← Living Well with Multiple Sclerosis
Living Well with Multiple Sclerosis
Webinar Highlights: the evidence behind diet and MS – foods to eat and avoid | S8E8
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The Mediterranean diet is the most well researched and highest ranking of all the dietary patterns and the Overcoming Ms. Diet is very similar and the research for people with Ms. Is, is consistent with the growing consensus on the importance of diet on brain health for everyone. And this rise in the Western diet is going alongside the rise in chronic health conditions as I've mentioned, including other neurodegenerative diseases like Alzheimer's, dementia and Parkinson's disease, and increasing levels of depression and other mental health problems in the general population.
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Welcome to Living well With Ms. This show comes to you from Overcoming ms, the world's leading multiple sclerosis healthy lifestyle charity which helps people live a full and healthy life. Through the Overcoming Ms. Program, we interview a range of experts and people with multiple sclerosis. Please remember, all opinions expressed are their own. Receive monthly tips and ideas about Living well with Ms. By signing up for our newsletter@overcomingms.org Newsletter and now let's meet our guest.
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My name is Karen Lee, I'm an Overcoming Ms. Programme facilitator, also a nutritionist and I'm joining you this evening from Mid Devon in the uk. We're going to be discussing the Overcoming Ms. Diet. We're going to be joined by community member, cookbook author and program facilitator Ingrid Adelsberger who will be sharing her experience of the diet pillar. I was diagnosed with relapsing Ms. Back in 2016. At the time I was working as intensive care nurse. Very soon after that retired from that work workplace. But I was already a qualified nutritionist and working as my alter ego which is a sensitive foodie. So I teach people about eating whole food, plant based diets, I create recipes and I'm an author as well. Before we go into the diet in detail, I just want to give you a little overview of the Overcoming Ms. Program as a whole. And as I'm sure you know that Ms. Is influenced by a mix of genetic and environmental factors and there's not just one gene involved here. The Ms. Trust state that there's over 200 genes have been recognised as influencing the risk of the onset of Ms. And it does. The risk does increase slightly if it's already in the family. But as genes take time to change and the number of people with Ms. Continues to increase, it's known that environmental factors seem to have a bigger influence and it's things like smoking, low vitamin D, stress, lack of exercise, poor diet. All of these lifestyle factors do increase the risk of Ms. As well as other chronic health conditions like heart disease. And we know that other chronic health issues also increase the risk of developing Ms. In the first place. And they also fuel disability and disease progression. And this is where the Overcoming Ms. Program really comes in. It's a research backed lifestyle modifications that can turn or can transform these negative environmental influences into positive ones. So I won't go into diet now because obviously we're going to be covering it in a moment but getting out in the sun and supplementing with vitamin D is, is important and we, we recommended to aim to keep our blood levels between 100 to 150 nanomoles per liter and that's in the UK, physical activity. So this includes basically moving in whatever way you enjoy and works for you. So the standard guidelines for exercise is to get 150 minutes per week. That can obviously be broken down into lots of different sessions. So it could include cardio if you like, so swimming or running, it could be working out at the gym, doing some resistant exercises, Pilates. It could also be chasing after the children or grandchildren, walking the dog, gardening. It's basically making sure that we keep moving. Stress management Stress has a major impact on Ms. And we recommend a daily mindfulness practice, ideally for 30 minutes medication. This includes disease modifying therapies if you choose to take them, but also other medications like it could be some painkillers or supplements that you choose to take. And family health is all about encouraging your siblings or your children to stay as healthy as possible to reduce, reduce their risk of developing Ms. So this includes encouraging them to take supplement with vitamin D or get outside and to eat healthily, to exercise and to manage their stress as well. And then the change your life for life pillar. Well this is probably the most important one really because Ms. Is a, is a condition that is with us for life and therefore the actions that we take need to be new habits and a changed mindset that enable us to live well even though we've got Ms. So what we eat is important for everyone, not just for people with Ms. And the old saying, you are what you eat is actors. We are literally made from the compounds taken from the food that we eat. When it comes to health, it's not over dramatic to say that every meal can either heal or harm. The rise in the western diet eating pattern over the last 80 years has coincided with a huge increase in chronic health conditions and obesity. You know, it's not just ms, it's affecting. The western diet is formed of cheap, low quality products which are high in saturated fats and refined sugars, high in animal products, low in fibre and low in fresh fruit and vegetables. And a poor quality diet fuels inflammation and cell degeneration, which are the underlying processes in Ms. And all chronic health conditions. So eating food that supports the body to stay well is now an important part of disease management. And how do we know that? Let's look at the research. So these two studies highlight that diet quality is key. Now, they don't recommend one specific dietary pattern, but quality is defined as one that's high in fruit, vegetables, whole grains and healthy fats, low in saturated fat, fine foods and red and processed meat. And both these studies conclude that diet can improve outcomes for people with ms, whether or not it's lessening disability and symptom burden, or reducing fatigue and increasing quality of life. All of which I think you'll probably agree are important things. And if you've been told there's no evidence that diet impacts MS, then remember this paper from 2023 that concludes that there really is sufficient evidence and it should be recommended as part of a disease management program. And getting the right support is key. And one of the wonderful things about the Overcoming Ms. Is that there is plenty of support in all sorts of different ways, and I'm going to cover those a bit later on. At Overcoming ms, we promote a brain healthy diet packed full of delicious, healthful food that nourishes the body and promotes healing. So it's low in saturated fat and it's full of healthy, healthier, unsaturated fats. It's packed full of whole plant foods and includes fish and seafood if you desire. It also includes a daily supplement, 20 to 40 mils of cold pressed flaxseed oil as a source of anti inflammatory omega 3 fats to the Mediterranean diet. And it matches the diet that is currently recommended by the American Heart association as a healthy diet. And the food included in the Overcoming Ms. Diet can be adapted to all budgets, cultures and cuisines. And this is so important as Ms. Affects people from all communities around the world. So it's a nutritionally sound framework that doesn't necessitate the need to buy expensive products and expensive supplements. And it can be adapted to the whole family. And I think something that's accessible, adaptable and affordable is really important. So what is the problem with saturated fat? So let's start with Dr. Roy Swank. So he hypothesized that a high saturated fat diet fueled disease progression for people with Ms. Now this was back in the early 1950s. He recruited 150 PET onto a trial and he told them to eat 20 grams or less of saturated fat a day. Now in the scheme of things, nuts, not actually that low. The current American Heart association guidelines to reduce cholesterol for example, is to eat only 11 to 13 grams of saturated fat a day. But despite this, half the participants couldn't reach this 20 gram target. So whilst there wasn't a control group, but the, the participants actually self selected into two groups for him to compare. And this study is outstanding because it ran for an incredible 34 years, which is a long time in research terms. And the early results indicated that those in the low saturated saturated fat group, and especially those eating 16 grams or less, had a significant drop in relapse rates after just one year. 95% drop after five years. And remember, this is way before there were any disease modifying therapies. So this is a time if you were diagnosed with ms, you were basically told that's it, it's nothing to do, just, just go home and you know, do your best. So it's really, must have been really exciting. The trial continued for an incredible 34 years and at the end those in the low saturated fat group remained mainly well with limited disease progression compared to the other group because out of those who were still alive they, they had much more severe disease progression and disability. And he concluded that this consuming a lower level of saturated fat and a higher level of polyunsaturated fats was particularly important as they supported this anti inflammatory pathways. So I just wanted to touch on about saturated fat in, and which is really abundant in the western diet. So it's found in processed foods in the form of palm oil, coconut oil, cocoa butter, in animal fats and in, in, in all sorts of meat products as well, whether or not that's red meat, processed meat, even poultry. And they're mainly found in what's called long chain fatty acids. So these are really stable and stiff fats. You may have heard of ones like lauric acid or aridonic acid and they're solid at room temperature, but they're also mainly solid at body temperature as well. And this is important when it comes to cell membranes. So cell membranes are the thin outer layer that are keeping the, the contents inside the cell. And they, our cells are constantly turning over throughout the body. Some are faster than others. And when this happens a new cell membrane is formed using the fats that gained from, from the food that we eat. So if you have a high amount of saturated fat in the diet, it gets incorporated into the cell membrane. Now we need a little bit in there because it helps with the structure of the cell. But if you have too much, the membrane becomes really rigid and sticky and it reduces the, its ability to function properly and the cells tend to clump together and this promotes an areas of cell degeneration. Now this obviously applies to all cells in the body, but specifically for ms, this includes cells in the myelin sheath, in our neurons and in our immune cells. Now polyunsaturated fatty acids or this PUFA here, they're fluid at room temperature and at body temperature and so they, when they get incorporated into cell membranes, they tend to be more flexible and enable them to function better. So the cells actually regenerate with healthier, less inflammatory fats. So I hope that that kind of sort of helps you understand that. So hopefully you've heard about the holism study. So this was started back in 2011 by Professor George Jelinek and his team at the Neuroepidemiology Unit in Australia, in Melbourne in Australia. And they were set up in order to look at the modifiable lifestyle risk factors of people who live with Ms. So he's looking at what can be changed to reduce the risk of progression and help to manage the disease. And this includes participants from all around the world who complete evaluation questionnaires about their diet and lifestyle, the things that they're doing that affect their Ms. And it's created this huge database from which over 40 different peer review papers have been reviewed. One of the things that's really important is this is independent, unbiased research for, specifically for the diet side of things. Some of the headlines is that they found that when you eat a low sat, low saturated fat, a polyunsaturated fat Diet, there's a 42% less chance of disability. And really interestingly is that when we supplement with flaxseed oil, there's a 60% reduction in relapse rates, which is quite phenomenal when you consider that a lot of DMTs or disease modifying therapies, you know, the, even the, the more powerful ones, that's the kind of figures that you get with Art and this latest study that came out from the holism or using the data focused on just over 600 people and they were looking at the relationship between their diet when the recent study started then and what they've been eating as they've gone along compared to where they are at the, the kind of the assessment date to monitor the disease progression. And they're followed up every two and a half years. So this half years, so we, we're getting at Some really good long data. And what was found was that frequent fish consumption and omega 3 supplementation was strongly associated with improved quality of life and reduced disease, activity and disability. But the those who ate meat and dairy had poorer outcomes. So, and this is really important because it showed that the importance of dietary habits over time, you know, so this comes back to this changing life for life. It's really important that to just to keep going and eating really great food, really, that helps reduce the progression of this condition. This study here, this study looked at different types of Ms. Diet because there are various ones. And I just wanted to highlight the fact that both the Mediterranean style diet and the swank diet were mentioned as having some good evidence and being nutritionally balanced, whereas others didn't fare as well. This one from the using the UK Biobank, which sourced a huge number of thousands of people, they found that a Mediterranean style diet that included oily fish had a protective effect for people with Ms. And then this study, initially, rather unsurprisingly, they looked at the Mediterranean diet and they found that it was easier for people to follow and also those that did follow it had less disease severity. This was a very small study, but interestingly it really focused on fiber as being important, which is really good for gut health. The Mediterranean diet is the most well researched and highest ranking of all the dietary patterns. And the overcoming Ms. Diet is very similar. And the research for people with Ms. Is consistent with the growing consensus on the importance of diet on brain health for everyone. And this rise in the Western diet is going alongside the rise in chronic health conditions as I've mentioned, including other neurodegenerative diseases like Alzheimer's, dementia and Parkinson's disease, and increasing levels of depression and other mental health problems in the general population. So let's dive into what we're going to be eating. So, so go first with my favourite, which is fresh fruits and vegetables. So you might be surprised to hear that just 20 or 9% of adults in the UK hit the 5 a day target. And that's actually supposed to be good. Apparently it is worse in some other countries, but it's still a real challenge. Fruits and vegetables are an amazing source of powerful nutrients that help support the body and reduce inflammation. And there's so many to choose from that even the fussy eaters can find something to enjoy. And don't forget that herbs and spices count in this group as well. So they're packed full of vitamins, minerals and phytonutrients and the really healthy compounds and every color carries different properties that support the body. And this makes eating the rainbow every day not only good for the taste buds, but great for the body too. And one particular group of compounds, which is polyphenols, also great for the microbiome. And fresh produce can be more expensive. So do try to buy what's in season because when, when it's, you know, there's a good harvest of something, there's just more available at better prices. Frozen fruit and vegetable is also a great option because it would, they're frozen very soon after harvest so it retains the nutrients well. But also if you're low in time and energy, you don't have to spend time doing lots of peeling and chopping as well. Whole grains are included, both gluten and non gluten containing grains. Now there's no conclusive connection between gluten and Ms. Specifically, but we know that some people like to avoid it. It could be due to another autoimmune condition or an intolerance, or you might just want to do a just in case policy and avoid it. Whole grains are very different to refined white grains and they're full of complex carbohydrates which are packed full of fibre. They also give us our calories for energy. There's also lots of minerals, there's protein, healthy fats even. And there is so many to choose from. And then beans and pulses or beans and lentils, this is another really, really healthy group. This is where you can get your main sources of plant protein from. They also contain minerals and fibre and complex, lots of complex carbohydrate where we get energy from and polyphenols and other antioxidants as well. And I love beans and lentils because they are super cheap and tinned are, are, are okay to eat as well, which is great because it means you don't have to spend hours soaking and cooking them so you can knock up some really quick and easy meals. And research tells us they're actually one of the healthiest foods that you can eat. A paper that was published in 2023 concluded that by eating beans regularly or every day, you can reduce obesity, it reduces low grade inflammation and it may play a role in immune related disease risk factors, you know, managing immune problems. Now one of the things I would say, however, is if you're not used to eating a high fiber diet, then you might want to go a little bit carefully on beans to start off with because they do have a win factor. And to start off with, once you're, once you're used to them, you're used to eating more fibre and your microbiome has finished partying on them, then things should settle down. So let's go on to healthy fats. So there's lots of whole food sources of this mainly in in nuts and seeds, but also fruits like avocados and olives. They have much higher levels of unsaturated fats, including omega 3 and omega 6 essential fatty acids. But they also contain protein and fibre, fat soluble vitamins and other antioxidants as well. And as I mentioned, flaxseed oil, the holism study showed a fantastic reduction in relapse rates. And when we're supplementing with that, you can also use extra virgin olive oil in, in your food as well in your meals. And that's high in polyphenols as well, so it's got that antioxidant effect. But just make sure that you don't directly heat these oils. They need to be added on rather than put on direct heat in a pan. You can also eat oily fish three times a week if you would like. And by oily fish we mean sardines, mackerel, anchovies, salmon, herrings and trout. Smaller fish are better because toxins and heavy metals can build up in the larger fish due to pollution in the water. So try to go for the smaller ones. And in all of these foods you, there is saturated fat in there, but there's a lot more unsaturated fat and like I say, you, you need it. We can't avoid saturated fat in our food and nor do we want to because we need to make sure that we have some just in much lower. And as for other food, well, there's fish and seafood which is a great protein source. There's lots of different types of fermented foods like sauerkraut, kimchi, miso. They provide gut benefits, can help digestion and also add flavour. It's another one though that if you're not used to fermented foods to build them up gradually rather than just sort of eating five different types because you might get some unexpected side effects. There's also lots of things to add in flavours. So there's different types of pickles and vinegars. And then on the drink side of things there's tea and coffee is absolutely fine and cocoa powder, cocoa's got a high level of flavonoids which is a type of antioxidant, and magnesium as well in the mineral. And interestingly, there was a small study done in 2019 that showed that people with Ms. Who had a hot chocolate every day for six weeks had improved fatigue. And then what to avoid? Well, we're going to, we want to avoid meat, especially red and processed meat, including poultry. It's high in saturated fat. There's no fiber in there at all. It promotes inflammatory compounds. Dairy we want to avoid as well, and that's dairy from cow, goat or sheep. There is saturated fat and a lot of dairy, but it's not just the fat. There is debate is still out about the, about what the issue is, but it's thought that butyrophylline, which is a protein in dairy, is very similar to protein on our oligodendrocytes on the myelin sheath. And when the immune system is overwhelmed and confused, it can start attacking proteins which are similar. So it starts attacking our own protein rather than the one that's being in, taken from, from dairy. And this process called manecular mimicry. So if we don't have the dairy, then that molecular mimicry is, is avoided. Egg yolks are also avoided and they're high in saturated fat as well. But egg, egg whites are fine and you'll find some protein in there. And then there's all of the shop bought pastries, cakes, snacks. Oh, that's far food, fast food. I mean we know that it's packed with saturated or adulterated fats which have this negative inflammatory effect in the body. Coconut, now it's promoted as being healthy, but, but it's really high in saturated fats so we, we, we want to avoid that as much as possible. Coconut water and coconut sugar are fine, so you can include those. And whilst cocoa powder is okay, chocolate itself is set with cocoa butter which is highly saturated. So that's off the menu as well.
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Are you ready to connect, learn and feel inspired? Register your interest in our latest events and courses by visiting overcomingms.orgevents to find out more.
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No, okay, that's enough from me now. So I would like to invite Ingrid to the stage.
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Thank you Karen for having me and for giving us all this great information. For all of you who don't know me, my name is Ingrid Adelsberger. I am a health coach and also an Overcoming Ms. Program facilitator. And I'm the editor of the OMS Cookbook. I'm also, also someone living with Ms. And with the Overcoming Ms. Diet or the entire program for already 14 years. And I really know firsthand what it feels like to live with that program and Ms. So there are struggles, but there are also really great things. So if you're new to our community, then please know that it's a wonderful community. And please also be rest assured that you are putting so much better food into your body compared to so many people out there. So a little bit about myself. I worked in the corporate world for over 10 years when I was diagnosed with Ms. In 2011. And when I was working on the OMS Cookbook, I realized that I really wanted to shift directions. So I became a health coach. And first I did a six month program. But I felt that I wanted more information to serve the people better. So I decided to do a master's in integrated health and wellness. As mentioned, I lived with this disease for a while and I know all the struggles and the ups and downs. So one of the things was really the label. Reading it was so stressful and exhausting. I didn't know what to eat. And then I was cooking every night. You know, first I was, you know, I was 30 at the time that I got diagnosed. So I was eating out, living in New York City. And then suddenly I had to stay home most of the time and cook myself. And even though putting in all the effort, effort, the food was pretty bland and boring. So I realized that I wasn't the only one when I went in 2013 to the first Overcoming Ms. Retreat that was outside of Australia and New Zealand in the uk. And then I met other people that fel the same way. So it gave me hope and also good ideas that the cookbook has to happen. And that's why it's also a crowdsourced cookbook, because we wanted all the people to be involved, involved in that cookbook. And if you're new to the diet, then I really hope that you feel like you're not alone because this is really how I felt and there are really many other people that also feel that way. So I needed good recipes, I wanted to have good food and I realized that other people wanted it too. So what are the things that have been helping me? And maybe one of them, you know, already like batch cooking. But batch cooking is really something when you need to have nutritious, good OMs friendly food. Maybe you don't have the time to cook every night. Maybe there's somebody out there that's also a mom like I am. And then you time is tight. You can't cook every night, something from scratch. So storing it in the fridge and or in the freezer, depending on do you want to eat it in a couple of days again or do you want to eat it next week? Then it's really important, and I'd really try not to to make meals only for one night. I always try to have at least two dinners, maybe one extra lunch for the family. Meal planning that was really a game changer for me. It was actually the idea of my husband because our daughter is a pretty picky eater. And then so there needed to be a lot of time to cook for her. And then there's also a lot of time to cook OMs friendly meals. So we had to come up with something that works for all of us. And so one of the things is, for example, we always have a Taco Tuesday, so. So I have corn tortillas and the rest of the family has wheat tortillas, but we have beans sometimes. We also have fish, but we share all the rest. And I think it was really important for me to find recipes that the entire family likes and that are also oms friendly. Then I think it's very important to always have emergency food on you. That could mean that you always have a treat with you. Either something that you make by yourself, or there are a couple of brands that you can find something that's almost friendly in stores. But it could also mean that you are invited to a dinner and you're not sure if there is anything for you to eat, so you want to make sure. Maybe you want to bring a side dish or something. Or it could also mean that you have oms friendly crackers with you. But it's really important that you don't get a situation where you're really hungry. And then maybe you make a decision that you would regret and you wouldn't make if you were in Tungui. The other thing is, know where you can order something from or where are the places that you can eat out. When I lived in New York or la, it was really easy for me. The US had so many more options earlier than Vienna, for example, had. But now, over the years that I'm back, I have found my places and I found a couple of places where I can order from. And it's just there are those nights where you can't cook or you don't want to cook or whatever the reason is, but you want something. You want to be sure that you have something if you can't cook and then also have your favorite fast go to meals. So for me, for example, that's brown rice and a protein, either like a salmon or chickpeas, and then some vegetables and a salad on the side. For me, I have just put some soy sauce and flax oil on it and I really love that. But maybe you want to spice it up with a little extra sauce and it could be something like a tahini sauce with tahini olive oil or flax oil, lemon salt and pepper. And it's really easy and done in a minute and it's really, really good. So that could be just some helpful tips. Maybe that can make life easier for you too. I wanted to share a few of my favorite recipes. Maybe that can also help you and inspire you and maybe also look for something else. So one thing from the Overcoming Oms cookbook is the Ghanaian fish stew and it's something that was very early on one of the recipes that I really loved. And I actually made it today because I'd forgotten it. I thought like, why not make that again and was lovely again. And it's so easy. It has four ingredients so it's really quick and easy and it's really delicious. Karen's book, for example, I looked for oil free granola for such a long time. I really love to have oatmeal in the morning quite often, but it's nice to sometimes spice it up with something else. And also I was trying to find something healthy for my daughter. I believe that children, they eat things that we wouldn't necessarily eat every day. But I always feel like you want to move the needle just a little bit and see what can you do. So one thing I found were lentil burgers and our whole family loves it and it's, it's not super easy, but it's pretty easy to make and she actually likes it. And it was so important for me that to introduce lentils for her because they are high in fiber, they are so healthy. So I wanted her to have something that she will have with lentils and that was one thing that I found and that really works well for us. And then last but not least, I wanted to also say I have Ashley Madden's book. She's somebody that's within the Overcoming Ms. Community as well and she follows the diet and even goes step stricter or stricter or further and she doesn't include any oil. And the pad Thai protein salad is really one that I love very much. So I can only recommend her cookbook as well. And then I wanted to leave you with one thought. Nobody is perfect and I am not perfect and you don't have to be. But consistency beats perfection. So if there is a mistake, for whatever reason, you know, intentionally or by accident because there is an ingredient in something that you happen to eat don't beat yourself up and just make sure that the next meal is a good one again. And the more great meals, the more good meals we have, that's really the important thing. So the consistency is what we want. So on that note, I think we gonna go to some questions. So the first question that we got was why are some saturated fats okay, for example, olive oil and avocados, but others are not allowed at all, such as coconut. So first of all, I think it's important to know that pretty much every fat has saturated and unsaturated fat. So when we talk about having unsaturated fat, there is always a little bit of saturated fat, part of it, but we want to take a look at what the fat is. So Karen talked about this already. Monounsaturated fats or polyunsaturated fat. And so as an example, avocado has a lot of. It also has a little bit of omega 3 fatty acids, but it also has some fiber and other vitamins. It does have a little bit of saturated fat, of course, but if you look at the whole avocado, there is so much more good stuff in it than there is less good stuff, such as the saturated fat. Extra virgin olive oil is the same. There is a little bit of saturated fat, but most of it is really good. And it's important to say that it's good for brain health, good for health overall. That's why some things are okay versus others are not. Because the main stuff of whatever the product is, for example, coconut oil, has mainly saturated fat. And that's something that we don't want to have. So I think the second question is for you, Karen.
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Yes. Yes. Are there better and worse whole grains? So when, when we're talking about whole grains, we're talking about obviously whole wheat flours, which contains gluten. There's lots of. So you can have whole wheat pasta, whole wheat bread, all of that side of things. But then, but then there's lots of other grains as well, like quinoa and amaranth and millet. There's lots and lots to choose from. And the key is that it's whole. So where, where we come into the problem is when grains have been refined. And so that's when you get your white flour because they, then what's been taken away is all of the good stuff, most of the fiber and the healthy oils and the protein and all, all of that is in, is in the brown part in the, in the husk and the whole wheat, like I mentioned, some People need to or prefer to avoid gluten and therefore you're going to go along those gluten free grains. More personally, I try to with the whole grain side I look to eat more ancient grains like spelt or Emma and I try to buy organic. One of the problems is by spraying the grains crops just before they're harvested with pesticides and everything. So, so there's, there's still quite a lot of residue on, on, on the, on the crop. If you're having buying organic if you can, then you're going to avoid that. So, so yeah, so just go with whatever you like and do experiments as well because there's so many different options and, and I think one of the things that I love exploring is using like, like pea flour or chickpea flour, millet flour, all of these different legumes that can be turned into a flour that you can create all sorts of interesting dishes with. So there's a lot to practice with.
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So the question is, I struggle with weight loss and find it difficult to consume enough calories. What can I be doing? Are vegan protein shakes okay? So first of all I want to tell you that when I started on the overcoming Ms. Diet I didn't struggle with weight loss, but I did struggle about one year after I had my daughter because I think through breastfeeding I lost so much weight and I struggled really to keep that weight back on. So I also had to find ways to make sure that I am okay. And it took me a few years to get back to like a healthy weight. But what happened for what helped me is like avocados, tahini, nut butters, legumes, all of them is really good to add to the meals. Obviously some of them are high in saturated fat, but it really does help to add them. And maybe it also means that you have to eat more frequently or have to eat more as far as the vegan protein shakes. So overcoming Ms. Recommends not to use the store baked bought, I'm sorry, store bought ones because very often they're high in sugar and they have additives that you don't want. But you can actually make quite a few good protein shakes by yourself with things like nut butters, banana, maybe some berries, add in some chia seeds or hemp seeds or ground flaxseed, whatever you want and that way you can make your own protein shake. And maybe you're thinking right now you would rather buy some, but if you throw all of that in the blender, it really doesn't take that long. So it Maybe takes a minute or two, I think, to make that. Karen, do you have anything to add with protein shakes?
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There are some slightly better versions around now, but I always think that homemade ones. Ones taste better. It comes down to time for a lot of people. So yeah, they just, just read the ingredients and work out what it is that's in there. But yeah, no, absolutely. Homemade's always best. So do you want to answer that bit of the. Your, your flaxseed question?
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Sure. Sounds good. So I know that there are some people that don't tolerate flax oil very well. Are there any alternatives and which one would you suggest and in what quantities? You could, for example, use the flax and I think six tablespoons or something like that would be the nine. Nine actually. Okay. Is the equivalent of like the amount that overcoming OMS suggests for flax oil. So that's really a lot. And for some people that may be a little bit too much fiber and maybe it's also. You don't know where to add that. So I always put in my oatmeal in the morning. I actually put the oil and a little bit of the ground flax seeds because I think they're good for fiber. But I wouldn't want to put in six or nine tablespoons. I think that's a little too much. But there are alternatives. Also. Chia seeds is really good, hemp seeds, but please know that they have less omega 3 compared to the flax seeds. There are algae based omega 3 supplements, so that can also help. But I think the really important thing is to know that the flax oil is the most concentrated when it comes to the omega 3. And that is the reason why we are taking the flax oil.
- [38:20]
A
One of the problems with flaxseed oil is it's because it's so volatile and it can really just sometimes catch the, you know, your esophagus as it goes down. So, and that's, that's actually a good thing because it just shows how active it is. Yeah, if you can hide it in food, that's the best way. I'm not, I'm not one for glugging. I like to drizzle it on my food. And if you really do struggle, then just have small amount so you don't have to have the whole dose in one go. You know, it's. It can be throughout the day. So you could just put a tiny bit in some soup or in a smoothie and then have a little bit later on. So spread it out if you can but the, the other thing about ground flaxseed, it's great to add in, you know, the odd tablespoon, but it's got, it has got a really high amount of fiber in there, but it's also got other properties as well. Lots of lignans and, and different types of compounds. Which 9 tablespoons really is, you know, that's hardcore and it's not ideal for, for most people. So this person says that they have osteoporosis. I'm sorry to hear that. And they've asked is the Overcoming Ms. Diet good for this and do I need to adapt it in a certain way? And obviously they have Ms. As well. So people with Ms. Are at increased risk of osteoporosis. So part of that is linked to if you've got this low grade inflammation that also affects your bone density and then increases your risk of fractures. But also, especially in the past, people with Ms. Were told not to exercise. So if you have limited mobility or if you're not moving that much, not doing much exercise, then that also increases your risk of getting osteoporosis. And there are some medications that can also affect bone health as well, one of those being steroids. And obviously they can be used as, you know, really useful as a emergency first aid for acute relapse. But if they're taken for a long time, they can have this negative effect. There's mainly, there's four things that we need for good bone health. So calcium, vitamin D, which obviously we're covering through supplementation, protein and weight bearing, exercise. Okay. So our bones need to be challenged. So within the Overcoming Ms. Diet, there's lots and lots of plant sources of calcium and of protein. You just need to make sure that you're eating a range of foods and you're eating enough of them. So for calcium, for example, things like almonds, sesame seeds, chickpeas. So if you like falafels, you've got chickpeas and, and tahini in there or hummus, that, that's, that's really good for your bones. Calcium set, tofu. So not only have you got a good dose of calcium in there, but you've also got a good complete plant protein as well. And leafy greens are packed with calcium, as are cruciferous vegetables like broccoli. And so and then protein again, lots of the foods I've just mentioned have got protein in, but other things like quinoa and nuts and seeds, obviously if you eat fish then you're getting a good amount of protein and even in if you're eating like tinned sardines, they often have the bones and they're ever so soft and obviously they've got calcium in as well. So that's another source. So, so all of those, just as long as you're eating enough then, then you will be getting the sort the, the food or the nutrients that you need for bone health. And then weight bearing exercise is really important. So that doesn't necessarily mean that you have to go out for a run because you might not be able to, but you might be able to go to the gym to do some weight bearing exercises. But even like resistance bands and you can get them, you can do exercises in a chair or at home. Another version if you, if you're, you're not going to the gym is like putting a backp on with some ice blocks or something in something a bit heavier and even just kind of like jumping out of the door so that you're getting some impact. And so, so the, so the question says it seems like the slides and research are only relevant to relapsing, remitting Ms. Rather than primary progressive. Please can you comment on that? I can. And is there any research with regard to diet and primary progressive ms? Okay, so a lot of the research, a lot of research full stop tends to be done on relapsing and remitting because obviously there's more people who've got that. But I think what we need to be mindful of is that now Ms. Is being looked at as just one condition. So. And a lot of the research is consistent with other brain research, you know, in diet and brain health, as I mentioned earlier. So, so you may not have like the same levels of inflammation, but it still cell degeneration and smouldering Ms. Is, is something that is going on in the background for a lot of people. So that is about reducing inflammation but also supporting the cell, the body cells, helping them to regenerate in a healthier way. As I mentioned about the cell membranes just providing all of these lovely sort of essential nutrients that enable the body to, to be well and to heal as much as, as possible. So we've seen from the research that it is slowing progression. But also like I say, we know that anything that helps to stop the degeneration of our cells in our brain as we age, our brains shrink anyway. But with Ms. We have that, that is a bit of an advance. So we making sure that those cells are don't degenerate as quickly by eating these types of foods.
- [44:12]
C
So yeah, so I'm wondering where we draw the line when defining processed food. Store bought bread, Homemade sourdough, soy milk, vegan yogurts, tempeh. I'm just never sure when something become processed. So my understanding is there is processed food and there is ultra processed food. So processed food would be already. If you take that apple and chop it and make applesauce out of it, my understanding is that's already processed. But obviously we do that and it's okay to do that. You know, if you make applesauce and it's homemade, then that's good. If you now have a lot of ingredients that you can't pronounce. Maybe they're E numbers or maybe there are things that you don't know what they are and you don't have an ingredient that you know it's coming from a plant or so then I think it becomes more difficult and I think that's where to draw the line. So when you, for example, you say tempeh, my understanding is tempeh is a healthier version of compared to tofu because it is differently processed because it's fermented. So yes, it's also processed, but I think that is definitely something that's okay. So I think it's okay to have some form of processed food but not ultra processed food.
- [45:35]
A
Great. Okay. And so yeah, and a big thank you to you, Ingrid for joining me today. It's been lovely talking with you, so thank you so much and take care. Bye Bye.
- [45:47]
B
Thank you for listening to this episode of Living well with Ms. Please check out this episode's show notes@overcomingms.org podcast. You'll find useful links and bonus information there. Don't forget to subscribe to the podcast so you never miss an episode. And please rate and review the show to help others find us. This show is made possible by the Overcoming Ms. Community. Our theme music is by Claire and Nab Dean. Our host is Jeff Alex. Our videos are edited by Lorna Greenwood and I'm the producer, Regina Beach. Have questions or ideas to share, email us@podcastvercomingms.org we'd love to hear from you. The Living well with Ms. Podcast is for private, non commercial use and exists to educate and inspire our community of listeners. We do not offer medical advice. For medical advice, please contact your doctor or other licensed healthcare professional.