S1E4 The Overcoming MS diet in a nutshell with Sam Josephs (part 2)

Sam Josephs  00:00 

And also with plant-based foods, the variety is enormous. You think about how many different fruits and vegetables are out there. And some of those are really versatile people are using, you know, courgetti spaghetti instead of a pasta spaghetti so extremely versatile.

Overcoming MS 00:19

Welcome to Living well with MS. This show comes to you from Overcoming MS, the world’s leading multiple sclerosis healthy lifestyle charity which helps people live a full and healthy life through the Overcoming MS program. We interview a range of experts and people with multiple sclerosis. Please remember all opinions expressed are their own. Don’t forget to subscribe to Living Well with MS on your favourite podcast platform so you never miss an episode. And now let’s meet our guest.

 

We’re revisiting some of our favourite episodes from season one, these early episodes break down the Overcoming MS program and feature doctors, facilitators and community members with top tips and personal stories about living well with MS. You can listen to the entire back catalogue at overcomingms.org/podcasts or wherever you listen to podcasts. Today’s episode features Overcoming MS facilitator and nutritional therapist Sam Josephs outlining the diet pillar of the program.

 

Geoff Allix  01:25

talk about the OMS diet. If people are newly diagnosed, and they’re starting with the OMS diet, do they need to go that 100% into it? Or would you sort of go step by step? Or does it depend on the individual? Or how would you get started with the OMS Diet? 

Sam Josephs  01: 43 

Yeah, that’s a really good question. Because everybody approaches it very differently. Some people are the sort of very all or nothing type. And some people need a more sort of gentle introduction before they let go of what they consider to be their sort of current favorite foods. The most important thing for everyone is that they tell their family and friends and get as much support as possible. Because the last thing you want is your friends or family around, going “oh go on just to have a cheese cracker. It’s not that bad.” So the most important thing is to make sure that everybody around you knows what you’re doing, and why you’re doing it that it’s to reduce relapses, and keep disability at bay. It’s not a diet for weight loss or anything like that. It’s far more life changing. So to get the support from family and friends is really important. 

 

Geoff Allix  02:38 

I found my MS nurse was the worst person, my family or friends were pretty good. And my MS nurse said, “oh, you know, you’ve got to live a little.” My neurologist was on board. And then my MS nurse is sort of saying, “Oh, well, yeah…” 

 

Sam Josephs  02:51 

Yeah, it’s a shame, isn’t it? And I think that just comes from, unfortunately, the MS nurses are much more kind of medication driven, and they haven’t really had the time to investigate the other kind of approaches that are out there and a more sort of all encompassing way to support the body. So that yeah, that is a real shame. And that’s exactly what I mean. But in terms of kind of actually physically getting started, the first thing to do is just kind of, accept that you have a chronic condition, and that in order to stay as well as you can, over your years as you age just to clear out the rubbish. So the first thing to do would be get rid of processed foods, hidden fats, and just sort of the rubbish in the diet, and then increase lots of plant foods, plant-based foods and the fish. And once you start doing that, the next thing to do really is just to go cold turkey on all dairy as quickly as you can, because that is a very inflammatory food and the connections between dairy intake and MS and MS progression is indisputable. And then from there, you’ve already accomplished most of it. Beyond that, it’s just giving up red meat, which is quite easy to do. Particularly with cardiovascular health. And, you know, farming practices and things. It’s something genuinely as a population we’re trying to do is reduce red meat anyway, so cutting that out. And then finally I think chicken and egg yolks to follow after that if you wanted to break it down into stages. Of course if you want to throw yourself straight in at the deep end and do everything all at once then that’s also a great way to do it and probably will see quicker results as well. 

 

Geoff Allix  04:40

I went full on because I was sort of just coming off a relapse and it was kind of everything to stop this. I just went for lunch but I think you need to sort of discover what you can do with fish as well. Fish is so versatile and seafood. The difference between tuna and cod, they’re completely different things and then like prawns and things like this that yes, there’s drastically different tastes and textures that you can use. I would always eat an original fish. But I think that’s the big thing was that he said the first thing is probably to get rid of all the processed junk.  

 

Sam Josephs  05:25 

Just a good clean up generally is a good way to start to feel better about yourself. 

 

Geoff Allix  05:31 

 I think probably a big problem with diet in western world now is so heavily processed? 

 

Sam Josephs  05:38 

negative nutrients we call them, 

 

Geoff Allix  05:41

Okay, and so a couple of other things that are coming up that are not necessarily in the OMS official guidelines and OMS book, one of these is getting a lot of attention is fasting. So a lot of people are talking about fasting, it’s been in a fair amount of news. In the UK some TV programs on the BBC about fasting, what’s your opinion on fasting and the different types of fasting around whether it’s worth trying? 

 

Sam Josephs  06:04 

Yeah, I do have a lot of clients who asked me about this, because as you said, it’s getting a lot of exposure. And the reason why is because the actual evidence in terms of published medical literature is building in how fasting or what’s called a fast-mimicking diet. So it doesn’t mean just sort of giving up all food for a whole week. What it actually means is fast mimicking, so it means drastically reducing calorie intake for a short time. And the evidence is building that it can dramatically reduce inflammation in the body, which is a key feature of relapsing remitting MS. They’ve also found that it can suppress autoimmunity as well. They’re not entirely sure what the mechanisms are around that. And there are lots of different ways now, to sort of induce this fast-mimicking effect. There is the 5:2 diet that was made was televised by Michael Mosley devised by him primarily for reducing cholesterol, balancing his insulin levels, reducing risk of various cancers and things, which involves a five-day, two-day cycle in the week, when two days you’re only consuming 500 calories for a woman or 600 calories for a man. So it’s not complete fasting. And, and then there are other ways of doing it as well, which might be fasting for 16 hours a day, and only eating in sort of an eight hour window. And then an early dinner and then going 16 hours between dinner, sleeping, and then the following morning breakfast. And there’s one other diet called ProLon which if you’ve got lots of money and you want to throw a lot of money at it, it’s quite nicely worked out for you. They send you a whole kit of what you need to eat in a five day window. I’m pretty sure it’s plant based. So it probably would be useful for someone with MS. I haven’t tried it myself. But it has been devised by a guy called Valter Longo, who’s one of the sort of primary in researchers in the in sort of fasting industry. So he’s done a lot of work on fasting and how it can help us live longer and live more healthily as well. But the main effect for MS is that it it can suppress autoimmunity, which is your own T cells attacking myelin. And they demonstrated in a study on mice that when they put them on a severely calorie restricted intermittent diet, that actually the cells that make myelin seem to multiply so it could potentially remeylinate as well. 

 

Geoff Allix  08:53 

That’s very much sort of the the next step as far as I’m concerned. It certainly is okay, we’ve done a lot of stuff to stop the damage but repair would be… 

 

Sam Josephs  09:05 

I mean, this sort of the fast mimicking, again, it’s something, it depends what kind of a person you are, if you want to throw yourself into it, then sort of sticking to the 5:2 diet, which is two days of fasting every week to achieve results. Or you could do something like the ProLon diet, which you could do once or twice a year, or even up to four times a year. But it’s only five days out of a month, or something like 16 hours of fasting daily. So again, there’s different approaches for different personality types based on what people find works for them in their own lifestyles. 

 

Geoff Allix  09:40 

And so it’s something you give it a try and then sort of say, like, after a couple of months, see how I feel? 

 

Sam Josephs  09:46 

Yeah, absolutely. And particularly, if there’s other issues going on. So quite often, you know, an MS patient may be at risk of type two diabetes from being overweight or other issues like that, then it would, I would definitely suggest trying the 5:2 diet, because it can help get so many of the body’s systems back in line, which if the body’s working more efficiently, across all its systems, it’s going to benefit the repair and calm the relapses and the inflammation in the body. 

 

Geoff Allix  10:22 

Okay, that’s really interesting. And another similar sort of thing, not necessarily in the official guidelines, but quite a popular area, it was something a lot of people find is gluten. Actually removing gluten completely, because there’s a lot of things as well as bread, pasta, and a lot of carbs did have some gluten in and so I did try it and didn’t notice a huge difference. But it’s that sort of similar things. Is it worth a try for a lot of people if they got gluten issues. 

 

Sam Josephs  10:54 

The sort of the connection between gluten and MS has been less demonstrated in the medical literature. But there is a huge body of evidence around neurological conditions generally and gluten in the diet. And some of the symptoms of a gluten intolerance can be things like brain fog, and difficulties with balance and stuff. So for some people, they find if they take gluten out the diet, certain symptoms might improve for them. Gluten, when we talk about gluten, we’re actually talking about a protein that’s found not just in wheat, but also barley and rye. And what the mechanism that they’ve discovered is that gluten has an ability to open up spaces between the cells in the gut, which means that it can then travel into the bloodstream and fire up the immune system. So whilst it’s not a proper allergy, which would be celiac disease, that is a full blown allergic response to gluten. It can fire up the immune system in people who are susceptible to this opening.  

 

Geoff Allix  12:06 

So is that the Leaky Gut you hear about?

 

Sam Josephs  12:08 

Yes, that’s right. That’s leaky gut, but also in people who don’t have leaky gut, when we consume gluten for a very small time, gluten appears to act on a certain enzyme that opens those junctions in all of us. And they’re not sure. And they are trying to demonstrate that actually, if it’s opening those tight junctions between the cells, it’s highly likely it’s potentially opening junctions in the blood-brain barrier as well because it’s a similar kind of tissue that lines the blood-brain barrier and lines the gut. So it is possible that these grains could be exacerbating multiple sclerosis. So when we eat these grains, if we do have a leaky gut, and it’s getting into the system, it’s firing up the immune system. That’s when the T-cells, increase in number. And that’s when they would increase their damage as well because you’re constantly triggering the immune system. So if it’s something that you think you want to try or have a go with, it’s really important when you take those foods out of your diet to replace them with other grains, because one of the things that these carbohydrates do is feed our bacteria in the gut, which we know also has a very beneficial effect on calming and balancing the immune system. So if you take out gluten, it’s important to put in the non-gluten containing grains. So things like corn, rice, brown rice, things like amaranth, quinoa, not spelt, spelt is another type of wheat. But to really make sure that you don’t just cut down on the grains altogether. Being sort of too reliant on any one food can also sometimes trigger this leaky gut that you mentioned. And so it’s a good idea, like you say, if you are someone who does enjoy making bread and make bread quite a lot to include different types of grains in your in flours, in your breadmaking as well, so that you don’t become too wheat dependent and wheat exclusive. But they have found in the literature, that there does seem to be a connection between celiac disease, which is the full-blown gluten allergy and that people with MS may be more likely to go on to develop celiac disease or even have a first degree relatives—so mother, sibling, somebody who actually has celiac disease as well. It is a type of autoimmune response on the gut wall. So if it was something that you were considering, it would be worth maybe going completely gluten free, which would mean checking all food labels, including things like soy sauce, including barley, rye, not just gluten, making sure the oats that you eat are gluten free, and see how it goes. And I would say probably a couple of months, it’s not as instantaneous a response as you can see when you take dairy, for example, out of the diet, sometimes takes a bit longer with gluten to really get it out the diet.

 

Geoff Allix  15:22

So if you’re starting out, the OMS diet, then once you’re fully compliant, then you can take it a little bit further and maybe try fasting and try removing gluten and then to see if you can get further improvement. 

 

Sam Josephs  15:35 

Yeah, it’s important when you remove anything from the diet to make sure you put back in plenty of things. You don’t like the idea of a restricted diet, just an elimination diet, certain things have been eliminated, but you don’t want to have a reduced variety or enjoyment of foods out there. It’s about being brave and experimental with foods that you might not have otherwise considered things like millet, things like buckwheat, all of which even though buckwheat sounds like it’s got wheat in it, there is essentially a gluten-free grain. But we do tend to rely on like you said couscous, pasta, bread, you know, things that are sort of dominated by gluten. 

 

Geoff Allix  16:18

Yeah, that was saying about taking out as well. That was something with the 5:2 diet. I read a book on that. And it was saying, unless you want to lose weight, don’t look to reduce your calories over the week. you actually eat more on the five days of the year, especially, you know, if you’re fast for 2 days, nothing’s saying the next day you couldn’t have an extra meal. 

 

Sam Josephs  16:44 

Yeah. And they actually found with that diet in some of the studies that you’re quite right, that it didn’t really matter how many more calories you had in those five days. As long as the two days are strict. The results were the same. Though the benefits were there, the inflammation reduced, insulin levels were balanced, cholesterol levels came down, all the benefit remained. 

 

Geoff Allix  17:09 

Okay. And to finish up if you’ve got any tips to make cooking easier for people following the OMS diet. 

 

Sam Josephs  17:18

Well, one of the things about making cooking easier is to make the shopping more effective, and to make sure that the right foods and ingredients are in the house to begin with. Going on the OMS program, of course has its benefits for everybody with MS but also with their families as well. Because in eating a more-plant based diet, as you were saying earlier, has wide-ranging health benefits for all sorts of chronic diseases. So just avoiding buying, sort of like put it in inverted commas “rubbish” in the first place, and processed foods to sort of stock in the cupboards and things is a good start. But in terms of making the actual cooking easier, and some people might have symptoms that make cooking difficult. It’s things like bulk cooking, when you make a meal, try and make double quantities and freeze half for the following week. If you’re making a nice tomato sauce, to go with a pasta or as a curry base or something, again make it in bulk, make more and freeze it. And then you can add to it and turn it into something different for another meal another time. yeah, you make use of the Internet, and the OMS cookbook for inspiration and ideas and not to be stuck in a rut making the same meals over and over. Because we all know variety is the spice of life. And also with plant-based foods, the variety is enormous. You think about how many different fruits and vegetables are out there. some of those are really versatile people are using, you know, courgetti spaghetti instead of a pasta spaghetti so extremely versatile.

Overcoming MS 19:04

Thank you for listening to this episode of Living Well with MS. Please check out this episode’s show notes at overcoming ms.org/podcast you’ll find useful links and bonus information there. Don’t forget to subscribe to the podcast so you never miss an episode, and please rate and review the show to help others find us. This show is made possible by the Overcoming MS community. Our theme music is by Claire and Nev Dean. Our host is GeoffAllix, our videos are edited by Lorna Greenwood, and I’m the producer Regina Beach. Have questions or ideas to share? Email us at podcast, at overcoming ms.org, we’d love to hear from you. The Living Well with MS Podcast is for private, non commercial use, and exists to educate and inspire our community of listeners. We do not offer medical advice. For medical advice, please contact your doctor or other licensed healthcare professional.