Food intolerance
Testing for possible food intolerances and then eliminating suspect foods is part of the Best Bet diet. Why is this? Let’s start by defining the difference between food intolerance and food allergy. A food allergy is a reaction (usually immediate) to eating a particular food. A severe reaction can cause the body to go into anaphylactic shock, a life-threatening condition. The offending substance can be pinpointed by a skin-prick or RAST test, which indicates if antibodies are present in the blood. It must then be avoided completely to prevent future reactions. Very often, it is foods that are eaten less frequently that are the culprits, such as nuts or prawns.
With food intolerance, on the other hand, the symptoms are less severe than in an allergic reaction but can be a lot more insidious. Foods that cause intolerance tend to be the ones – such as wheat and milk – that we eat in large quantities on a regular basis, so that the effect is sometimes masked. They are also often the foods that we crave the most. Food intolerances do not usually show up on skin-prick or RAST tests and often go undetected, sometimes for years. Moreover, many doctors in the UK, while acknowledging that there is such a thing as food intolerance, believe that it is fairly rare.
Unfortunately, few trials involving food sensitivity have been carried out in this country, and there is controversy over the findings of most of those that have. Until more scientific evidence is available, doctors may continue to underestimate this problem.
Food intolerance and MS
Food intolerance can have a direct effect on the body’s ability to assimilate nutrients; it can affect the way the digestive organs function and, in particular, may prevent the body breaking down fat properly. Dr Embry, instigator of the Best Bet diet, believes food intolerances may be responsible for the breaching of the blood–brain barrier, which may be one factor involved in the onset of MS. Different foods affect different people in different ways. This is one of the reasons it’s so difficult to carry out controlled tests involving food sensitivities. It also means it’s impossible to predict which of your symptoms might improve once you give up a certain food. All you can do is omit the suspect food and see what happens. Chronic fatigue, depression, muscle and joint pains, diarrhoea and constipation, headaches and food cravings are just some of the symptoms that can be indicative of food intolerance.
Finding out if you have food intolerances
There are several options.
Elimination diet
The only medically approved and scientifically proven method of identifying food intolerances is to go on an elimination diet and then slowly reintroduce suspect foods one by one to see if they cause a reaction. This is probably the most reliable method of diagnosing food intolerances if carried out correctly, and it is the method used in NHS allergy clinics. If you suffer from hay fever, asthma, eczema or allergic rhinitis (constant runny nose) you could ask for a referral to one of these clinics, but having MS would not normally be considered an adequate reason for such a referral.
The most common allergens are wheat, milk, egg, citrus fruit, yeast, chocolate and additives. If you do have food sensitivities, you are likely to see a reduction in symptoms within seven to ten days, and reintroduction of the culprit foods will then trigger a recurrence of symptoms.
It is possible to carry out this process yourself. For a step-by-step guide, see The Complete Guide to Food Allergy and Intolerance by Professor Jonathan Brostoff and Linda Gamlin, which explains the different options open to you. To carry out an elimination diet effectively, you need to stick to the diet faithfully for the required length of time or the results will not be reliable.
Warning If you have ever had a severe reaction to a food in the past or you suffered from atopic eczema as a child, you should not attempt the elimination and reintroduction of suspect foods without medical support or you could risk going into anaphylactic shock when you reintroduce a culprit food.
Food diary
The charity Allergy UK suggests keeping a record for a couple of months of everything you consume – food, drink, medication, supplements – and any symptoms you experience. Correlating food and symptoms may give you some ideas about what it is you are sensitive to. Food diaries can sometimes produce unexpected results. For instance, I found out by using a food diary that whenever I took evening primrose oil I would get severe muscle spasms. You can be sensitive to anything, even foods generally regarded as beneficial.
Blood tests
Blood tests designed to detect food intolerances, such as the ELISA blood test recommended by the Best Bet diet group, are known as IgG tests. Everybody makes IgG antibodies to food, and the testers claim that a person with a food intolerance will make more IgG antibodies than a healthy person would. Unfortunately, factors such as how often you eat a food or whether you have a ‘leaky gut’ can cause IgG levels in blood to vary, and this can compromise the accuracy of the test. This, together with the fact that little research has been done into the relationship between IgG antibodies and food intolerance, is why most doctors do not endorse these tests. If you do decide to go down this route, the ELISA blood test is available from Cambridge Nutritional Sciences in the UK (see page 146 for details).
‘Alternative’ methods
Many complementary health clinics offer ‘alternative’ methods of testing for food intolerances, such as Vega tests, applied kinesiology and pulse rate changes. There is no scientific proof that any of these methods work, so if you are considering using one of these clinics, proceed cautiously. Check what testing methods they use, what qualifications the staff have, and what their success rate is in accurately pinpointing food sensitivities. This is important, because if you are already omitting some categories of food from your diet, the last thing you need is to be told to omit foods that actually do you no harm.
Can I combine nutritional medicine with drug therapy?
If you are receiving disease-modifying drugs such as Betaferon or Copaxone, you can still modify your diet and get the resultant health benefits. You don’t have to choose between the two approaches. It is important, though, to let your GP or neurologist know what supplements you are taking, as some combinations of drugs and supplements can cause harm.
Are these diets suitable for anyone with MS?
There are a few points to bear in mind before you start to follow one of the diets in this book.
If you are already following another special diet for medical reasons (because you are diabetic, for example), you should always discuss any proposed changes with a dietician or your local MS nurse or GP before you start. The same advice applies if you are pregnant, breastfeeding or trying to conceive.
Whatever foods you exclude from your diet, make sure you eat enough protein. This is very important in order to maintain your energy levels. The protein can come from animal or vegetable sources, depending on which diet you are following, but aim to consume about 350 g (12 oz) of protein per day. It is not possible to follow the Best Bet diet if you are a vegetarian or vegan, because omitting dairy products, legumes and pulses will leave you short of protein.
If you decide to omit a food or a group of foods, replace it either with another food that contains the same nutrients or with an appropriate supplement.
Don’t go on any form of exclusion diet if you are seriously underweight or if you suffer from an eating disorder. In these circumstances the healthy eating diet is as far as you should go.
Swallowing problems
Some people with MS have trouble swallowing food and liquid (dysphagia). This is a problem that often affects those with more advanced MS, but it can also be experienced by people with less severe forms of the disease. Symptoms can include problems with chewing and swallowing; food particles sticking in the throat, sometimes leading to choking; and excessive saliva.
There are several risks associated with this condition. Instead of passing down the oesophagus, food and liquid may trickle into the airways and eventually reach the lungs, with a risk of causing respiratory infections. People may also eat and drink less than they would normally because they are anxious about potential problems such as choking, and this may lead to them becoming malnourished or dehydrated.
There are things you can do to help yourself if you suffer from dysphagia.
•Eat and drink in a relaxed atmosphere and allow yourself plenty of time to eat your meal.
•Sit upright and tuck your chin in as you swallow. This helps to close airways, making choking less likely.
•Take small mouthfuls and sips of liquid and chew each mouthful well before you swallow it.
•Don’t try to talk while eating.
•Cold liquids or hot, thickened liquids, such as soups or tea with milk, are easier to swallow than hot thin liquids, such as herbal tea.
•Moist, soft foods are easier to swallow, so purée or liquefy foods before eating. Alternatively, add a thick liquid, such as gravy or custard, to drier foods.
•Alternate liquid and solid food.
•At the end of the meal, drink a small amount of liquid and cough once or twice to dislodge any remaining particles. Sit upright for 30 minutes after you have finished eating to help the digestive process.
Many of the recipes in this book would be suitable for people with swallowing problems, such as smoothies; porridge; pasta dishes (so long as the meat, fish and vegetables are in small pieces and well softened in the cooking process, such as Sardine Pasta, see page 114); puréed soups such as sweet potato and coriander; and desserts such as Apricot and Banana Granola Crumble and Apple Snow (pages 128 and 127).
If you want to take supplements and you cannot swallow conventional tablets or capsules, some vitamins and minerals, such as vitamin C, are now available in powder form and can be dissolved in liquid for easier consumption.
If you have been diagnosed with dysphagia, you are likely to be referred to a dietician and you should discuss any potential dietary changes with him or her.
How long will it take for a change in diet to bring health benefits?
Our bodies are regenerating themselves all the time. Wounds heal; broken bones knit together; cut hair regrows. It takes about two years for the entire human body to be rebuilt. Depending on how severe and longstanding your symptoms are, it could take at least this time for all possible improvements to take place. Anecdotal evidence suggests that people who start to use diet therapy as soon as they are diagnosed sometimes see very quick improvements, while those who have been ill for several years may have to wait much longer in order to get results. However, if you have seen no improvement in your health after six months, or if some of your symptoms are worse, you should reconsider whether this is the right diet for you. Bear in mind too that with a disease such as MS there is a point of no return, after which some damage may be irreversible. Once you have received a firm diagnosis, the sooner you start the dietary approach the better, in order to obtain the best possible outcome.
Diet and other conditions
Developing additional autoimmune diseases is always a possibility when the immune system is not functioning properly. In fact, while researching this book I was surprised to discover how many people with MS have also been diagnosed with other illnesses such as coeliac disease, Hughes Syndrome, rheumatoid arthritis or Type 1 diabetes.
For coeliac disease, dietary intervention is a medically approved treatment; coeliacs have to stick to a gluten-free diet for life. Diabetes, too, involves a medically approved diet that is very similar to the healthy eating diet in that it recommends regular intake of unrefined starchy foods to control blood sugar levels, a reduction in fat, sugar and salt and an increased consumption of fruit, vegetables and oily fish. There is also evidence that eating less saturated fat and more fish oil, and identifying food sensitivities, is helpful in healing rheumatoid arthritis.
In all immune diseases the immune system, instead of protecting the body from attack, itself attacks parts of the body it sees as a threat. Dr Terry Wahls, in The Wahls Protocol, states that all immune diseases share a further five characteristics:
1mitochondria produce energy less efficiently, leading to excess production of free radicals;
2inflammation occurs throughout the body;
3toxins and chronic infections worsen symptoms;
4vitamin D levels are low and stress hormone levels high;
5the body is deficient in vitamins, minerals and EFAs.
Dr Wahls suggests that faulty biochemistry is the cause of all autoimmune diseases, including MS, and that therefore detoxing the body and providing it with all the nutrients it needs is crucial in the healing process.
Protecting your family
Multiple sclerosis isn’t hereditary, but the children of a man or woman with MS have a 1 in 48 chance of contracting it, so they are theoretically more at risk than the general population, whose chances of getting MS are 1 in 330.
Genes, however, make up only half the risk factors in whether or not you get MS; the other risk factors are environmental. We do not yet know for sure whether diet is one of these risk factors, but it makes sense to help protect your children’s health by encouraging them to eat a healthy diet and teaching them how to cook nutritious meals, especially since studies in the USA and Sweden have found that young people who are overweight at 20 are at greater risk of developing MS in later life.
It is also important for those who care for people with MS to eat a healthy diet themselves. Caring can be stressful, and stress can make you ill. When you are exhausted from looking after someone else’s needs, it is all too easy to neglect your own.
Dr Ashton Embry, pioneer of the Best Bet diet, suggests that lack of vitamin D may be a trigger for MS in people who are genetically vulnerable (that is, people with a family history of MS). He believes that we can help protect young people, particularly those who live in cooler climates such as Britain and Canada, by giving them vitamin D supplements from an early age. This seems good advice when you consider how many children today spend hours in darkened rooms playing computer games rather than running around out of doors. For more guidance on vitamin D supplementation for children, consult your GP or MS nurse.