Scientific Concepts, Strategies, Best Bet Diet Basics, Frequently Asked Questions.
This cook book has been prepared to help persons with Multiple Sclerosis implement the nutritional strategies which are recommended by our charity, Direct-MS and MS Hope. The following strategies are often referred to as the “Best Bet Diet” within the cookbook.
We would like to note that although we developed this diet as an effective strategy specifically to help people with MS, our research and some testimonials suggest it could be beneficial for persons with other autoimmune diseases, as well as anyone searching for better health.
We begin with a summary of the scientific concepts that link various nutritional factors to the MS disease process. To us, it is important to understand the basic scientific rationale for why various nutritional factors are a key part of the initiation and ongoing progression of MS. We then discuss the various foods which either contribute to the MS disease process and the foods which help to suppress and halt the disease process.
Clearly, it is essential to eliminate the pro-MS foods and to significantly increase the consumption of foods and supplements which counter MS. Thus, we have sections on foods to eliminate, foods to reduce, and foods to increase, as well as a list of supplements. We realize it is often very difficult to give up foods which you have enjoyed over a lifetime; such as dairy and gluten-containing products. To help you accomplish this, we discuss acceptable substitutes for common foods which are very problematic for MS. We have also provided suggestions for breakfast, lunch, dinner and snacks.
At the heart of this book are the recipes which we have gleaned from many sources and we ourselves have used over the past 24 years. We have ensured that each recipe follows the recommended nutritional strategies and that it can be prepared with relative ease.
We would also encourage you to develop your own recipes and adapt ones you discover by using the basic principles of the Best Bet Diet. The list of food substitutes should help ensure that any recipe does not contain foods to avoid.
We value your feedback on this book. Please feel free to send your comments to mathew.embry@mshope.com
The Best Bet Diet is a nutritional strategy for managing MS that was developed by Dr. Ashton Embry in the 1990s. He formulated this diet after his son was diagnosed with MS by reading numerous scientific papers on multiple sclerosis and nutrition.
MS is classified as an autoimmune disease. The basic disease process of an autoimmune disease, such as MS, is that a person’s own immune system attacks specific parts of the body, which, for MS, is the central nervous system. The specific tissue that is the main target of the immune attack is myelin, a fatty substance that wraps around and insulates the nerve axons of the central nervous system. With the loss of myelin, the nerve axons themselves eventually are damaged and destroyed. The axons deliver instructions from the brain to all the parts of the body and their loss causes such messages to be delayed and blocked. This translates into the multiple disabilities that characterize MS.
Studies suggest that the MS disease process begins in childhood and that it is often 20–30 years before it becomes clinically apparent in young adulthood. Such a long lag time between the start of the disease process and its recognition characterizes many chronic diseases including cancer and heart disease.
It is now firmly established that genes play a significant role in the onset of MS and that only people who carry specific genes are susceptible to contracting MS. Studies have shown that many genes are involved in MS susceptibility with numerous genes related to the immune system being very important. It appears that less than 2 percent of people are genetically susceptible to MS.
Most importantly, it is also known that environmental factors also play a major role in MS onset and progression. Such environmental factors are those which result in one’s own immune system attacking and destroying myelin in the central nervous system.
There are two main disease processes that result in myelin being attacked through autoimmunereactions. These are:
The Best Bet Diet has been formulated on the basis of identifying the foods that contribute to these two disease processes which drive MS and result in accumulating disabilities. Firstly, we will look at the various types of foods that contribute to the activation of myelin-attacking immune cells and this includes both the ingestion of harmful foods and deficiencies in beneficial foods.
Dairy products are very problematic for MS because they contain proteins that closely resemble myelin proteins. Myelin-attacking cells often become activated whenever the dairy proteins encounter the immune system. Lactose-free dairy products do not contain lactose, a sugar found in milk. Notably, it is the dairy proteins, not the lactose, which are part of the MS disease process. Such products should be excluded. Other foods that contain proteins that potentially can activate myelin-attacking immune cells are grains containing gluten and legumes.
Importantly, food proteins usually remain in the gut and are separated from the immune system by the gut wall which forms a barrier. However, some food proteins cause the gut wall to become leaky and to allow both food proteins and gut bacteria to pass through it. Proteins which are known to open up the gut barrier are found in gluten grains and in legumes.
Furthermore, the gut wall is also damaged by inflammation which often results from eating foods which cause allergenic reactions. Once the gut wall becomes open, food proteins and gut bacteria can pass through the barrier and encounter the immune system where they can activate myelin-attacking immune cells.
It is also important to note the existence of a second barrier which helps to protect the central nervous system from damage and prevent diseases such as MS. The blood vessels in the brain have much stronger walls than other blood vessels in the body. This barrier was designed to keep problematic immune cells and chemicals in the circulatory system out of the central nervous system, where they can do damage. This barrier is called the Blood Brain Barrier and it is well established that a damaged blood brain barrier is a characteristic feature of MS.
Just like the gut barrier, the blood-brain barrier is damaged and opened up by both proteins from gluten and legumes and by inflammatory reactions which are accompanied by oxidation. If myelin-attacking immune cells are present in circulation, they can access the central nervous system and myelin much more readily through a damaged blood-brain barrier.
Another factor which plays a major role in MS by way of gut health is the microbiome which consists of trillions of bacteria which live in the human gut. Recently, medical scientists have determined the importance of a healthy microbiome and how an unhealthy microbiome contributes to a variety of diseases including MS. The good gut bacteria promote well regulated immune reactions and strengthen the gut wall. On the other hand, refined sugar and artificial sweeteners, which are found in many food products, contribute to the occurrence of very unhealthy gut bacteria. Furthermore, a deficiency of fiber, also results in an unhealthy microbiome and the overgrowth of problematic bacteria. The bad bacteria are pro-inflammatory and increase gut leakiness and thus are part of the progression of MS.
Another substance that contributes to the activation of specific immune cells that attack myelin is sodium which is found mainly in salt. Clinical research confirmed this by demonstrating that MS patients with a high salt intake experienced 3 to 4 times higher rates of both relapses and new lesion development compared with MS patients with a low salt intake. The Best Bet Diet recommends a daily intake of sodium of no more than 1000 mg (1 gram) which approximates a Paleolithic intake This is much less than the average daily intake of sodium of Canadians which is about 3500 mg. Notably, about 70% of our sodium intake comes from packaged foods and restaurant meals. It is essential to read the sodium content on the nutrition label on all packaged products and to greatly reduce the consumption of foods with a high sodium content. Table salt can also supply a lot of sodium (1 tsp = 2350 mg of sodium). To offset this, one can use either “half-salt” or “no-salt” products which contain mainly potassium rather than sodium.
Now we can look at the nutrients which support the suppressor side of the immune system to ensure it functions well and keeps any autoimmune reactions well controlled. As discussed earlier, foods which promote a healthy microbiome contribute to better immune regulation. Other nutrients that increase immune regulation and help to control autoimmunity are:
Omega 3 polyunsaturated fat
Found in fish, game animals and a few plants such as flax.
Anti-oxidants
Include a range of vitamins, minerals and special substances found in fruits and vegetables.
Vitamin D
Comes mainly from the action of sunlight on skin and from some fish.
There is a large amount of scientific information that demonstrates these nutrients are very important for maintaining well-functioning, immune suppression. More importantly, there is also abundant information that links deficiencies of these nutrients to Multiple Sclerosis.
The Best Bet Diet or BBD was designed to accomplish five main tasks, all of which will potentially slow or halt the MS disease processes:
Based on the five strategies to prevent or halt MS, the basics of the Best Bet Diet are to eliminate, reduce and increase certain foods. Please see the Meal Strategies Section on pages 36–50 for a more detailed list of what foods to avoid and food substitute options.
Foods that contain proteins which have the potential to cause autoimmune reactions and/or increase intestinal permeability. These are:
Multiple Sclerosis is an autoimmune disease which can result in serious disabilities. Because genetics play a significant role in MS, close relatives of persons with MS are at high risk of contracting MS.
It is worthwhile for them to use a few simple nutritional strategies to greater lower and likely eliminate their risk of MS.
Two nutritional factors that are implicated in MS by abundant data are deficiencies in vitamin D and fish oil. Data from areas where MS rates vary from low to high indicate that a high supply of vitamin D either from sun exposure or the consumption of fish will greatly lower the risk of MS. Persons at high risk of MS should ensure they have a high intake of vitamin D and fish oil. For children ten years old and younger, a daily supplement of 1000 IU of vitamin D and 2 grams of omega 3 fatty acids (10 ml fish oil) will very likely provide protection from MS. For children over ten, a vitamin D supplement of 2000 IU and 4 grams of omega 3 fatty acids (20 ml fish oil) are recommended. The most convenient way to get an adequate supply of both these nutrients is to use flavoured cod liver oil.
In addition to Vitamin D and fish oil, following the nutritional strategies of eliminating certain foods would also be helpful in preventing MS. Plus, we've found that when the whole household supports and adopts the Best Bet Diet it is much easily for the family member with MS to follow it and stay in good health.
There is a great deal of scientific information linking various nutritional factors to the onset and progression of MS. Many of these nutritional issues related to MS can be readily addressed and resolved by the strategies discussed in this book. Notably, many people have had great success in keeping MS well controlled by using the recommended, science-based, nutritional strategies.
The length of time between starting the use of nutritional strategies and seeing positive benefits greatly varies from person to person. Many have reported obvious benefits within a month, whereas others have had to wait between 6 months and a year.
Dairy products contain proteins that activate myelin-sensitive immune cells and thus any consumption of dairy products helps to drive the MS disease process. All dairy products from milk to cheese to yogurt to butter, and including those from goats, must be completely avoided at all times. Any “cheating” on this can be very problematic. There are a number of good substitutes for dairy products available. I might note that when I go to a restaurant, I always tell the waiter I have allergies and that it is most important that my meal be completely free of dairy and gluten.
The biggest reason gluten is a major problem for MS is that it contains proteins which stimulate the production of zonulin. Zonulin opens both the intestinal barrier and the blood-brain barrier and the failure of these barriers is a key part of the MS disease process. The complete avoidance of gluten at all times is essential. Notably, a number of neurological problems are directly related to gluten ingestion.
A variety of scientific studies have shown that excess sodium contributes to the MS disease process. The best way to avoid excess sodium is to limit sodium intake to less than 1 gram (1000 mg) a day (average Canadian intake is 3500 mg/day). This will involve reducing salt intake as much as possible. Most products have sodium content listed on the package and it is important to avoid products with excessive sodium.
One wants to maintain a blood level of vitamin D of 100–150 nmol/l (40-60 ng/ml) to ensure all systems have access to required vitamin D. A daily supplement of 4000–5000 IU of vitamin D3 should be sufficient for most people and the cost is less than a dime a day.
There are four different types of fat with two being potentially problematic and two being of help. There is solid scientific evidence that excess saturated fat and omega 6 fat contribute to MS worsening. Monounsaturated fat and omega 3 fat are beneficial for MS. The key to fat intake is a balance of the four fat types. For a reasonable intake of 80 grams of fat a day, 40 g of monounsaturated (olive oil best), 20 g of saturated, 13 g of omega 6, and 7 g of omega 3 (fish oil mainly) is an ideal balance.
It is important to combat excess oxidation which is part of the MS inflammatory process. Most persons with MS have been shown to be deficient in anti-oxidants. The best way to ensure adequate anti-oxidants is to consume lots of vegetables and fruits, the more the better. Antioxidant supplements also can help.
Research has demonstrated that adverse elements in the gut flora are part of the MS disease process by way of altering immune responses and increasing gut wall permeability. Our nutritional recommendations, which include pre-biotics and probiotic supplements, will ensure a healthy gut flora is established and maintained.
Given there is a genetic component of MS, anyone with a family member with MS should definitely look at ways to reduce the risk of MS. The easiest way to prevent MS is to ensure adequate vitamin D (4000–6000 IU/d) (1000–4000 IU for children) and to use other nutritional strategies such as the avoidance of dairy and gluten. Ensuring a healthy gut flora would also greatly lessen the chance of developing MS.
Some people experience weight loss on the BBD and this is not a problem as long as a reasonable weight is maintained. To avoid unwanted weight loss, one can eat more of the allowed foods (i.e. nuts which are high in good fats) and use more extra virgin olive oil on
the vegetables.
Created by Joan Embry, the Best Bet Diet Cookbook offers recipes and strategies to help those affected by MS.
