Many people are confused about exactly what constitutes a healthy diet. However, there is broad agreement among members of the medical professions, dieticians and nutritionists on what we should be eating to promote health and well-being, and what we should cut down on if we don’t want to become ill. If you follow the seven principles below, you won’t go far wrong.
1 Eat less saturated fat
Saturated fats are bad for us in several ways.
They can form sticky platelets that clump together and clog up arteries, leading to the formation of blood clots and strokes.
Saturated fats increase the amount of cholesterol in the bloodstream. Cholesterol is one factor in atherosclerosis, where deposits of protein, fats, cholesterol and minerals narrow arteries, cutting off blood supplies and nutrients to the organs they serve. Blocked arteries can cause stroke, heart attack, pulmonary embolism or gangrene. Cholesterol cannot easily be broken down by the body; it has to be excreted and this requires an adequate fibre intake. This is why a diet full of saturated fat (fried food and red meat) and low in fibre (fruit and vegetables) is so bad for health.
Atherosclerosis also hardens arteries, making them less resilient, and this in turn raises blood pressure, another factor in heart disease. There is also evidence that a high-fat diet is particularly bad for people with MS (see the low-fat diet, Chapter 4).
Fats that are hard at room temperature, such as lard, butter and suet, are called saturated fats. Red meat (beef, pork and lamb) often contains a lot of saturated fat, and so do some types of poultry such as duck and geese, although chicken and turkey are low-fat meats apart from the skin. Processed foods such as pies, sausages, pâtés, chocolate, cakes and biscuits are all likely to be high in saturated fat, as are crisps and chips and any food that has been fried.
Ways to cut down on saturated fats
•Buy lean cuts of meat and cut off visible fat before cooking.
•Use a rack in the roasting tray or grill pan when cooking meat or chicken so that excess fat can drain away.
•Eat less fried food and fry in oil rather than butter or lard. Use the smallest possible amount of oil required to prevent food from sticking to the pan. Never reuse cooking oil.
•Try to avoid deep-fried food such as chips altogether. Instead, choose low-fat varieties of oven chips.
•Replace butter with polyunsaturated margarine on bread and toast, and use olive oil in cooking.
•Limit yourself to four medium eggs a week (unless you are underweight).
2 Eat fewer refined carbohydrates
Carbohydrates (starches and sugars) fuel the body’s energy systems and metabolism and are our main source of calories. Our ancestors ate a lot of complex carbohydrates, found in fruit, vegetables, pulses and whole grains. The modern Western diet, on the other hand, contains far more refined carbohydrates in the form of white flour, white rice and white sugar. These foods have been heavily processed in ways that destroy much of their natural goodness. They contain only ‘empty’ calories that make you fat while at the same time leaving you short of vitamins, minerals and dietary fibre. Eat too many of these foods and you could suffer from malnutrition even while being overweight. If you have MS it is particularly important to avoid foods that will encourage weight gain without giving you any health benefit.
Refined carbohydrates are predigested so they bypass our digestive systems and give us a quick burst of energy. However, this type of energy won’t last long. Complex carbohydrates, on the other hand, release energy more slowly over a longer period and also provide essential nutrients.
Sugar has the potential to cause more damage than any other refined carbohydrate, triggering conditions such as diabetes and hyperglycaemia, which can make your blood sugar levels fluctuate wildly and cause sugar cravings. Sugar can give you a quick energy boost, but when your levels fall again you crave more sweet food.
Sugary drinks are a particular problem. A recent survey by Action on Sugar tested the sugar content of canned fizzy drinks. Of the cans tested, 79 per cent contained at least 6 teaspoonfuls of sugar: colas contained 9, while some ginger beers contained 13! You can make your own healthy fizzy drinks from a small amount of fruit juice mixed with sparkling spring water.
The World Health Organization currently recommends that sugars should form no more than 10 per cent of our daily calorie intake, but it is considering reducing this target further to 5 per cent.
Research at the University of Alabama has shown that white sugar has a rapid and adverse effect upon the ability of white blood cells to fight infection. This suggests that people who have recurrent infections or infections that don’t respond to normal treatment should consider avoiding white sugar completely.
Simply using artificial sweeteners instead of sugar isn’t the answer either, as they just encourage your sweet tooth. Why not start by replacing your usual sugary snacks with fresh or dried fruit or fruit smoothies (see page 94) and using natural sweeteners such as honey, maple syrup or muscovado (the least refined form of sugar) instead of white sugar.
Good carbs – eat more of these
•Wholemeal and granary bread and rolls.
•Wholegrain cereals, such as Shredded Wheat and Weetabix.
•Oats in the form of porridge (but not the quick-cook variety), muesli or oatcakes.
•Pasta made from unrefined flours, such as brown rice, buckwheat or maize.
•Brown rice or other unrefined whole grains, such as millet or quinoa.
•Wholegrain crackers, such as Ryvita.
•Starchy vegetables, such as sweetcorn, broccoli and cauliflower. Note that potatoes, though starchy, should not be eaten in large quantities as they tend to break down quickly in the body like refined carbohydrates.
Bad carbs – eat less of these
•White bread and rolls.
•Refined, sugary cereals and sugary drinks such as cola.
•All forms of refined rice and pasta.
•Cakes, pastries, biscuits, crackers, confectionery and other manufactured goodies made with white flour and white sugar.
3 Eat more fish
Fish, especially oily fish such as tuna, mackerel and salmon, is full of omega-3 essential fatty acids. These can’t be made by the body; you can only get them by eating the right foods. The additional importance of EFAs to people with MS is explained in Chapter 4, but there are many other good reasons for eating fish.
•Fish is a good source of low-fat protein.
•It’s quick and easy to cook and delicious to eat.
•Oily fish such as salmon and trout contain vitamin D, which is a crucial nutrient for people with MS.
•Tinned oily fish with bones, such as sardines, are an excellent source of calcium.
•White fish is a good source of the antioxidant selenium, which is often missing in the modern diet.
•Shellfish are another good source of low-fat protein. However, they are also a source of cholesterol so if you have high blood pressure or a heart condition it may be better to avoid them.
4 Eat low-fat dairy products
Dairy products are good protein foods and useful sources of calcium (although by no means the only ones). However, most of them, such as cream, cream cheese, hard cheeses such as Cheddar and ice-cream, are naturally high in saturated fat. Cut down on these foods and eat more low-fat dairy products, such as:
•skimmed or semi-skimmed milk
•low-fat natural yogurt (but not the flavoured, low-fat yogurts as extra sugar may have been added to compensate for the lack of fat)
•fromage frais – virtually fat-free (0.4 per cent fat) or creamy (7.9 per cent fat)
•cottage cheese or curd cheese
•quark – a soft white cheese made from fermented skimmed milk that is virtually fat-free; a useful ingredient in dips
•half-fat Cheddar.
5 Eat five portions of fruit and vegetables daily
The World Health Organization recommends that we all eat at least five portions of fruit and vegetables every day in order to stay healthy. Recent research suggests that upping your intake to seven portions a day could cut even further your risk of dying from cancer or heart disease.
Fresh fruit and vegetables are best because they contain most nutrients, but frozen, tinned and dried varieties also count towards your five portions a day, as do pulses (peas, beans and lentils). If you have a glass of fruit juice with your breakfast, a salad at lunch, a portion of cooked vegetables with your evening meal and a couple of pieces of fruit between meals, you’ll easily achieve your five a day.
Smoothies are another delicious way of eating fruit (see page 94) and you can use raw celery sticks, carrot or cucumber as dippers with dishes such as hummus (see page 100). In hot weather you can also pour fruit juice, puréed fruit or fruit smoothies into lolly moulds and freeze them – a really delicious way of cooling down!
Tubs of rice or pasta salad are good lunch-box fillers, and adding slices of tomato, cucumber and pepper to sandwiches makes them taste more interesting as well as bumping up their nutritional value.
It is particularly important if you have MS to eat a helping of dark-green leafy vegetables, such as cabbage, spinach, broccoli or greens, every day, as they contain large quantities of magnesium, which will help oxygenate your blood and also help prevent all sorts of problems such as constipation, depression and tiredness. Don’t overcook vegetables as this destroys the nutrients (see instructions for preparing and cooking vegetables on pages 102–5). Don’t leave fruit and vegetables lying around too long before you eat them, as they lose nutrients with each passing day.
So what exactly is a ‘portion’ of fruit and vegetables? Here are some guidelines:
•1 medium-sized piece of fruit, such as an apple, banana or orange
•10–15 cherries or grapes
•2 smaller fruits, such as plums or satsumas
•1 tablespoon of dried fruit, such as raisins
•1 slice of melon
•1 glass 100 per cent pure fruit juice
•1 tomato, 1 onion or half a pepper
•1 heaped tablespoon of carrots, peas or sweetcorn
•1 cereal bowlful of salad.
Note that you can only count juice as one portion, however much you drink in one day, and potatoes don’t count towards your five a day because they are classified as a carbohydrate.
Table 3.1 lists when fruit and vegetables are in season.
Table 3.1 Fruit and vegetables in season
Try to buy fruit and vegetables in season when they are at their tasty, succulent best. Produce that has been flown in from abroad out of season is more expensive and will almost certainly have lost some of its nutrient content.
Fruit |
In season |
Apples (English) |
September to November |
Apricots |
June to August |
Cherries |
June, July |
Figs |
September |
Grapes |
December to March |
Grapefruit |
December to March |
Nuts |
October to December |
Oranges |
January to March |
Peaches |
June to September |
Pears |
September to February |
Plums |
August |
Raspberries |
July, August |
Rhubarb |
December to June |
Strawberries |
May to July |
Tangerines |
December |
Vegetables |
In Season |
Asparagus |
May, June |
Aubergine |
June to August |
Beans (green) |
May to September |
Beetroot |
July to April |
Broccoli |
June to November |
Brussels sprouts |
August to March |
Cauliflower |
July to April |
Celery |
June to August |
Celeriac |
December to May |
Corn on the cob |
July to September |
Courgettes |
May to October |
Fennel |
June to August |
Garlic |
September to November |
Leek |
December to May |
Lettuce |
May to October |
New potatoes |
April to June |
Parsnips |
September to April |
Peppers |
May to September |
Radishes |
April to June |
Spinach |
March, April |
Tomatoes |
June to November |
Watercress |
March to August |
NB: Onions, carrots, cabbages, mushrooms and salad cress are available all year round.
6 Eat less salt
The RDA for salt for an adult is 6 g (1 tsp). However, as 75 per cent of the salt we eat is already in the food we buy, such as bread and cereals, you may not be aware of how much you are eating.
A recent study in Argentina that investigated the link between salt intake and MS symptoms found that those participants who consumed a large amount of salt in their diet had a measureable increase in disease activity.
According to scientists at the University of Vermont, salt may also turn out to be one of the environmental factors contributing to MS, as their research suggests that salt has an influence on the immune cells that cause MS.
Both these studies suggest that you would be wise to cut down on salty foods, such as crisps, and look for low-salt options when buying processed foods.
Salt clogs up the arteries and can be a contributory factor in heart disease, so cutting your intake will also benefit your general health. Try substituting black pepper and herbs and spices for salt in recipes to enhance flavour.
7 Ensure you drink enough liquid
Our bodies need water to help absorb nutrients and to flush out toxins and waste matter. Few of us drink enough liquid, and this can lead to problems as varied as headaches, mood changes and constipation.
Try to drink six to eight glasses of liquid per day, preferably in the form of water, herb tea or diluted fruit juice rather than tea, coffee and alcohol, which act as diuretics and flush essential minerals from the body. People who are very active may need more.
Don’t make the mistake of drinking less in order to minimize visits to the toilet. Your urine will become concentrated, which can irritate your bladder and encourage bladder infections. If you are prone to these, why not drink a large glass of cranberry juice every day? Finnish researchers have found that tannins in the juice have an antibacterial effect, which helps prevent bladder infections.
It’s easy to become dehydrated. If you’re busy, you may forget to drink, or you may confuse thirst with hunger and eat instead of drinking. Urine that is dark yellow instead of clear and pale is a sign that you are not drinking enough liquid.
If you drink filtered water, remember that the filter will remove beneficial minerals as well as harmful chemicals, so it is advisable to take a multimineral supplement. Make sure you change the filter as often as the manufacturer recommends, or you could become ill. Carbonated water has the same effect, as the carbon minerals bind to the other minerals in the water and remove them from your body. Naturally sparkling spring water is a better bet.
A useful product for anyone who has a problem transporting, holding or lifting drinks is the Hydrant, which clips on to a belt, bed or wheelchair and has a flexible plastic drinking tube (see page 147 for purchase details).
Superfoods
Most health professionals agree that foods containing antioxidants are extremely beneficial. (The reasons for this are given on page 13.) Here are some of the most useful antioxidant-rich foods.
•Blueberries Dark berries, such as blueberries, blackberries and blackcurrants, contain some of the most powerful natural antioxidants in existence. Blueberries and cranberries also contain a compound that helps prevent bacteria sticking to the lining of the bladder so they can protect against cystitis and bladder infections.
•Tomatoes Tomatoes contain high levels of vitamin C. Heating them releases an antioxidant called lycopene, which has anti-cancer properties, and cooking them with olive oil increases absorption of the lycopene. Lycopene is also found in red peppers and watermelons.
•Carrots Carrots are a good source of carotene, which converts into vitamin A in the body and helps reduce your risk of heart disease and cancer. Regular intakes can help reduce cholesterol levels and prevent macular degeneration and cataracts, which can lead to blindness. Carrots also contain vitamin C, potassium, calcium, iron and zinc. Eat them with a little oil or fat to encourage absorption of the carotene.
•Dark-green leafy vegetables Spring greens, spinach, kale, chard and broccoli are all good sources of vitamins C and E and carotenoids. They are also rich in calcium, potassium (which helps prevent calcium loss) and folic acid and are a good source of fibre. Broccoli has been shown to have anti-cancer properties. It contains lipoic acid, which has been linked with increased brain power and energy, and lutein, which helps maintain healthy eyes. Broccoli and spinach both also contain co-enzyme Q10, which is needed for cellular energy.
•Green tea All tea is rich in antioxidants, but green tea also has anti-inflammatory and neuro-protective qualities that particularly benefit people with MS. In addition, it kills the streptococcus bacteria that encourage tooth decay and gum disease. Use four tea bags to one mug of hot water and steep for 10 minutes for full therapeutic benefit. Green tea contains caffeine, but the herbal extract (available at health food shops) does not.
Organic or not?
While only approved pesticides and chemicals can be used in the production of fruit and vegetables on commercial farms, some chemicals that are banned from food production in other countries are deemed safe in the UK. Alternatively, some substances banned in the UK are still used on imported produce. Until we have international agreement on what is safe and what is not, we cannot be sure what we are eating. Recently, 174 scientists from 28 countries jointly participated in a project to investigate the ‘cocktail effect’ of mixing different approved chemicals in the food we eat. They concluded that one in five cancers may be caused when chemicals deemed safe on their own blend lethally inside the human body.
Official data shows that over the past 50 years there has been a steady decline in mineral levels in fruit and vegetables. Nutrient levels are 85 per cent higher in organic soils. Researchers found higher vitamin C levels, higher mineral levels, more amino acids and less water in organic produce, which also contained lower levels of nitrates, nitrites and pesticide residues.
We are exposed to hundreds of different potential toxins in our food and environment. Many additives used in manufactured food and drink have been linked with health problems and are banned in organic food production.
Organic meat and poultry also offer health benefits. The routine use of antibiotics on animals to prevent illness is prohibited, and grass-fed animals have higher levels of CLA (a form of linoleic acid, an omega-6 fatty acid). Organic eggs also contain more essential fatty acids because the chickens eat a more natural diet.
The UK Food Standards Agency believes that there is not yet conclusive proof that organic food is better for us than inorganic produce. More research is needed, but some scientific studies already show the superiority of some types of organic food. For instance, a study at the University of Aberdeen showed that organic milk contained more omega-3 and vitamins than normal milk, and a ten-year study at the University of California proved that organic tomatoes were much higher in antioxidants than normal tomatoes.
Genetically modified (GM) foods are another controversial issue, and these, of course, are banned from organic farms. Although GM foods have not so far been proved to have any harmful effects, they have only been around for a few years, and some people are concerned that as yet unsuspected health problems may emerge at some time in the future.
If you would like to find out more about the health benefits of organic food, take a look at Organic Farming, Food Quality and Human Health: A review of the evidence by Shane Heaton (Soil Association, 2001).
There are, however, ways to ensure the food you eat is as nutritious as it can be – organic or not.
Organic produce is often difficult to get hold of and may be expensive. One alternative, if you live in the country, is a farm shop or farmers’ market. Locally grown food should be fresher and therefore more nutritious than supermarket produce, which may have been transported thousands of miles to reach you. If you are a townie, use a local greengrocer and buy only produce that is in season.
When buying inorganic produce, always wash it well before use. Peel fruits such as apples and pears and always peel carrots, which frequently test positive for pesticide residues.
You may be able to find an organic box scheme, which will deliver fresh fruit and vegetables to your door once a week. This is particularly useful if you find shopping difficult. The Soil Association can provide you with a list of box schemes, farm shops, farmers’ markets and retailers (see Useful addresses).
If you have a friend or family member who is a keen gardener or who has an allotment, ask if he or she can supply you with fresh produce. Many gardeners nowadays use natural means of pest control; in any case, there will probably be less pesticide on home-grown fruit and vegetables than on supermarket purchases.
It is possible to grow some of your own food even if you are disabled or don’t have a proper garden. You can grow all sorts of things in pots and planters, from salad leaves, herbs and tomatoes to strawberries and small fruit trees. All you need is a sunny patio, or even a table indoors in front of a south-facing window. Or why not turn the conservatory into a greenhouse? I’ve successfully grown peppers indoors on a wide sunny windowsill, and salad leaves and herbs in planters on the patio. Just remember that growing plants need regular watering, so if you can’t manage this yourself, you may need some help.
Getting the balance right
Meals should be based round pasta, rice, potatoes, bread or cereal; then add a portion of fruit or vegetables and some protein – dairy products, meat, fish, chicken or pulses. Anyone with MS should always be sure to eat enough protein, as too little can worsen muscle weakness or fatigue – 115 g (4 oz) of protein per person per meal is about right.
Sometimes people with MS are overweight, perhaps because they cannot exercise properly or because depression leads them to ‘comfort eat’. If you need to lose weight, the healthy eating diet should help, because you will be eating less of the sugary, fatty, refined foods that pile on the calories.
Vegetarians
According to the Vegetarian Society, research shows that, compared with an omnivorous (meat-eating) diet, a varied vegetarian diet contains less saturated fat and cholesterol and more folate, fibre, antioxidants and phytochemicals. It is also likely to contain more than the recommended five a day fruit and vegetables. The Oxford Vegetarian Survey, which compared the health of 6,000 vegetarians with that of 5,000 meat eaters over 12 years, reported that vegetarians were 40 per cent less at risk from cancer, 30 per cent less at risk from heart disease and 20 per cent less likely to meet a premature death from other causes than the meat eaters. In countries such as India where vegetable protein forms the staple diet, MS is virtually unknown.
In a vegetarian diet, eating the right combination of foods to achieve an adequate protein intake can be quite a challenge. It is important not to take the easy option and just add cheese to every dish, as this will lead to a diet containing too much fat. Learn how to use nuts, beans and pulses to enhance your meals – the recipes in this book will show you the way. Because vegetarians eat a more limited range of foods, you need to ensure that as much as possible of what you eat is fresh, good quality, unrefined food full of vitamins and minerals.
If you rely on carers
Anyone who has to rely on agency carers for meals will be aware that they never have enough time to cook a meal from scratch using fresh ingredients. In any case, many professional carers have had virtually no training in cookery or nutrition. Some are reluctant to use a hob or grill because a microwave is the only form of cooking apparatus they are familiar with. I have even come across a few who do not know how to operate a can opener! In the circumstances, microwave meals from the supermarket may seem the only viable option for dinner.
Some years ago, after I broke my leg and was unable to access my kitchen easily, I needed to use agency carers to help me prepare meals. Luckily it wasn’t long before I discovered the direct payments scheme, which enabled me to appoint my own carer, someone who could cook and was willing to follow my instructions to produce the sort of food I needed for my particular diet. I also paid a local lady to make a loaf of gluten-free bread, some gluten-free muffins and a batch of soup for me each week. During that period I proved that, by organizing the right help, it is possible to follow a special diet and eat extremely well even if you are unable to do any cooking yourself.
Explain to whoever helps you with shopping and cooking that you are trying to improve your health by changing what you eat. All that is required is buying a different range of food at the supermarket and changing the menu slightly. Most people are eager to help once they realize the changes needed are not complicated and will benefit your health.
First of all, make some changes to your shopping list. These could include buying:
•wholemeal bread instead of white bread, and wholegrain and reduced-sugar cereals
•ham and cooked chicken from delicatessens rather than the cheap processed variety
•polyunsaturated margarine instead of butter
•skimmed milk rather than full-fat milk, natural yogurt rather than ice-cream and low-fat or cottage cheese rather than hard cheese
•fruit juice and bottled water in place of fruit squash and cola drinks
•sugar-free jams and marmalades or honey
•items for your larder such as tinned fish (tuna, salmon and sardines), tinned fruit in fruit juice (not syrup), reduced-sugar baked beans and some good-quality tinned or chilled soups – those containing lentils and beans are particularly good as they are both filling and nutritious
•some salad ingredients, such as tomatoes, cucumber, celery and punnets of salad cress, large potatoes for baking in the microwave and individual packets of mixed vegetables designed to be cooked in a microwave
•a selection of fresh fruit, dried fruit, small packets of nuts and raisins or a tub of olives from the delicatessen, wholegrain crackers (such as Ryvita) to spread with hummus (also from the deli) and additive-free fruit smoothies for snacks
•the healthier, low-fat ranges of ready meals, opting for those made with chicken and fish rather than beef and lamb (it’s surprising just how large the difference in fat content can be between these ranges and the standard ones).
Using these ingredients, your carers can prepare simple, healthy meals for you. Here are some suggestions.
•Breakfast Porridge made in the microwave, cereal with skimmed milk and sultanas or raisins instead of sugar or wholemeal toast with honey or sugar-free jam and a glass of fruit juice.
•Lunch A sandwich filled with ham or chicken and salad or tuna with low-fat mayonnaise or mashed sardine with sliced tomato. Scrambled eggs on toast or a potato baked in the microwave and served with cottage cheese or baked beans and a salad. A really simple salad that requires absolutely no expertise to prepare is a few slices of cucumber, a quartered tomato and half a punnet of salad cress. Try a large bowl of soup served with bread and a low-fat margarine. Have a piece of fruit for pudding.
•Dinner A ready meal served with a portion of cooked vegetables. Finish with a dessert of tinned fruit with low-fat custard or natural yogurt, a small bowl of muesli with milk or yogurt or another piece of fruit, such as half a small melon.
And finally . . .
A few words about all those things we love, but which can do us harm if we overindulge.
Caffeine
Caffeine, which is found in coffee, tea, cola, chocolate, energy drinks and some medicines, has a drug-like effect on the body. It is a diuretic, so it may make bladder problems worse. It is also a stimulant, causing the release of adrenaline into the body. This may prevent you relaxing properly, and too much could make your blood pressure rise. If consumed in large quantities, it can become addictive and can even cause heart attacks in otherwise healthy young people. In some people it can also cause mood swings, tremors, headaches, palpitations, insomnia and tingling in the arms and legs. Research in the USA has also found that caffeine makes it more difficult for the body to control acute inflammation.
If you consume a lot of caffeine on a daily basis, and especially if you suspect you may be addicted to it, you should consider cutting your intake. Reduce your consumption gradually to avoid withdrawal symptoms such as headaches. Start by replacing some cups of tea or coffee with the decaffeinated variety. After a week or so, you can substitute herbal teas for the decaffeinated drinks; there are some very exotic flavours available nowadays. Redbush makes an acceptable alternative to tea, and roasted chicory is a good coffee substitute. You could also try Barleycup if you are not avoiding gluten.
Of course, if you limit your coffee intake to, say, one cup a day and do not try to use it as a substitute for food when your energy is low, you may find you do not have a problem with caffeine.
Chocolate
Chocolate is a high-fat product, and all the paler varieties contain full-fat milk or cream and quite a lot of sugar. According to Jonathan Brostoff, Professor of Allergic and Environmental Health at King’s College, London, there is limited evidence that some MS patients may be particularly susceptible to something in chocolate, and that this may play a part in developing their MS.
One Dutch medic, Dr Anna Maas, has had a great deal of success treating people with MS by removing from their diet chocolate and other substances such as cola and caffeine, which could cause an adverse reaction. She speculates that people with MS may lack an enzyme which is needed to metabolize chocolate properly.
On the other hand, recent research has shown that the flavonoids in dark chocolate helped reduce inflammation in heart attack and stroke victims. Since inflammation is a feature of MS, some people are now suggesting that eating small amounts of dark chocolate every day might well benefit people with MS. Dark chocolate contains more flavonoids than the paler dairy chocolate and also more than red wine, but has a much lower fat and sugar content.
If – like many people today – you’re a bit of a chocoholic, this will come as good news to you. If, however, like me, you feel worse after eating chocolate, you may opt to try cutting it out altogether for a while and see if your health improves.
Alcohol
You may think that if you stick to the recommended maximum weekly intake – 14 units per week for both women and men – you are unlikely to do yourself any harm (1 unit of alcohol is 1 pint of beer or lager, 1 glass of wine, 1 measure of spirits or 1 bottle of alcopop). These units should be spread out through the week and people should have at least two alcohol-free days a week. Advice from the Department of Health states that pregnant women or women trying to conceive should not drink alcohol at all. If they do choose to drink, to minimize the risk to the baby they should not drink more than 1–2 units of alcohol once or twice a week and should not get drunk. These guidelines, however, are intended for the average healthy adult. If you have MS, there are even more good reasons for cutting down on alcohol.
Alcohol can worsen MS symptoms such as difficulties with walking, co-ordination, speech, balance and memory. Remember, also, that MS can decrease your tolerance to alcohol, so it may take only a small amount to cause deterioration in your symptoms. It is a depressant, so if you are feeling low and have a drink to make you feel better, it may have the opposite effect. Like tea and coffee, alcohol is a diuretic and may exacerbate bladder problems. It inhibits the conversion process of EFAs, which are very important for people with MS (see pages 49–50). It can also destroy the body’s supply of vitamin C and zinc, and a heavy drinker may need to take as much as 500 mg vitamin C per day to replace that destroyed by alcohol.
Don’t forget either that most alcoholic drinks contain sugar and yeast, and some contain gluten as well, so alcohol consumption needs to be restricted on the Best Bet diet and the Wahls diet. Professor Jelinek believes that moderate quantities of red wine are the safest bet because of their beneficial antioxidant content.
As with chocolate, my advice would be to try cutting alcohol out completely for a few weeks, to see if this has any effect on your symptoms, and after that to drink only in moderation (a maximum of 2 units at a time and no more than 4 units per week).
Smoking
Research into smoking and MS suggests that smoking more than doubles your chances of getting MS, even after you have given it up. It may also help transform relapsing–remitting MS into progressive MS. There is also proof that MS progresses faster in smokers than in non-smokers.
Research also shows that, far from helping you cope with stress, smoking actually raises stress levels, so it can often make MS symptoms worse. It can make you more prone to respiratory illnesses such as bronchitis and pneumonia, which can be harder to recover from if you already have a chronic illness. Smoking lowers your skin temperature, so it makes you feel worse if you suffer from frozen hands or feet in cold weather.
Cigarette smoke contains a cocktail of poisonous chemicals including carbon monoxide, which attaches itself to the oxygen-carrying part of your red blood cells so they can’t carry as much oxygen around your body. If you already suffer from MS fatigue, this will leave you with even less energy. There is not much point in using diet to improve your health if you continue to bombard your body with toxic chemicals from cigarettes. A single cigarette can destroy 25 mg of vitamin C in your body. Cancer, emphysema and cardiovascular disease are all linked to smoking. Do you really want to increase your burden of illness?
Giving up smoking could also save you a considerable amount of money, which could instead go towards good-quality food and supplements. There is a lot of help available nowadays for anyone who wants to quit smoking. Nicotine replacement therapy comes in several different forms and is available on prescription. There are also drugs such as Zyban that help, although they can have side effects.
E-cigarettes are a fairly recent innovation for those who want to stop smoking. Recent research by Public Health England came to the conclusion that e-cigarettes are 95 per cent less harmful to health than normal cigarettes, though they do still contain nicotine, which is addictive. Evidence suggests that, when combined with a ‘stop smoking’ scheme such as NHS Smokefree, they help most smokers to quit smoking. (For details of the NHS scheme, see page 147.)
Supplements for the healthy eating diet
Anyone eating a healthy diet containing both animal and vegetable protein should be consuming a wide variety of vitamins and minerals. However, you may like to consider taking extra therapeutic doses of vitamins and minerals as outlined in ‘Supplements that can help MS’ (see page 13). In particular, if you smoke, or drink more than 4 units of alcohol per week, you should also consider taking a vitamin C supplement.
Vegetarians may need to take a vitamin B12 supplement as this vitamin is only found in sufficient quantities in animal-based foods. Anyone taking doses of individual B vitamins such as B12 should also take a B complex supplement as the two work together.
Vegetarians are also often short of iron. Although iron can be found in wholegrain bread, dark-green leafy vegetables and some dried fruit, we get most of our iron from animal protein, particularly red meat. Your GP can test your iron levels and prescribe a supplement if you need one.