S1E3 The Overcoming MS diet in a nutshell with Sam Josephs

Geoff Allix  00:02 

Welcome back to the Overcoming MS Living Well with Multiple Sclerosis podcast. I’m Geoff Allix and in this episode we’ll be looking at the diet aspects of the Overcoming MS protocol. Joining me for this episode is Samantha Josephs. With a BA Honours from Leeds University Samantha later qualified with distinction as a nutritional therapist from BC NH, the UK College of Nutrition and Health in 2008. She’s a member of BANT, the British Association for nutrition and lifestyle medicine and the CNHC, the Complementary and Natural Health Care Council, as well as running nutritionist or a busy part time practice in Crouch End, Samantha is also a guest lecturer at both BCNH and ION, the Institute of  Optimum Nutrition. She has worked as a specialist guest teaching elements of nutrition to school and college students, and has appeared as a guest speaker, at MS groups, as well as the MS Life Expo, Samantha’s husband was diagnosed with MS in 2002. Hence, she has a personal interest in the condition, and many MS patients in her practice. She’s a firm believer in the evidence-based approach to recovery from chronic conditions and as a keen follower of the OMS protocol. So with that, I’d like to welcome Sam Josephs.  

 

Sam Josephs  01:20 

Hello.  

 

Geoff Allix  01:21 

And can I start with just a bit about your background? With OMS, how you discovered OMS? And so on? 

 

Sam Josephs  01:29 

Yes, sure. So in about 2002, just before his 30th birthday, my husband was diagnosed with MS, which was somewhat of a shock to us. We knew nothing about it at that point in time. And we were given very little lifestyle advice by the doctors. In fact, we were told to just go away wait for a second relapse, in order to confirm the diagnosis, and just carry on with life as it was. Neither one of us was content with that kind of approach. And we both went off to try and research as much as we could, what was out there in terms of taking control of things that we could do ourselves from a lifestyle perspective. And we came across the work of Dr. Swank, and the idea of the very low saturated fat diet, avoiding dairy and increasing all the good fats. And immediately, my husband gave up on dairy and modified his diet and noticed lots of benefits straightaway. A few years later, I went for a career change. And I qualified as a nutritional therapist. Initially, I was a bit reluctant, I think to sort of focus on MS in my practice. I felt like I was living it at home and it wasn’t something that I wanted to be doing all day at work as well. So I was focusing more on general health and nutrition for my clients. But over time, word got out that my husband’s got MS that we live with a certain lifestyle. And my practice is built more and more and my sort of involvement in the MS community has grown and grown. The OMS program wasn’t around when he was diagnosed. So it was great when we sort of found the OMS book, and all the the Facebook pages and everything associated with it as well. Because finally there was a there was a proper program, evidence based in black and white. For us to really sort of confirm what we knew what we were doing, and what I was trying to achieve in my practice with my MS clients as well. 

 

Geoff Allix  04:02 

I think you’re actually the first person I’ve come across that except for Professor Jelinek that discovered Swank before OMS. I think I certainly came across OMS and then found out about Swank through that. So he’s just been doing quite well on it? He’s actually be on it quite a long time now.  

 

Sam Josephs  04:20 

Yeah, I mean, he still is in relapsing phase, which is you know, he’s had it now for more than 15 years and he’s still in the relapsing and remitting phase. There has been a slow decline, but he’s absolutely convinced of his diet and lifestyle as being one of his key crutches to to maintaining good health and strength. He goes to the gym regularly. He knows that if he eats something out that may have been contaminated by bit of dairy he can feel it instantly in his finger. As he says he can feel the tingling instantly in his fingers. And that’s quite a remarkable symptom. And then directly pointing to the fact that the dairy really has no positive benefit for him whatsoever. So he’s absolutely convinced of the diet and lifestyle. 

 

Geoff Allix  05:20 

Yeah, I had I’ve had that. I didn’t know whether it was a mental thing because I  I have pizza out sometimes because it’s quite easy. Because you can have pizza without cheese on it. And then it’s quite straightforward thing to have an OMS friendly pizza. But I now don’t have cheese at all, because I’d actually really like pizza without cheese anyway, but I had a pizza with a supposedly vegan cheese, which turned out that they’d made a mistake and they put actual cheese on it. And I just had a couple of bites. And then I thought that is, because vegan cheeses, if you’ve ever tried it, it’s not very nice. I don’t recommend. Some of them are okay, you can get some sort of quite artisan vegan cheeses, but the ones that they serve you at pizza restaurants are not very nice. And yeah, I just thought this is too cheesy. And I said, that’s this I’m sure it’s cheese and then they felt it made a terrible mistake. And then they were worried about me rushing off to hospital in an ambulance. And, but yeah, no I felt really weird afterwards. But I don’t know if it’s because it was my head. Or, but yeah, it feels to me like dairy is really a real No-no, I really don’t I’ve very much yeah. 

 

Sam Josephs  06:46 

When we first met, and before he had his diagnosis, he used to love to eat cheese, particularly sort of French cheeses and strong cheeses. But he always said that he loved eating cheese. But it used to give him a “cheese feeling.” And it used to make his forehead prickle. And he used to say, “Oh, I’ve had too much cheese. I’m getting cheese feeling.” There was definitely something physiological that he was feeling from eating the cheese. Yeah, I think it is more than just something psychosomatic. 

 

Geoff Allix  07:23 

And there’s often I found actually people saying about the diet with friends and so on. They say, “how do you manage to not have dairy?” or they don’t think it’s natural. So what about, you know, you’re missing out so much stuff with dairy. And it was I think it was an OMSer on the forum or something came we came up with saying that they say this is natural, and that you’re missing out on something natural. But how is it natural that there’s a species on this planet that needs to drink milk from the breast of another species? That can’t be natural. 

 

Sam Josephs  08:00 

Yeah, exactly. Exactly. And I think when my husband was diagnosed, and it was, so it was 16 years ago, something like that. The world was a different place. Even in London, the idea of being dairy free was something fairly new and radical. Now, you hear people ordering their skinny soya lattes all day long, or saying, Oh, can I have that, but I’m dairy free. So I think we’re really lucky that the substitutes have sort of taken over the market, and are becoming much more commonplace. And people are questioning less and less people’s decisions to go dairy free. 

 

Geoff Allix  08:45 

But now you get a choice of non dairy milk, don’t you?  

 

Sam Josephs  08:48 

Yeah, exactly. We have oat, we have soya. We have almond. What would you prefer?  

 

Geoff Allix  08:54 

So can we just go through a bit about the basic rules of the OMS diet stuff? 

 

Sam Josephs  08:59 

Yeah. So in a nutshell, the OMS diet is a plant-based diet, so it means no meat. That includes chicken and poultry, and no egg yolks, and no dairy as well. And otherwise, everything else is pretty much good to go. There are a few things like watching saturated fat from plant foods like coconut oil, coconut milk, but beyond that, it’s enjoying pretty much everything else that includes things like whole grains, tofu, obviously lots of all the fruits and vegetables, beans, pulses, nuts, less so peanuts, but all the sort of almonds, walnuts, pecans, hazelnuts, all the seeds, and then foods like tofu, tempe those kind of vegetarian proteins as well. 

 

Geoff Allix  09:59 

And what about fish? 

 

Sam Josephs  10:01 

Fish is the only “meat” in inverted commas. That’s that’s allowed on the OMS diet. And that’s because of its very high content of the good fats, which is one of the sort of basic principles of the diet. It’s all about the balance of the saturated to the polyunsaturated fats. So those the fish are a very good source of these polyunsaturated fish. And there’s an acronym which I use with my clients, which is SMASH. So those are the sort of the main oily fish to enjoy on the diet. So that would be sardines, mackerel, anchovies, salmon, and herring. This sort of smaller, cold water, oily fish, they’re very, very high in polyunsaturated fat. 

 

Geoff Allix  10:50 

Do you worry it’s the bigger fish? Because you start to get mercury and other heavy metals? Yes. Is that the big risk? 

 

Sam Josephs  10:58 

Predominantly, yeah, the bigger the higher, you go up the food chain, and the bigger the fish, the more the mercury deposits, not just the mercury, but other toxins from the ocean, the PCBs and that kind of thing. But Mercury specifically is a neurotoxin that’s often been linked with multiple sclerosis as well. So that includes tuna, shark and swordfish. Those are sort of the three standout ones as being the big fish at the top of the food chain. 

 

Geoff Allix  11:26 

So typically it’s sort of smaller the fish typically better? That SMASH acronym is pretty good. 

 

Sam Josephs  11:31 

Yeah, the other white fish. Cod, haddack, coley, Pollock, halibut. They’re all allowed, as well. They’re less oily. So they’re less rich and polyunsaturated fats, but they’re still a very good source of low-fat protein that is allowed on the diet. But the ones that really bring particular benefits are the ones from the SMASH acronym. 

 

Geoff Allix  12:03 

And what about shellfish as well? 

 

Sam Josephs  12:05 

Yep, shellfish are allowed. They’re a good source of protein. And again, low in saturated fat. Some people get a bit confused with the shellfish because they do contain cholesterol. So some people who have been on a low cholesterol diet would have been told to avoid prawns, for example. But we know that cholesterol is a vital component of the brain. And as long as we have a diet that’s high in fruits and vegetables, and doesn’t allow the carrier proteins for this cholesterol to become oxidized, that actually cholesterol in the diet shouldn’t really have too much of an impact on the cholesterol levels in the blood. So definitely seafood is something that can be enjoyed as well, on the OMS diet. 

 

Geoff Allix  12:56 

Do you find that you end up eating sort of pretty much the same meals sort of very much salad based?  

 

Sam Josephs  13:07 

Good question. No short answer. People do get a bit kind of jumpy when you say plant-based diet and they say what is that just salad? Of course, salad is extremely nutrient dense. But salad can mean lots of things. Salad could have a whole grain basis to it like brown rice or amaranth and quinoa, or even pasta-based. In terms of protein, we don’t want to be eating just salad all the time. Because whilst vegetables are a really good source of lots of vitamins, minerals, antioxidants, fiber, there isn’t a huge amount of protein in vegetables. So that’s where things like tofu and pulses, things like lentils, and the different beans and things like black beans, kidney beans, chickpeas, where they come in as well bringing variety, and they’re pretty versatile foods, you can smash them up to make falafels and burgers. Yeah, I think and also using things like tofu. You can make tofu scramble to sort of substitute a scrambled egg. So I think not to be afraid or put off that a plant-based diet would be a repetitive meal of salad over and over, but to kind of embrace the adventure of discovering new ways to eat and prepare foods. 

 

Geoff Allix  14:56 

So there’s actually been it’s quite a big thing now, isn’t it Whole Food Plant Based eating. And so I’ve got a number of different cookbooks there’s the OMS cookbook actually. There’s actually a couple of my recipes in it. But other ones like that really popular things like Deliciously Ella is a really popular certainly in the UK. We’ve got a Bosch. 

 

Sam Josephs  15:26 

Hemsley is a good one as well. I find 

 

Geoff Allix  15:29 

Are they the brothers? 

 

Sam Josephs  15:32 

 Two sisters.  

 

Geoff Allix  15:33 

There’s another one that’s well Happy Pear, which is two brothers. So what tips would you have? Because they’re not, I’ve found that they’re obviously plant based whole food, but then they’re not always compliant. So what are the sort of key things you look out for where you might need to either not do that recipe or substitute? 

 

Sam Josephs  15:54 

Yeah, so quite often, if, if they’re using a whole egg for binding, I would say it’s fine to just substitute with the egg white, that can have a similar effect. Any sort of dairy is easily substituted with all the nut milks. But actually, that doesn’t feature too much in the, in the more sort of vegan based books, things with Deliciously Ella, it’s watching out for the coconut milks because they are very high in saturated fat. And you might want to substitute it with something like an oat cream or something, check in with fat levels on that. I think the internet as well as the cookbooks has got some great places to look for quick and easy recipes that can be easily adapted. Things like the One Pound chef and even the Tasty app that I think sometimes flashes out quite a lot on our Facebook feeds. They often have quite simple meal ideas that can be easily substituted. Quite often if it’s a chicken breast, why not just use a piece of salmon fillet instead? That’s what that’s what we do here. 

 

Geoff Allix  17:21 

There’s one thing I do actually, I’d run it by you, which is because I quite like Southeast Asian food and Thai food and so on, where they use a lot of coconut. And using something like an oat milk or almond milk and non dairy milk, and then there’s coconut essence. Which is like an intense coconut flavor. But it’s not the fat of the coconut but you can just like a few drips of that into a non dairy milk tastes like coconut milk. And that’s made so that you can make Thai curry that way.  

 

Sam Josephs  18:00 

Yeah, well I’ve done a Thai curry. The thing with the Thai curry is that the spices are so fragrant. And whilst the coconut milk does bring an element of flavor, a lot of the coconut milk just brings the kind of creaminess to it. So we use quite a lot of soya yogurt for curry basis. Here so particularly like a lot more with Indian stuff, we do things with soya yogurt. But in Thai food the great thing about the Thai food is the abundance of some aromatic fragrant herbs, the kefir lime leaves the coriander, lemongrass, ginger, all of which I think are so pungent on their own that I think you lose less by taking out the coconut milk. I certainly wouldn’t want to take out any of those spices. Much more flavor. 

 

Geoff Allix  18:58 

And what if you’re eating out? Do you find it relatively straightforward to eat in restaurants following the OMS program? 

 

Sam Josephs  19:06 

Yes, I think nowadays yes, I’d say 15 or 16 years ago, it was much more of a challenge. And much more limiting. Now. I think it’s it’s almost trendy to have some kind of dietary requirement. And what we do is if we are going out to eat we quite often look online first. Most restaurants have got their menus available online and check dishes that perhaps look suitable or looked like they could be easily modified. And then we tend to call ahead and make sure that that is an option and that they know we’re coming in because once or twice we’ve been caught out where we’ve looked at a menu. It looks like it might be OMS friendly when we’ve arrived at the restaurant. We’ve been told that no they can’t, they don’t put the sauce on the side, or serve it without the sauce because the chef doesn’t like to modify the way he does his dishes. So, we generally phone ahead, whenever we’re going out for dinner, and just let the restaurant know that we’re looking for something that’s strictly dairy free. Which is usually everything else is pretty much visual on the plate. I wouldn’t choose a chicken dish, for example. Or we’d say, could we have the, you know, the chicken dish, but with a piece of salmon instead? That kind of thing and make sure that they are happy to jig things around for us. And nine times out of 10? I would say that was fine. 

 

Geoff Allix  20:47 

Yeah, and I’ve personally, there was one particular instance where I really couldn’t eat anything. And we left having not eaten anything. I think actually, the better the restaurant, sometimes the chefs quite like it, because it’s a bit of a challenge. And they’re not cooking exactly the same thing again. And I’ve had chefs come out, and they’re really sort of just excited about. And I take a little card with me with the do’s and don’ts. What about if you’re traveling abroad as well? Does that become more problematic? Going to foreign countries where they may be? Because I certainly like, yeah, the UK is pretty good. Now America is excellent, because basically everyone has some sort of dietary requirement. But if you’re going to like some sort of certainly European countries, where there may be less inclined to, I’m thinking France now actually a disaster. 

 

Sam Josephs  21:49 

Yeah. And I think if you find some good places, you can always go back to them if you’re in the same place. Last year we were considering Sri Lanka. And we didn’t go because we looked at typical meals there. And they were very coconut based, right? And so we thought, Well, I’m not sure this is really going to work. And we didn’t go but actually then I spoke to a Germany OMSer recently and he been to Sri Lanka the week before he said it’s fine. Yeah, so I think a lot of places it almost the more Western and develop the country is and the more likely you are to be presented with heavily processed foods.  I was about to say, apart from France, which appears to be everything wants to be served in a cream sauce. And with lashings of butter. But I think even in France, I would imagine they are kind of coming around a bit more to Mediterranean cooking. When you say to them, oh, you know, could we just have the fish without the sauce, please? Is it cooked in butter, they look at you like you’re crazy. And so of course, it’s not cooked in butter, we use olive oil. And find that definitely Italy and Spain and Portugal, there’s very little dairy that’s used in cooking, unless it’s a cheese, which is easy to identify on the plate and make sure that it’s not there. A lot of the food is cooked in olive oil. It is tricky. When you’re going abroad, we’ve quite often done Villa holidays, and then you kind of spending a bit longer in supermarkets, double checking ingredients on labels of things we’re not quite familiar with. But same again, you know, if we’ve sort of planned to go out to eat, then just checking with the staff when we get there, but they can do you know, foods that are OMS friendly before taking a table. And, and just kind of, you know, not being not being afraid to try new things. Foods that you wouldn’t maybe necessarily because you’re abroad, sort of be experimental. Try something else with the sea food. And that is the other thing about holidays, we all tend to sort of unless we’re in a city, we’re quite often near the seaside, and then you’ve got lots of fish and seafood on that, which is a good thing about being abroard. Yeah, absolutely. I was gonna say in Asia, I think Asia generally is quite dairy free. I mean, Indian cooking, they use ghee. So it’s sort of ensuring that things aren’t cooked in ghee but yeah, I think Asian cooking is quite easy to be OMS friendly and you, even I think once you are sort of outside of the sort of typical Western diet, you find even into the Mediterranean foods, there’s a lot more beans and pulses on the menu, used a lot more imaginatively, Mediterranean and Mediterranean cooking uses beans in a huge amount of their dishes. You know, there’s a lot of plant-based foods in Indian cuisine, obviously, sushi is a great food. Not so much plant based, but very high-end, fish. And lots of good, interesting foods like seaweed salad that we don’t come across so often here, but again, highly nutritious. And that idea of being adventurous and trying slightly new foods. I think being on the OMS diet and going on holiday doesn’t mean that you’re necessarily going to eat less than you would do at home, you might be exposed to other new and exciting things you wouldn’t otherwise have come across that turn out to be OMS. Friendly. 

 

Geoff Allix  26:06 

And talking about holidays. What about Christmas holidays, or those sort of seasonal? When you do a sort of specific thing about Christmas, it’s very much defined isn’t it. 

 

Sam Josephs  26:20 

Well Christmas is defined by pigging out here in the UK.  

 

Geoff Allix  26:29 

I mean, last year, I did a nut roast as instead of a turkey. I think that’s pretty high saturated fat. So this year, I’m kind of thinking, I actually just won’t have the meat because the problem is you’ve got family coming around everything. So they have to have turkey and they have to have like sausages wrapped in bacon, and they have to have all this. Yeah, but almost part of me thinks I don’t know if it really works putting a little bit of salmon in.  

 

Sam Josephs  27:01 

It does, I think sort of doing something dramatic with the fish like a whole side of salmon. Or you know, like sort of a whole steamed fragrant lemongrass, coriander, sea bass or something doing something slightly dramatic and a bit more kind of towards the fine dining level then you would have been eating genuinely at home for evening meals can can make it just feel special and by definition Christmassy. But it is tricky because there’s an awful lot of chocolates flying around heavy heavy puddings and and things like that. So it is a tricky time when I think OMSers have to have to just pride themselves on being slightly holier than thou. And being smart for it afterwards, because they don’t have to go on some mad crash diet beginning of January to compensate for the gluttony of Christmas. 

 

Geoff Allix  28:08 

Though, I do think there’s, a lot of things that we’re helping at our health, it’s not just the MS side of things, actually, there’s all the Western illnesses, you know, it’s you’re less likely to have heart disease, diabetes, and cancer even by having a much healthier diet. 

 

Sam Josephs  28:28 

It’s not just the big ones either. Just having a healthier diet means that you will be a healthier weight, you will be less prone to general coughs and colds and if you catch the flu, you probably will recover from it quicker than someone who’s eating a highly processed junk food diet. So you know, and all those sorts of more minor infections and illnesses that you can get just from being sort of malnourished on a Western diet can improve your MS experience as well, because some of those illnesses can often cause a relapse. So it’s not just about long term health improving, which it will but it’s also just on a daily basis as well. You’ll be protecting yourself from more relapses just by staying healthier overall, giving your body what it needs. The Western diet because of its highly processed nature, and actually because it is quite nutrient poor. means that despite the fact we’re all over fed, many of us are still malnourished. One thing that comes up a lot in questions is chicken breasts because it’s not massively high saturated fat. It’s obvious slightly different to having the mammal protein sort of beef, pork and so on the species obviously quite different. So is there as there doesn’t seem to be as much science, certainly in the OMS books about about poultry. And is it that bad? Would you sort of sometimes think, Okay, well, a bit of chicken breast isn’t really a problem? Well, the OMS approach is a real lifestyle commitment. It’s a whole mindset. And to sort of think that way, and just say, “Well, I’m going to be meat free,” does mean that you will have to give up chicken. And like you say, even though chicken in terms of its saturated fat level is not so much of a shocker, a grilled chicken breast could still contain up to four grams of saturated fat. It also contains more omega 6 saturated fats that we know in the way they’re metabolized can also become pro inflammatory in the body. So the idea behind the rule of leaving chicken breast off the menu is really in order to to sort of enforce the idea of this plant-based diet. You’re right, there is less research around a direct link between chicken breasts and MS itself. But unfortunately, the chicken farming industry is kind of out of control in terms of its toxins that it’s bringing to the food chain. And I think on that level, it’s something that people with a chronic condition like MS really need to be aware. So for example, cooking chicken at a very high key levels can release something called Heterocyclic Amines or HCHs. And these are carcinogenic. We know for example, that there are high levels of arsenic in some of the fields that they give to chickens in order to control parasites and things in the farming industry. And this arsenic can have a detrimental effect on people’s nervous systems. So whilst the meat itself may not be particularly high in saturated fat, and particularly associated with a damaging effect on MS, I think, overall, the picture that we get of chicken and don’t forget a lot of the chicken as well is pumped full of hormones, 

 

Geoff Allix  33:04 

So it’s been processed while it’s still alive. 

 

Sam Josephs  33:08 

It’s quite a poluted food on the food chain. And people with MS have quite delicate nervous systems, immune systems. And I think the burden of the toxins that that they’re exposed to, by having chicken in the diet outweigh any of the benefits, the danger with chicken. And the idea of saying “okay, well look, chicken may not be that high in saturated fat. So a little bit of chicken is all right,” because it is so versatile, it’s all too easy to end up relying on chicken as one of your primary protein sources. And then all of a sudden, that is not the basis of the OMS diet. And so in order to sort of avoid that kind of spiral, it’s better to just leave the chicken off the menu. 

 

Geoff Allix  33:58 

I’m going to pause this podcast for now because there’s a lot of content to cover. And we’ll continue this in the next episode. Don’t forget there’s a wealth of information at overcomingms.org Once again, that overcomingms.org There’s loads of diet information on there, there’s recipes and there’s tips you can follow for the other pillars of the program. And there’s also the ability to connect with other OMSers. There’s a forum there. And there’s also the OMS circles program. website is a great place to learn about the research going on in the MS world in general and anything relating to OMS specifically, so I’d encourage you to register on the site and stay informed about the latest news and updates.