dosage of Rebif and eventually go off of it because he is sticking to the diet so well.  I highly recommend giving this a try it has given us such a great quality of life.  

  • christinerlb
    christinerlb Jul 01, 2014 7:39 PM

    RE:July Discussion of the Month - Diet & Nutrition

    And by no means is it easy to do the no gluten, dairy, or red meat nor is it cheap.  But what has really helped us is meal planning and having a constant supply of our go to meals in the fridge.  HE is just beyond disciplined with it because he sees this as a step in the right direction to live a longer healthier life for our family.  

  • nicseiler
    nicseiler Jul 03, 2014 5:59 AM

    RE:July Discussion of the Month - Diet & Nutrition

    When I was diagnosed with MS, I was following a fairly strict vegan diet. Before I began following my vegan diet, I was very strict vegetarian. So with that said, no matter how healthy I ate, I was still diagnosed with MS. I still believe in the health benefits of a plant based diet, whether one has MS or not. At this point I am not strict vegan, but still eat no meat products, except for some dairy and eggs. 

    I do prefer to focus on eating plant proteins (nuts, legumes, quinoa, soy) and various fruits and vegetables. I feel better when I get more of that in my diet than when I eat lots of carbs and dairy/eggs.  

    What's most important is to eat a balanced diet which is full of macronutrients that fits into your lifestyle and finances. I do understand that it is expensive to eat healthy, so one has to do the best they can. 

  • refusetoquit
    refusetoquit Jul 04, 2014 7:52 PM

    RE:July Discussion of the Month - Diet & Nutrition

    About The Wahls Diet............I started two year's ago with her book "Minding my Mitochondria" and began understanding the role of fruits and vegtables for the brain, for thr Myelin Sheath. Started ADDING proper nutritional eating with vitamin regiman(for all 16yrs I took vitamins but this tweeked it). Played around with glueten free but ended up without the OBVIOUS wheat products.I realized no dairy cleared my achne of which was hard to control with milk and cheese.  So, yes dairy was easy to switch with almond milk. WHOLE FOODS, no box prepared meals, or drive throughs.ALL THIS TOOK TIME TO TEST WITH MY SYSTEM 

    I've had MANY or practically all symptom's and now feel normal other than MS. This Wahls Protocol give's three levels that you work with......I'm now playing with level 3 as my MS continues the decline BUT 3X's better feeling.  As far as 'giving up' fav food's the craving's are gone and I don't particularly like them anymore. TRANSFORMATION is amazing. There's no 'easy way'.........if health is what you strive for.

    The next two year's should continue positive........Dr. Wahl's was walking in 4yrs, it's my 'goal', to give it my all which means .........'upping the anti' in my eating............or alway's wonder, WHAT IF or IF ONLY. I'm the only one that REALLY cares for me.............I'll end it here. LOL   

  • emilylanmoore
    emilylanmoore Jul 07, 2014 9:16 AM

    RE:July Discussion of the Month - Diet & Nutrition

    My doctor said that I should watch my sodium intake, but did not give any specifics.  How much sodium intake would you recommend for an MS patient?  Should I follow the American Heart Association guidelines?  Thank you!

  • amb2288
    amb2288 Jul 07, 2014 10:28 AM

    RE:July Discussion of the Month - Diet & Nutrition

    I've heard that the paleo diet can inhibit symptoms of autoimmune disorders including MS. There is so much research published arguing different points and I believe that a decent portion of the disease is individually based, however if the paleo diet can antagonize the MS process I would be willing to try it out! :)

  • flatbush78
    flatbush78 Jul 07, 2014 11:50 AM

    RE:July Discussion of the Month - Diet & Nutrition

    cahill54 wrote:

    I have tried to find a diet specifically for MS, all i hear is to eat right, eat healthy...well if i knew what worked, i would give it a try. I'm on a limited income, no food stamps or government assistance, so organic is out of my income level. Any help?



    Limit the intake of breads, pastas, potatoes and sugars. Eat lean meats, get rid of soda, drink things like Gatorade, Light V8 Fusion, water and other juices that are low in sugar, eat a lot of vegetables and fruits. You don't have to go organic to eat well. Also exercise, walk as much as you can, if you have a bike, ride when the weather permits. I use the trail close to my home and I walk twice a week. I bought a cheap bike and I ride when I can. If you are eligible for Medicare, look into Silver Sneakers. The diet for MS is a basic diet, no processed food, eat clean and cut down on the bad carbs like sugars and white flours.

  • riella84
    riella84 Jul 07, 2014 12:35 PM

    RE:July Discussion of the Month - Diet & Nutrition

    After being diagnosed back in 2012, I read a lot of articles and books that suggested giving up foods that you are intolerant to so decided to get tested and found I was highly intolerant to eggs, dairy and gluten. I have since given it up and the difference in my symptoms were amazing. I have had hardly any new symptoms or relapses. There have been instances when I do break my strict regime and my symptoms return within days!!  For me, following that strict regime has made a massive difference in my MS progression.  I've had an MRI scan recently and was told there are no new legions which was probably the best news I've heard in a long time.

  • maria1
    maria1 Jul 09, 2014 1:32 PM

    RE:July Discussion of the Month - Diet & Nutrition

    Ma, my stomach hurts.

    Are your bowels pen?

    Ma, my head hurts.

    Are your bowels open?

    Ma, I  scraped my knee.

    Are your bowels open?

    lol. As important as nutrition is, evacuating waste is what no one speaks to. Removing poisons from the body should be the forefront of good nutrition. Anything injested that impedes expelling toxins should be avoided. You all know what is least appealing to your own individual plumbing, let that be the first advance to a healthy diet. The brain needs plenty of oxygen, so if you drink a cup of coffee it is said you ought drink two cups of water to replace the oxygen the coffee depletes.

    Sometimes comfort foods ease the strain of living with ms and gives us a feeling of our old selves, if that is what is emotionally needed at the time, allowing the indulgence is good karma. Probiotics ought be considered to replace or maintain all that good flora in the gut, yogurt just won't cut it.

  • MS_Navigators
    MS_Navigators Jul 16, 2014 1:44 PM

    RE:July Discussion of the Month - Diet & Nutrition

    cahill54 wrote:

    I have tried to find a diet specifically for MS, all i hear is to eat right, eat healthy...well if i knew what worked, i would give it a try. I'm on a limited income, no food stamps or government assistance, so organic is out of my income level. Any help?

     

    Ellen Mowry, MD:

    At this point in time, there isn’t enough research to support one specific diet for people with MS. For my patients who are interested in pursuing dietary modifications, I usually suggest diets that may benefit their overall health and may impact their risk of developing other diseases, which in turn can make the MS worse.

    One diet that has been shown to be beneficial for overall health is a Mediterranean-style diet that includes less red meat, fewer refined sugars, healthier types of oils (such as extra virgin olive oil), lots of fruits and vegetables, whole grains, and more fish.

    Denise Nowack, RD:

    Eating well doesn't have to take a bite into your budget, either. A little work up front can save you time and money down the road. Here are some tips to keep a few pennies in your pocket without compromising your health.

    Have a plan. 

    Look for healthy recipe ideas using budget-conscious ingredients.  (Search the internet using the ingredient as the key word.)   Create a master shopping list to keep your refrigerator and pantry filled with staples that are quick and easy to cook, and kind to your wallet. These can include:

    • Pastas
    • Quick-cooking grains (like quinoa, couscous, brown rice)
    • Canned beans (a great source of fiber and protein)
    • Soups (choose reduced-sodium varieties)
    • Canned & frozen fish
    • Canned & frozen varieties of fruits and vegetables
    • Nonfat powdered milk (use when milk is needed as an ingredient in cooking)

     

    Shop smart. 

    • Clip coupons…or go online to look for discounts on the products you use most. 
    • Check your list and stick to it!  Resist the urge to pick up “extra” items from end-of-aisle displays or at the checkout counter.
    • Buy in bulk and store in ready-to-use portions.  If storage space is limited consider splitting packages with a friend to take advantage of volume savings.
    • Look for specials. Stock up on staples when they go on sale.
    • Take advantage of fresh fruits and vegetables in season.  For other produce, frozen and canned products can be good choices and just as nutritious as fresh.  Opt for low-salt products and avoid those prepared in sauces or with added sugar. 
    • Go generic.  Buying the store's brand of canned, frozen or bagged foods can provide great savings without compromising nutritional value.

     

    Make the most out of meals. 

    When you have the energy to cook, double up on recipes! Freeze the extra in oven-ready containers, or use later in the week for lunches or quick dinners. Leftovers from a roasted chicken at dinner can be reinvented the next night in as chicken pesto pasta or for lunch in a chicken salad.  Leftover vegetables can give canned soups, rice or pasta a nutritional boost.

    While precleaned and precut produce can save time and energy in the kitchen they can be more expensive than their standard counterparts.  Go for whole fruits and vegetables and cut them up yourself. Chop and package them in common portion sizes for the recipes you use most, or slice and store them for an easy snack. 

    Be a savvy snacker

    Healthy snacking can be your best friend in managing fatigue.  However, single-serving snack foods can be costly.  Save money and watch your waistline by making your own 100-calorie snack packs. Buy in bulk, pack in sealable bags or reusable containers and you’ll have a nutritious snack you can throw in your lunch bag. Here are a few suggestions:

    • 12-15 almonds
    • 7 walnuts
    • 25 pistachios
    • 11 cashews
    • 16 peanuts
    • 40 pretzel sticks
    • 10 walnut halves
    • 1/3 cup of whole-grain granola
    • 1 ¾ cup reduced-fat popcorn
    • 6 dried apricots
    • 12 mini-cheddar rice cakes
    • 15 chocolate-covered raisins
    • 10 baked corn chips


     

  • MS_Navigators
    MS_Navigators Jul 16, 2014 1:46 PM

    RE:July Discussion of the Month - Diet & Nutrition

    christinerlb wrote:

    Since being diagnosed my fiance's doctor told him to go gluten free, dairy free, and red meat free.  This has allowed to him to lose over 50 pounds within 4 months and has made a world of the difference in how he feels.  He also now takes Metanx, daily multivitamin, Vitamin D, and fish oil.  We are reading the Wahls Protocol now, she has an amazing Ted Talk about her experience, and all the additional reading we have done suggest a Paleo Diet.  The doctor has said he is doing so well that he might be able to lower the dosage of Rebif and eventually go off of it because he is sticking to the diet so well.  I highly recommend giving this a try it has given us such a great quality of life.  

     

    Ellen Mowry, MD:

    One thing that is fairly common when people receive a new diagnosis, is to make a lot of changes at the same time. Your fiancé made three major dietary changes, started four supplements, and started Rebif all at the same time. So, it’s hard to know if all of those particular changes had an impact on his MS. If he had tried two of the modifications would that be better or worse? Maybe it is the gluten-free diet that’s helping him the most? Or maybe it’s actually the Rebif? The goal of Rebif and other disease modifying therapies is to slow down or stop progression, in which case you may see fewer symptoms. While the decision to reduce or terminate a therapy needs to be made by a patient and his or her doctor, you could argue that the Rebif itself may have been a big contributor to his improved health.

    It could be that your fiancé’s weight loss is impacting the functioning of his immune system, if he was overweight prior to starting the diet. Recent studies looking at body mass index – a measure of carrying enough, not enough or too much weight – have demonstrated that children or adolescents who are overweight or obese have an increased risk of developing MS. The fat that we carry in our bodies produces a lot of hormones. It makes chemicals that can increase inflammation and impact the immune system. So, fat itself may be an active contributor to the functioning of the immune system in someone whose immune systems isn’t working correctly, perhaps making some of these chemicals or hormones and revving up the immune system in a bad way.

    With respect to each of these diets or any of the supplements, there really are very limited data to support any one of them as a definite helper for people with MS. There have been only very small studies of removing gluten from the diet. There has been one observational study – meaning it wasn’t randomized – looking at people who went on a gluten-free diet and they didn’t see any link between the diet and changing MS activity. However, that doesn’t necessarily mean that it won’t be helpful – it just means we need more research. 

    Unfortunately, the same is true for dairy and red meat: there really just aren’t great data. This answer can be frustrating – and it can be tempting to take matters into your own hands when food and supplements are readily available. However, it’s important to consider that anything you put into your body with the intention of changing your disease or your health is being used like a medication. And so, the same way that approved MS medications have to go through a rigorous research process, including clinical trials, so should diets and supplements. If something has the potential to impact your disease in a positive manner, it also has the potential to do harm.  We owe it to people with MS to study promising diet changes or promising supplements really carefully to make sure that when we make recommendations, we’re not contributing to the worsening of the disease.

    Denise Nowack, RD:

    If you’re concerned about your weight, it’s also important to look at what may be contributing to weight gain or inability to lose weight. Is your diet a contributor? And are your symptoms contributors? Depression can contribute to being overweight. Mobility and activity limitations can contribute to being overweight. Fatigue can be a contributor to being overweight. So just look at where symptoms may play a role and ask the question: when you experience this, how does this impact that way you eat? When you’re tired, what gets in your way of eating well?

    A Word About Gluten…

    Gluten is the protein component of wheat, rye and barley. Most of us have the ability to easily digest this protein. However in people who may be genetically vulnerable, the protein (gluten) creates an autoimmune reaction resulting in a condition called Celiac Disease. This triggers the body to attack itself inflaming and ultimately destroying the microvilli of the small intestine. Typical symptoms of true celiac disease include chronic diarrhea, fatigue, malabsorption that can lead to risk of osteoporosis due to non-absorption of calcium. This affects about 1% of the population.

    Gluten Sensitivity is believed to be a separate non‐immune mediated condition that has similar but less severe symptoms. In gluten sensitivity gluten is an irritant and the body acts to repel this irritant, but does not attack its own tissue. Some people only have a response to wheat but not all grains and that could relate back to an allergic reaction to just wheat.

    Scientific studies have shown that celiac disease occurs much more frequently in people with MS than in the general population, leading to speculation that a gluten‐free diet might help relieve MS symptoms. This may be true for those who are truly gluten intolerant, but not the MS population in general. If you are allergic to gluten grains, you will know for sure by observation and testing. Maintaining a detailed nutritional notebook is a great starting tool.
     

  • MS_Navigators
    MS_Navigators Jul 16, 2014 1:47 PM

    RE:July Discussion of the Month - Diet & Nutrition

    christinerlb wrote:

    And by no means is it easy to do the no gluten, dairy, or red meat nor is it cheap.  But what has really helped us is meal planning and having a constant supply of our go to meals in the fridge.  HE is just beyond disciplined with it because he sees this as a step in the right direction to live a longer healthier life for our family.  

     

    Denise Nowack, RD:

    This is a great strategy!

    I like to ask people to think about whether or not they have the tools to be successful. Do they understand enough about where they want to be and the things they want to change? And if they’re looking to change things, I encourage taking mini-steps. Making drastic changes can work for some people, but we know this from weight management literature that most people keep up with it for a period of time, but are not able to sustain it. So, if you make a plan to change your diet, what are the things that they want to conquer first? When you are successful at that, what is the next step?

    Do you have support in this process? What are the barriers going to be? What is your plan when you bump up against those barriers? For example, if your family isn’t on board, it’s going to be much more challenging. It’s important to have a back-up plan in place so that you don’t get sabotaged. I’m a big fan of taking smaller steps and being successful around those steps and in finding strategies – which might be different from person to person – that work for you.

    [You can find more tips in my response to cahill54’s question above.]


     

  • MS_Navigators
    MS_Navigators Jul 16, 2014 1:48 PM

    RE:July Discussion of the Month - Diet & Nutrition

    emilylanmoore wrote:

    My doctor said that I should watch my sodium intake, but did not give any specifics.  How much sodium intake would you recommend for an MS patient?  Should I follow the American Heart Association guidelines?  Thank you!

     

    Ellen Mowry, MD:

    There was an interesting recent study about salt in the mouse version of multiple sclerosis. (It’s important to state that findings from the mouse type of MS don’t always translate to humans.) In this particular study, they fed mice a high salt diet, and found that those mice were at increased risk of developing the mouse type of MS and that the disease was more severe. That said, the data in humans are pretty limited at this point. Early studies are starting to look at this in people with MS. Hopefully we’ll know more in the near future.

    Anyone who wants to modify salt intake on his or her own should first talk to their primary care provider. Salt has a lot of implications for other diseases like kidney disease, heart disease, and high blood pressure. Unfortunately, there isn’t a one size fits all recommendation for the global MS community.

    Denise Nowack, RD:

    If you’re trying to control your sodium intake understand that one-third of the sodium in our foods mother nature puts there, the other two-thirds we add ourselves or manufactures add to the foods we eat. Be aware that processed foods can be higher in sodium and salt. Buy low-sodium versions of canned tomato sauce or tomatoes, as well as broths and stocks. I buy packaged grain products that are easy and quick to cook, but I might leave the seasoning packet out or use only half of it.


     

  • MS_Navigators
    MS_Navigators Jul 16, 2014 1:53 PM

    RE:July Discussion of the Month - Diet & Nutrition

    AuntieB wrote: I tried this diet. After attending an MS society exercise program for 12 weeks, the scale didn't budge. I decided to try a gluten free, (mostly) dairy free diet, knowing that I probably wouldn't be able to maintain it for an extended amount of time. I managed to lose about 10 lbs in 3 weeks. Felt pretty good and was actually sleeping better, which is one of my major problems. Then came my birthday, other celebrations, and blew the gluten free thing (I like cake lol!). I'm hoping to try it again after the 4th of July barbecues are over. The full-on Wahl's diet includes no gluten, no grains of any kind, no dairy, and wants you to eat organ meats (liver and heart - yuck!). I think one of the premises of the Wahl's book is that there is no real option for "cheating". The author implies that she loses all accumulated benefits if she cheats a bit. I think it (the gluten free option) might be something I can do for a while, but it isn't really going to be a permanent thing for me. The idea of permanently eliminating grains and dairy for my diet just doesn't seem feasible. Could this be an unhealthy "fad" diet? Sure, but I'm willing to give it a shot knowing that if my body needs grains or dairy, I will probably crave it. I'm not going to permanently deny myself any food group, but figure if I use it as a weight loss kick start, it won't hurt me.

     

    Ellen Mowry, MD:

    To me, any diet that hasn’t been tested in the form of a randomized trial, has not met the qualifications for me as a physician scientist to recommend that diet to a patient as a way of modifying their disease course. Since the Mediterranean diet, for example, has been shown to be of benefit for overall health, I can stand behind it.

    Eating food is really one of the great pleasures of life. And I don’t have MS, but I can imagine that it’s a pretty big pill to swallow to just get a diagnosis of MS. You already have so much to think about and worry about. If there is not a definite benefit or enough scientific data to really show you that cutting out a pleasurable part of your diet it will really help your MS, I’d hate to add one more thing to that list.

    Denise Nowack, RD:

    I agree. It’s hard enough to try to maintain positive lifestyle habits in the best case scenario, and then you overlay MS which can throw up barriers constantly and cause setbacks despite your best intentions.

    While it’s easy to say, “eat x, y and z,” some diets can be expensive and difficult to maintain – and not everyone can access fresh foods. It’s important to be practical and consider what it takes to be successful.

    Whenever possible, it’s great to eat fresh fruits and vegetables. When considering protein sources, pay attention to portion sizes and make lower fat choices. Choose fish and poultry more often over red meat and opt for leaner cuts when you do. Prepare foods with little or no added fat and – healthy oils as a replacement for butter or margarine and low or nonfat dairy products.  If you’re managing constipation, you may want to include more fiber-rich foods (i.e. legumes, whole grains, nuts, seeds). If you’re living with other health conditions such as cardiovascular disease, watch out for diets that are high in saturated fat.


     

  • naneus
    naneus Jul 17, 2014 8:12 AM

    RE:July Discussion of the Month - Diet & Nutrition

    I have been a vegetarian for 21 years and exercise regularly. My neurologist is very impressed with how well I am doing after 20 years with MS.

  • fight4yourlife
    fight4yourlife Jul 17, 2014 8:53 AM

    RE:July Discussion of the Month - Diet & Nutrition

    I am making a cheap kale smoothie 2 times a day.  I keep it cheap by growing my own kale in a large bucket.  I supliment by buying kale in bulk.  I just mix kale with an Apple and a banana in a blender.  This is cheaper the about anything.  I hope this helps.