Diet And Nutrition In MS

There are several diets that claim to help with the symptoms of MS.

The two main ones are The Best Bet Diet and The Swank Diet.

Ashton Embry’s Best Bet Diet (BBD)

Ashton Embry has based his diet on the theory that an autoimmunity process is ignited by undigested food proteins escaping through the gut wall and into the circulatory system. This causes the immune system to attack the ‘invaders’. This process is known as Leaky Gut Syndrome.

Ashton Embry believes that the molecular structure of parts of the protein of certain foods is very similar to parts of the proteins in myelin. The immune system cannot tell the difference between these ‘invaders’ and its own cells and so attacks the myelin as well as the invaders.

The Best Bet Diet

• Dairy – Avoid all animal milks and all butters, cheeses and yoghurts made from animal milks and all products that contain them. A suitable alternative is rice milk or low fat coconut milk.
• Gluten – Avoid all wheat, rye and barley and all products containing them. It is advised that oats are also avoided. These can be replaced by rice, corn, quinoa and gluten-free flours and grains.
• Legumes – Avoid all beans, peas and pulses, especially soya, and all products containing them. All other vegetables are allowed.
• Refined Sugar – avoid where possible as this can make leaky gut worse and can also affect the immune system. More acceptable alternative sweeteners are honey, maple syrup, fruit sugar (fructose) and stevia.

As an additional precaution, it is suggested that an ELISA blood test is carried out (further details below) to identify which foods have escaped across the leaky gut (if any) in the past. There may be a hypersensitivity issue which is contributing to the leaky gut syndrome.

The Best Bet Diet also recommends taking a number of supplements (some of which are detailed below).

For more information about the Best Bet Diet, please visit the Best Bet Diet pages.

The Swank Diet

Another diet which people with MS have found beneficial is the Swank Diet. Dr Roy Swank began his research over 60 years ago. Below are the basic principles of the Swank diet:

Swank Quick Reference guide

• Eat no more than 15g of Saturated fat a day
• Have between 20-50g of unsaturated fat per day
• Eat no red meat whatsoever for the first year on the diet
• After the first year, eat no more than 3oz (85g) of red meat per week
• Avoid dairy products which contain more 1% butterfat
• Avoid processed foods which contain saturated fat
• It is recommended you take 1 tablespoon (or capsule equivalent) of Cod Liver Oil and a multivitamin & mineral supplement daily

For more information about the Swank diet, please visit The Swank Diet page. Alternatively you could visit the Swank diet website - http://www.swankmsdiet.org/

Please note this list is not exhaustive and these are not the only diets those with MS have found beneficial, however these are the main diets specifically designed with MS in mind.

Leaky Gut Syndrome

What is Leaky Gut?
A leaky gut is when the lining of the intestine becomes permeable like a sieve.

This allows partly digested food to pass through and into the bloodstream.

It also means that nutrients are not absorbed properly.

Typical symptoms of leaky gut include:

• Fatigue
• Muscle Ache
• Abdominal pain
• Raised temperature
• General malaise
• Food Allergies
• Candida
• Poor exercise tolerance

How do you test for Leaky Gut?
The standard test for leaky gut is the mannitol and lactulose test. Both of these substances are not used by the body. Mannitol is easily absorbed by someone with a healthy gut. Lactulose is only slightly absorbed. The test involves drinking a solution containing both these substances and then having a urine test 6 hours later. The amount of each substance in the urine is measured. If high levels of both mannitol and lactulose are detected then this indicates a leaky gut condition.

What causes Leaky Gut?
Leaky gut could be caused by a number of things including Candida, nutritional deficiencies, refined sugar, stress, trauma, alcohol or tobacco.

How do you treat Leaky Gut?
You can take supplements such as:
• Glutamine - the main fuel for cells of the intestine and promotes healing of the gut lining.
• Probiotics, for example Lactobacillus bifidus – friendly bacteria which counteract the bad bacteria or Candida and boost the immune system.
• Antioxidants – e.g. Proanthocyanidins from grape seeds, Pycnogenal from pine bark, Vitamin C, Vitamin E
• Gingko Bilboa
• Zinc
• Cats Claw
• Slippery Elm

Candida

What is Candida?
Candida is a fungal overgrowth of the gut, where the natural fungus of the gut gets out of control and overloads the immune system. In Candida, the normal yeast has changed into a parasitic fungus which penetrates the bowel, causing little holes which in turn causes leaky gut syndrome.
Typical symptoms of Candida include:
• General malaise
• Low energy
• Bloated and heavy gut

What causes Candida?
Candida can be caused by the over-use of antibiotics, the contraceptive pill, long term use of steroids and some other drugs which can destroy the healthy gut bacteria. Yeasts, parasites and bacteria may also be a trigger.

How do you test for Candida?
A simple home testing kit is available to test for Candida. (See ELISA tests below)

How is Candida treated?
To treat Candida, the fungal overgrowth needs to be controlled and the balance of healthy bacteria in the gut restored. As Candida feeds on things which are sweet, fungal and fermented, a change in diet can help.

The Anti-Candida Diet
Avoid:
• Yeast, Bread & Pastries
• All fermented products
• Alcohol
• Sugar
• White Flour
• Citrus fruit juices
• Milk
• Processed and Smoked Meats and Fish
• Dried and Candied Fruits
• Melons, Ripe Bananas and Grapes
• Mushrooms and all fungi
• Cheese
• Drugs which promote the growth of yeast e.g. steroids, antibiotics, the contraceptive pill
• Coffee and Tea

Other ways to treat Candida include grapefruit seed extract, Camomile, Redbush tea and Oxygen Therapy

ELISA Testing

An ELISA test is a blood test for food intolerances. MSRC currently offer two options for ELISA tests – Cambridge Nutritional Sciences & York Labs. Both are available worldwide.

They are home tests and there is no need to visit a doctor to have a sample taken or to have the results analysed.

A special kit will be sent to your home, from the lab, and all that is needed is a thumb prick to release enough blood to soak a small swab.

The test results will show if you are intolerant to 113-120 foods (depending on which option you chose) and to which degree you are intolerant.

Cambridge Nutritional Sciences also offer a Candida Albicans test which can be done at the same time as the Elisa test.

ELISA testing is also available for vegetarians and Vegans are a reduced rate.

For more information about these tests please contact the MSRC office.

Supplements

There are a number of supplements which have been found to be beneficial. The most common are listed below, however for a more comprehensive list, please visit our website.

Vitamin D
Some research suggests that there is a link between MS and Vitamin D deficiency. It is important Vitamin D3 is taken and not D2. This is because D3 is the natural form and not a synthetic supplement. It is recommended that a daily Vitamin D3 supplement of 5000IU is taken.

However, exposure to ultraviolet B (UVB) radiation in sunlight is the most effective way to boost Vitamin D supply and as little as 15 minutes in the sun a day will increase Vitamin D levels without increasing the risk of cancer. Below is an extract from a recent consensus statement released by a number of societies including Cancer Research UK:

“This consensus statement represents the unified views of the British Association of Dermatologists, Cancer Research UK, Diabetes UK, the Multiple Sclerosis Society, the National Heart Forum, the National Osteoporosis Society and the Primary Care Dermatology Society. Vitamin D is essential for good bone health and for most people sunlight is the most important source of Vitamin D. The time required to make sufficient Vitamin D varies according to a number of environmental, physical and personal factors, but is typically short and less than the amount of time needed for skin to redden and burn.

Enjoying the sun safely, while taking care not to burn, can help to provide the benefits of Vitamin D without unduly raising the risk of skin cancer. Vitamin D supplements and specific foods can help to maintain sufficient levels of Vitamin D, particularly in people at risk of deficiency. However, there is still a lot of uncertainty around what levels qualify as “optimal” or “sufficient”, how much sunlight different people need to achieve a given level of Vitamin D, whether Vitamin D protects against chronic diseases such as cancer, heart disease and diabetes, and the benefits and risks of widespread supplementation.”

Calcium and Magnesium
These minerals are both essential to the normal function of muscles, not only in muscle contraction but also in maintaining an appropriate level of muscle tone during periods of relaxation. The occurrence of muscle cramp, due to spasm, is well known to be associated with calcium deficiency. The recommended daily dose is at least 1000mg of Calcium and 500mg of magnesium.

Omega 3 & 6
Omega 3 and Omega 6 are essential fatty acids.

Omega 3 is needed for the normal function of the nervous system and the production of myelin.

Omega 6 helps to regulate the immune system and has anti-viral properties.

These essential fatty acids can be found in the following supplements:

• Fish Oil Supplements (e.g. cod liver oil) - High in Omega 3
• Evening Primrose Oil or Starflower Oil – Both are high in Omega 6
• Flax Seed Oil or Hemp Seed Oil – both contain a good balance of both Omega 3 and Omega 6

B Vitamins
The B Vitamins are needed for the normal functioning of the nerves and brain and for the repair and maintenance of tissue. Vitamin B12 in particular is needed for a healthy myelin sheath, nervous system and bone marrow. A deficiency of Vitamin B12 can adversely affect the processes of the immune system. It is recommended that 100mg of Vitamin B complex and 1mg of Vitamin B12 is taken to ensure optimum levels of these important vitamins.

Further Information

If you accept that MS is an autoimmune disorder, in other words a condition where the individual's own immune system attacks the myelin in the central nervous system, then what is unknown is what kick-starts this attack on self. However, there is a serious and credible scientific argument that undigested food proteins, leaking into the bloodstream through the gut wall may well be the culprit.

Once in the bloodstream, the argument goes that the body's immune system sees these intact food proteins as invaders and commences an attack against them. However, as part of the protein in myelin closely resembles parts of the proteins in some common foods, namely dairy, gluten and legumes, a case of mistaken identity results in an attack on the myelin in the CNS. A lack of omega 3 and vitamin D, together with an abundance of omega 6 and saturated fat in the diet, contributes to this immune system malfunction.

The scientific data linking nutritional factors to MS onset and progression are so robust, that Dr. Peter Seland, the Chair of the Medical Advisory Committee of the MS Society, Calgary, Canada, conceded that he "cannot assure persons with MS that common foods such as dairy, gluten (wheat, rye) and yeast are safe in regard to MS."

Having weighed up all the evidence, we at The MSRC feel that it is better to adopt a "better safe than sorry" approach and provide all the current information on possible links between diet and MS!

Diet, another important factor, however is still being widely ignored. Yet when you actually study the epidemiology of MS you discover that the only environmental factors which correlates and explains the prevalence of MS in various parts of the world alongside Sunshine, is diet. In high prevalence areas the diet is generally high in dairy, cereal, grain and saturated fat content. In places where the consumption of dairy, cereal grain, and saturated fat is low, and the intake of fish is high (containing Omega 3 EFAs) the prevalence of MS is generally low.

There is also an overwhelming amount of supportive anecdotal evidence to back the MS-Diet link from people with MS, living their lives, making changes to their diet and getting results, stabilising, gradually improving or even recovering from MS. The UK internet based Best Bet Diet Group has over 130 members world-wide and are getting results!  

Added to this, Dr Ashton Embry’s scientific theory, as to how diet may affect the onset and progression of MS is highly plausible. From Ashton’s work has sprung the charity Direct MS (Dietary Research into the Cause and Treatment of Multiple Sclerosis), set-up in Canada by people with MS and their families, determined to raise the money for properly conducted research trials. After many years of fundraising they have at long last achieved their goal of raising $175,000 - enough money to start carrying out proper scientific 'Best Bet' dietary research trials. It will be at least another five years however before the results of this trial become available.

So plausible is Ashton’s theory that Dr. Peter Serland, Head of Research for MS Society in Canada has had to admit that he cannot assure people with MS, that foods such as such foods as dairy, gluten and yeast are safe to eat.

Imagine if a city official suddenly announced that he could not guarantee the safety of your tap water. Everybody would be demanding that the city determine beyond a doubt if the water was safe or not and in the shortest possible time.

Many University Academics agree.

"There is no doubt that clinical trials with diet are needed" states Prof. Christine Williams. "There is sufficient indication that diet could be an effective modulator for this disease that affects many young people." 

Prof. Bill Hardcastle states

"We are establishing in the Faculty of Health Sciences here at Queen Margaret University College, a Centre of Complementary Medicine and we have number of high profile people very interested in this initiative."

Dr. Peter McCaffery adds

"MS is disproportionately prevalent in Northeast Scotland, and diet was the suggested explanation offered by a lady I used to know whose husband suffered from it."

Dr Carsten Timmermann also offers support

"I think that personal experience with things like diet is often just as valid as, if not more than what you may want to call systematic science."

But sadly such anecdotal evidence though valid is meaningless in the real world of science.

Prof. D. A. Ledward enlarges on this problem.

"We all of course accept that diet plays a crucial role in many illnesses but unfortunately trials to confirm most of these relationships because of our biochemical individuality, make them very expensive to prove to any degree of acceptable significance."

However, though difficult, it is possible to reduce the number of variables and produce valid scientific results, it is just very expensive and herein lays the real problem. In order to secure funding a researcher have to submit a proposal in this area. As there is very little money to be made from proving that people can make themselves better through simple supplemented dietary change, it is almost impossible to find sponsors willing to fund such a venture.

Prof. Christine Williams gives her honest view on this matter

"The real reason that such studies are not done is that they lack the high tech glamour and required impact on 'wealth creation'."

Prof. Charles Warlow adds

"I’m afraid the power of the drug companies has distracted many MS researchers away from diet, and other non-drug issues."

He clarifies the situation further.

"There is a general problem with the evaluation of non-drug treatments for many disorders, and MS is no exception. It is much easier for a researcher to do a drug company sponsored drug trial than raise funds to do a serious trial of dietary interventions. This is not to blame industry. They are doing what they have to do in a competitive market. The problem lies with government which is not prepared to redress the balance and fund research into interventions of no commercial interest."

Maybe we could accept this if all the money drugs companies ploughed into long term laboratory research studies on such subjects as genetics, molecular biology and immunology, were producing results that actually helped people with MS.

But the irony is, as Prof. Williams rightly points out,

"After all the money put into developing beta-Interferon it cannot now be prescribed for most MS patients because it is too expensive and only effective in small numbers of people. Better perhaps to fund diet trials, which could result in cost effective treatment for more people?"

 Prof. Warlow adds,

"Patients themselves, and our MS Society, have become obsessed with beta interferon, even though any effect is marginal at best." 

That is why it is our responsibility to raise awareness not only among ourselves, but we must also tell the government by writing to our MP’s, people who have money and can pull strings and make things happen. We must suggest diet as a realistic alternative and even a possible solution to their current dilemma with Beta-interferon and highlight the urgent need to secure funding the diet research trials. We must also lobby our MS Society as they too have the resources to fund such research and the power to raise awareness and change lives. Isn’t it about time that doctors will at last be able to provide peoples with MS with reliable information on that frequently asked question "Does diet play a role in MS?"

The current answer provided by the Society and Neurologists of "We do not know" clearly is not adequate. We am not suggesting that diet is the whole answer but it is an important part of the jigsaw puzzle of MS that needs to be fitted to help us gain a clearer picture and prevent more people than necessary falling victim to MS, through lack of awareness.

Further Information

• For further info on the Dietary Research Publicity Campaign please phone 01506 491441.

Our thanks to:

• Professor Christine Williams, Nutrition Unit, University of Reading
• Professor William Hardcastle, Dean of the Faculty of Health Sciences - Queen Margaret University College London
• Dr. Peter McCaffery, Cultural History Group, University of Aberdeen
• Dr Carsten Timmermann, Welcome Research Fellow, Centre for the History of Science, Technology & Medicine, University of Manchester
• Professor D.A. Ledward, Head of the Dept. of Food & Science Technology, University of Reading
• Professor Charles Warlow, Dept. of Clinical Neurosciences at Western General Hospital, University of Edinburgh.

© Multiple Sclerosis Resource Centre (MSRC)