A Healthy Diet for Multiple Sclerosis

Jean,

I read with great interest your article on celiac disease. I was recently diagnosed with Multiple Sclerosis (MS) and was wondering if you have any insight on how diet might contribute to this condition, which is basically an autoimmune disorder that attacks the protecting myelin coating of the nerves.

About 400,000 people have been diagnosed with MS in the US, and its incidence seems to be increasing. My assigned neurologist, who specializes in treating MS patients, used MRI scans to identify "plaques" on my brain and spinal cord. On the MRI images, these appear as light-colored spots of inflammation. These, he says, are the cause of sensory problems in my feet and legs, as well as occasional vision and equilibrium loss when I overheat.

He prescribed beta-inferon injections every other day to modulate my immune response. I'm giving myself these injections now. This does not improve my condition, but is supposed to help keep it from getting worse.

Other than to suggest a healthy low-fat diet, the neurologist who diagnosed me was quick to discount any connection with diet when I asked about it. But I have read a number of "fringe" natural health pieces that point tomilk, gluten and other food allergies as potential culprits.

No one has suggested I get a test for food allergies, but I'm thinking maybe it would be a good idea. What are your thoughts on this, and how reliable are these food allergy tests? And, why wouldn't my neurologist or GP suggest such an allergy test?

Thanks,
WW

Hi WW,

Thanks for writing--first, I'm sorry to hear that you have MS; hopefully your treatment will be as effective as can be expected. Secondly, the source of MS is highly controversial and no one can say definitively what caused yours. Anyone who does make that claim is not truthful. Finally, I am not a doctor, and MS is not my area of expertise; however, after a quick literature review there are a few points of advice I would offer.

1. There may be an association between MS and vitamin D deficiency, as reported in JAMA by researcher at the Harvard school of public health (Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A (2006). "Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis". JAMA 296 (23): 2832–8).

High sun exposure causes too much damage for your body, but salmon, mackerel and tuna are all good sources of vitamin D. Furthermore, these foods are also naturally high in bio-active omega-3 fats, of which nearly all Americans are not getting sufficient amounts.

2. MS and stress/viral infection are HIGHLY associated. Therefore, it would behoove you to practice a relaxing form of meditation or exercise, such as yoga, consistently (like daily). Also, I would examine your life and eliminate extraneous stressors. Don't try to pack too much into your days; plan ahead to avoid unwanted surprises. Take a nice vacation (even if it's local, just make it care-free)!

Sleep loss induces inflammatory and stress responses in the body; adequate sleep should be a priority for you!

A high intake of high phytochemical/nutrient fruits and vegetables is associated with reduced risk of colds and other viral infections. An antioxidant juice is NOT a substitute for a good diet. The only way to eat a healthy diet is to eat lots and lots of fruit and vegetables. Especially for an MS patient, the bulk of your diet should be leafy greens, berries, broccoli, etc. Frozen is fine; avoid canned produce.

You do not need a special supplement or juice; you need good food in your body ALL the time to enhance immunity.

3. Food allergies are common culprits of bodily discomfort but I cannot say that they are directly linked to chronic disease. Variety (especially of fruits and vegetables) is the key to a healthy diet for all humans. Out of the 100s of grains in our world, the American's idea of variety is a wheat bagel at breakfast, wheat bread for lunch, and wheat pasta at dinner. Furthermore, materials like latex generally evolve into allergies with repeated exposure. It is not surprising to me that many people have a problem with wheat when its consumption is so incredibly pervasive in our society. You may have a problem with wheat; you may not. It is certainly not needed on a healthy diet, so go ahead and eliminate it for a while if you feel like it. Remember, in lieu of grains, you will need to get plenty of whole fruit in your diet for adequate carbohydrate intake.

Food allergy testing on the skin, as it is commonly done, has a tendency to OVER-DIAGNOSE people with food allergies. In order to truly identify food allergies, your blood must be tested for certain antibodies. This is quite costly, which is why it is rarely done. Elimination allergy diets should only be done under the care of a physician (MD!) who specializes in allergies, ideally in collaboration with a registered dietitian (RD).

Since there is no scientifically validated and clear association between a particular food and MS, it would not have been prudent for your neurologist to recommend allergy testing. He or she is attempting to maximize the good of your financial resources by focusing on validated medical treatments.

I hope this helps somewhat.

All best wishes,

Jean

7:00 PM - 1 Comments - 4 Kudos - Add Comment

Easy, Fast, and Delicious High Protein Breakfast-- Eggs on the Grill!

Though a daily morning omelet is delightful, neither the smoldering summer heat nor a busy schedule are conducive to preparing breakfast over a hot stove! This dish is designed to be a convenient, tasty and healthful breakfast option. Enjoy!

Equipment:
Gas Grill: preheat to medium-hot heat)
Round non-stick cake pan
Fitting lid or aluminum foil
Heavy duty oven mitts (silicone or fabric that can take the heat)

Ingredients:
       cooking spray
1     cup egg whites or egg beaters
3/4  cup left over grilled summer squash, onions and bell peppers
1/4  cup feta or Gorgonzola cheese, divided
2     sprigs basil (leaves pull off and torn into pieces
       salt and pepper to taste

Directions
1. Preheat grill to medium or high (if you are cooking on a small grill)
2. Spray non-stick cake pan with cooking spray
3. Add egg whites or egg beaters to cake pan
4. Sprinkle veggies and 1/2 of the feta cheese (2 Tbsp; 15g) on top evenly
5. Cover and place on the grill where the pan will be exposed to even, and preferably indirect, heat
6. Take a quick shower (5-7 minutes; this time will vary based on the heat of your grill and cake pan size)
7. Go outside and pull your meal off the grill
8. Sprinkle the remaining cheese and 1/2 basil on one side of the cooked omelet; fold the omelet over
9. Transfer to a plate and top with the remaining basil; salt and pepper as desired.

Wow! Now you have breakfast that took 2 minutes of effort and kept your house cool!

Nutrition:
260 kcal; 33 g protein; 9 g fat; 6 g sat fat; 11g carbs; 2 g fiber

12:23 AM - 0 Comments - 0 Kudos - Add Comment

Too Hot to Handle–Reported to the Dean for Being a Babe!

So, I was called into the principal's office today…

 …actually it was the office of my chair.

 Anyway,

"Jean, this is half-joke, half serious. It's funny that you someone even reported you and serious because you actually have to do something about it.  As you know ***** is very image concious and apparently you're a 'babe of the' something…"

I was named "Babe of the Month" by my local rock station and the sound byte on the radio goes something like this

"Hi fellahs!  My name is Jean; I'm a registered dietitian, ivy league graduate, and I'll soon have my PhD in Exercise Nutrition.  But more importantly, I'm The Bear's 'Babe of the Month' for June…"

Apparently someone at unsaid university thought my provacative photos were not in line with the University's mission, so I had to take all links to unsaid University off my website and blogs.

 Oy.  What's next?

 Though, I have to also acknowledge that plastering scores of nearly nude photos of myself all over the internet is not highly professional and it may seriously bite me in the ass in about a year when I'm seeking employment.

Something to ponder…

7:36 PM - 4 Comments - 5 Kudos - Add Comment

Vegan Avocado Eater?

hey jean,

i read this and was quite intrigued...

my first instict is to be dismissive (those crazy vegans) but i thought i'd run it past you to see if there's any truth to these claims:

Link

(look in her "about me" section)

hope all is well!

j

Ah, quacks; I love it!  Next, she'll be selling avocado in pill form, to save us from the greasy green mess!  My mom actually started taking a supplement that was supposed allegedly like eating 8 cups of veggies...conveniently packaged into 2 little geltabs.  Sorry folks!  There's simply no substitute to a well-balanced healthy diet!

There are a number of marketing tricks in this little nutritional bit, which are important to look out for generally.  I will respond to her claims conversation style.

*Avocados are the perfect food! Avocados are bursting with nutrients--vitamins, A, B-complex, C, E, H, K, and folic acid, plus the minerals magnesium, copper, iron, calcium, potassium and many other trace elements.*

But in what amounts?  No vegan food is a great source of B-12, which is a common deficiency in a vegan diet.

 *Avocados provide all of the essential amino acids (those that must be provided by our diet), with 18 amino acids in all,*

Again, overall QUANTITY of amino acids are low; most foods contain at least a trace amount of each essential amino acid.  Veggies are an imcomplete source of protein generally because they have at least one limiting amino acid.  This means that at least one essential amino acid (one your body needs but cannot make) is low in comparison to the non-essential amino acids the food provides.

 *plus 7 fatty acids, including Omega 3 and 6.*

I will blog on this soon (meant to do it about a month ago).  omega-3 and omega-6 fatty acids from plant sources do not have pharmacological benefits (straight from the top o-3/o-6 researchers at experimental bio conference in april).  Eat fatty fish or take fish oil supplements!

*Avocados contain more protein than cow's milk, about 2% per edible portion. Since rapidly growing nursing infants obtain no more than 2% protein from mother's milk, we can safely assume that children and adults do not regularly require foods richer in protein than avocado.*

I think these statements are completely misleading and false.  Even so, generally speaking, comparing a solid food and a liquid food's protein content does not make sense, since liquid food nutrient percentages are thrown off by large quantities of water.  Water has no calories (water is the bulk of milk's overall content), whereas fat is calorically very dense.  For example, a cup of whole milk is only 4% fat, but contributes the majority of the overall calories contained therein, even though the percentage is small.  Furthermore, a serving of avacado (say 1/4 cup) has only 1g protein, whereas 1 serving of milk (1 cup) has 8g protein.  Even cup for cup, milk has twice as much protein as avocado, and it is also much higher quality (essential amino acids are not only present, but also in the right balance).

 *Our bodies recycle approximately 80% of our protein; cooked protein is denatured and largely unusable, thus our protein need is far lower than what is taught by conventional dietetics. A small avocado will provide more usable protein then a huge steak because cooked protein in meat is deranged and mostly unavailable to our liver, the organ which makes all of our body's protein.*

1.  Are we trying to get bigger (add protein mass to our bodies) or do we want to barely stay alive?  Building muscle requires a lot of protein, plain and simple.

2.  Steak is a great source of protein and creatine (when cooked rare to medium).  Protein of any kind is denatured the second it hits the highly acidic environment of the stomach in any case.

3.   Proteins are made in every cell of the body that has DNA and the organelles required to make protein.  That's like, all cells in the body!

*Ripe, raw organically grown avocados are naturally pure and furnish all of the elements we need to build the highest quality protein in our bodies. The water content of avocado by weight averages 74%. Because avocado is a ripe, watery, enzymatically-alive fruit, it ranks as the most easily digested rich source of fats and proteins in whole food form. The ripening action of the sun "predigests" complex proteins into simple, easily digested amino acids. The fat content (by weight) varies from 7 to 26 % according to the variety, averaging 15%. Approximately 63% of the fat in avocados is monounsaturated, 20% is polyunsaturated and 17% is saturated.*Avocados are the perfect source of dietary fat--appetizing in their raw state, digestible, and pure.*

Some of the above are just facts about avacado, some are just weird. 

*Another plus is that avocados have no cholesterol.*

Just like every other vegetable, fruit, grain, legume, etc!  My favorite is cholesterol-free chips...

All plant products are cholesterol-free, since plants cannot manufacture animal cholesterol.  Most low-fat meat and dairy products are also very low in cholesterol.

In addition, as work by Walter Willet at the Harvard School of public health has shown, blood "bad cholesterol" levels are raised more by refined carbs (white sugar; white bread/pasta) than animal cholesterol.  That's just one more reason to love eggs!

*Avocado is an alkalinizing food. Avocado eaters who eat a healthful vegan diet typically experience more lustrous hair, softer, smoother skin, more pliable nails, fewer joint problems, slimmer belly, less body odor, improved mental function and enhanced libido. http://www.living-foods.com/articles/avocadoarticle.html*

A vegan diet can be healthful, when executed properly. If you eat a vegan diet that consists of all whole foods, you will be slimmer, and you may like the way you feel. You'd have to try it to know.  Also, you MUST avoid products like soy ice cream/sweetened yogurts, etc.  These processed products are not more healthful than their traditional counterparts.

Vegans should supplement with B-12, B-6, possibly iron (especially women) and should learn how to compliment proteins properly (making sure you get enough essential amino acids each day from your vegan diet).

All that said, many athletes are meat-o-philes, self included.  On the other hand there are certainly many vegetarian (still include diary and eggs) atheletes too.

In essence, avocados are a fine food, but are not suitable as a foundation of one's entire diet.  They are high in fat and lacking in sufficient quantities of many nutrients needed to sustain life.  All things in moderation!

1:46 AM - 1 Comments - 0 Kudos - Add Comment

Make a Muscle Cocktail: 4 Supplements Worth Their Weigh tin Lean Mass!

Sometimes it's hard to tell the difference between supplements that build lean muscle and those that build only debt.  Thankfully, scientific research shows that some supplements, taken at the right times, will help you sculpt a muscular physique.

1.         Protein

            To build significant muscle, you need to eat extra energy and nutrients.  The extra calories should come from high-quality protein and carbohydrates, mostly before and after workouts (1). Protein supplementation after weight training increases lean mass gain more than weight training alone-- thousands of studies support this conclusion.

            For weight-lifters, the daily protein recommendation from the ..:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" />American College of Sports Medicine (ACSM) is 1.6-1.7 g/kg, which is equal to 0.73-0.77g/lb (2). For instance, a 145 pound woman should take in 105-112g/day.  Remember that this recommendation is based on the needs for athletic performance.  If physique goals influence your food choices, you may choose a diet that is a bit higher in overall protein.

            Before and During Workouts: Studies show that taking some protein before a workout serves at least three purposes.  First, the protein will help prevent muscle breakdown during exercise (3).  An added benefit of taking protein before you start is an increase muscle-building after training has stopped (3).  Finally, supplementation will boost muscular endurance and increase the volume of training per weight-lifting session (4).  Whey protein is a high-quality, quickly-absorbed protein source, so it is good to take before, during and after workouts.  Have about 5g (1 heaping teaspoon) before workouts and 5g during your workout.

            After Workouts:  In addition to reducing muscle damage and breakdown, post-workout protein contributes to a release of muscle-building signals.  Certain amino acids, contained in complete proteins like whey, cause the pancreas to release insulin (5). Insulin release following a midnight binge promotes fat storage, but an insulin spike after weight-training results in more glycogen storage and muscle building.  In essence, weight training tells the body to send energy to the muscles instead of fat cells.  In the end, the insulin helps you to build lean mass without its infamous fat-promoting effects.  Also, protein's amino acids provide the raw materials for muscle building.  Fifteen grams of protein after your workout is recommended by nutrition expert Dr. John Ivy in his book Nutrient Timing (6).

2.         BCAA

The branched chain amino acids (BCAA) include leucine, isoleucine, and valine. All of these amino acids (the smallest units of protein), and leucine especially, increase the rate of muscle building and decrease the rate of muscle breakdown (7,8), so it's a dually effective supplement for building muscle.

Before and During a Workout: The muscles use BCAA during a strength workout for up to 15% of muscle energy needs (9).  If the BCAAs are not readily available to muscles before and during a workout, your body is more likely to breakdown existing muscle mass to meet energy needs.  As a result, a BCAA supplement before and during weight training supports overall muscle-building. Take about 2 grams of BCAA for each 50 kg of body mass before and during your workouts.

After Workouts:  After a workout BCAA, especially leucine, also promotes an insulin response, signals the muscle to rebuild itself, and act as raw materials for muscle formation.  Take of BCAA about 3 grams for each 50 kg of body mass before and after workouts.  A pure BCAA powder is the most economical way to take this supplement; one rounded teaspoon is about 5 grams.  Fair warning: BCAA have a bitter taste and poor mixability, so many people like to take capsules instead of the powder.

3.         Carbohydrates

Carbohydrates are an important fuel source for all kinds of exercise, including weight training.  Muscle glycogen, though usually associated with endurance training, is also an important energy source for strength-training; muscle glycogen will be maintained if carbohydrates are taken before and during workouts.  Also, well-timed carbohydrate reduces release of the stress hormone cortisol (10).  High circulating cortisol levels are associated with lower immune function and muscle breakdown. Lower glycemic or "slow" absorbed carbohydrates should be consumed in the last food meal before a workout. Good choices are oats, berries, and whole grain pasta. 

            Before and During a Workout: Pre-workout carbohydrates are important to spare glycogen.  Have about 20g carbohydrates immediately before and during your workout (40g total).

            After a workout: In addition to the benefits mentioned, carbohydrate is the strongest stimulator muscle-building insulin and helps replace lost glycogen.  Carbohydrate and protein should be supplemented after a workout in a 3:1 or 4:1 ratio.  Have about 45g of carbohydrate with 15g of protein.

4.         Creatine

If you're looking for more mass and strength, look no farther than your trusty tub of creatine (11). One study looked at two groups of men following the same weight training schedule; those taking creatine showed about twice as much lean mass gain as compared to the placebo group when completing the same resistance training program (12). The men supplemented with 20 grams/day during a one week loading phase and 5 grams/day for the rest of the twelve week study for maintenance. If you choose to do a loading phase, be sure to split the creatine up into 4 or 5 doses throughout the day to minimize stomach cramps.  Also remember that dosing on the label of a creatine bottle is specifically for men; women do not need as much, in general.  Depending on weight, 10-15 grams will be adequate for the loading phase and 2-3 grams will be enough for maintenance. Creatine should be taken with your pre work-out drink during the maintenance phase.

            You can improve your gains with smart and consistent use of sports supplements, which are taken strategically around your workouts.  With the exception of creatine, the supplements can be skipped on non-training days—you won't need the extra calories then.

            When you are training to add lean mass, be sure to fuel your workouts: 1) Take your pre-workout supplements 15-30 minutes before you begin training; 2) Drink important nutrients during your workout; and 3) Take your post-workout supplements within 30 minutes of completing your workout.

Muscle Cocktail I (Before and during training)

16        oz water

1          heaping teaspoon whey protein (5 g protein)

1          teaspoon BCAA (3-4 g BCAA)

1          dose creatine (5g serving)

4          tsp honey (20g carbohydrates)

½-1      individual packet of sugar-free lemonade

            Combine all ingredients in a shaker cup or water bottle; enjoy.

Muscle Cocktail II (After Training)

8          oz water or ice

8          oz fat-free milk (12g carbohydrates; 8 g protein)

½         scoop (oz) chocolate or vanilla whey protein (10 g protein)

3          Tbsp chocolate syrup (36 g carbohydrates)

1          teaspoon BCAA (3-4 g BCAA)

            Combine all ingredients in a shaker cup or blender; enjoy.

References

1.      Cribb PJ, Hayes A. Effects of supplement timing and resistance exercise on skeletal muscle hypertrophy. Med Sci Sports Exer. 2006;38: 1918-25.

2.      Joint Position Statement of the American College of Sports Medicine, American Dietetics Association, and Dietitians of Canada on Nutrition and Athletic Performance.  Med Sci Sports Exer. 2000; 32: 2130-2135.

3.      Tipton KD, Rasmussen BB, Miller SL, Wolf SE, Owens-Stovall SK, Petrini1 BE, Wolfe RR. Timing of amino acid-carbohydrate ingestion alters anabolic response of muscle to resistance exercise. Am J Physiol Endocrinol Metab. 2001; 281: E197-E206.

4.      Kerksick CM, Rasmussen CJ, Lancaster SL, Magu B, Smith P, Melton C, Greenwood M, Almada AL, Earnest CP, Kreider RB. The effects of protein and amino acid supplementation on performance and training adaptations during ten weeks of resistance training. J Strength Cond Res. 2006; 20: 643-53.

5.      van Loon LJC, Kruijshoop M, Verhagen H, Saris WHM and Wagenmakers AJM. Ingestion of Protein Hydrolysate and Amino Acid–Carbohydrate Mixtures Increases Postexercise Plasma Insulin Responses in Men. J Nutr. 2000;130: 2508-2513.

6.      Ivy J and Portman R. (2004). Nutrient Timing. New York: Basic Health.

7.      Blomstrand E, Eliasson J, Karlsson HK, Kohnke R. Branched-chain amino acids activate key enzymes in protein synthesis after physical exercise. J Nutr. 2006; 136:269S-73S.

8.      Escobar J, Frank JW, Suryawan A, Nguyen HV, Kimball SR, Jefferson LS, Davis TA. Regulation of cardiac and skeletal muscle protein synthesis by individual branched-chain amino acids in neonatal pigs. Am J Physiol Endocrinol Metab. 2006; 290: E612-21.

9.      Kraemer WJ, Volek JS, Bush JA, Putukian M, and Sebastianelli WJ. Hormonal responses to consecutive days of heavy-resistance exercise with or without nutritional supplementation. J Appl Physiol. 1998; 85: 1544-1555.

10. Voltek JS, Rawson ES.  Scientific basis and practical aspects of creatine supplementation for athletes.  Nutrition. 2004; 20: 609-614.

11.  Volek JS, Duncan ND, Mazzetti SA, Staron RS, Putukian M, Gomez AL, Pearson DR, Fink WJ, Kraemer WJ. Performance and muscle fiber adaptations to creatine supplementation and heavy resistance training. Med Sci Sports Exerc. 1999; 31: 1147-56.

12.  Burke DG, Chilibeck PD, Davidson KS, Candow DG, Farthing J, Smith-Palmer T. The effect of whey protein supplementation with and without creatine monohydrate combined with resistance training on lean tissue mass and muscle strength. Int J Sport Nutr Exerc Metab. 2001; 11: 349-64.

4:27 AM - 4 Comments - 6 Kudos - Add Comment

First in Ronnie Coleman Class A figure!

I'm silly; my "fan base" left before the end of the night show, so I ended up going to the grocery store and buying the following:

1. Strawberries
2. Cottage cheese
3. String cheese
4. Lite Cool Whip
5. Reeses PB topping
6. Peanut Butter coated whopper malt balls (had my eyes on those for a while ;-)

I made a fake sundae with the C cheese, cool whip, PB topping, and whoppers. Trying not to go to crazy so I don't completely destroy my winning form ;-)

6:12 AM - 5 Comments - 10 Kudos - Add Comment

Guest on "The Weekend Workout" Radio Show this Weekend, April 13th!

1:58 PM - 5 Comments - 2 Kudos - Add Comment

All-Natural High Protein Chocolate Cream Pie Filling

Artificial sweeteners are a sources of controversy, since they are lab-created compounds with only a hundred years (saccharin) or a decade worth of history (like sucralose/splenda). Since I have an immense sweet tooth, and specific dietary specifications, I decided to write a few recipes that highlight "all natural" products.

What does natural mean?

Essentially, natural products are not made in a lab. For example, vanillin, the chemical that makes vanilla taste distinctive, can be extracted from a vanilla bean with a solvent (like alcohol). On the other hand, the vanillin compound itself can be created in a lab and dissolved in alcohol. They are both tasty products that add flavor to food, but the bean extract is a "natural" product and the lab-created version is "artificial."

Directly from the FDA:

Foods are natural "if they contain no artificial or synthetic ingredients, and if they are minimally processed"

By this definition, every artificial sweetener is a synthetic and unnatural product. Furthermore, a sugar source like honey is more natural than a sugar source like white granulated sugar because it is less processed.

Below is a recipe for high-protein chocolate cream pie filling (pudding filling); the recipe contians the natural non-nutritive sweetener Stevia to boost the sweetness of the finished product. Be sure that you use pure Stevia powder (link for illustration only; any brand of pure stevia will do); avoid the product with extra starch filler.

Ingredients

Combine in a food processor:

1 8 oz package fat-free cream cheese
1 12 oz container low-fat ricotta
½ cup no sugar added soy milk

4 scoops