S6E16 Nutritional Therapy with Bristol Ambassador Jenna Cox

Overcoming MS  00:01 

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 favorite podcast platforms so you never miss an episode. And now, let’s meet our guest. 

 

Geoff Allix  00:34 

Joining me on this edition is Jenna Cox. Jenna is a nutritional therapist and the OMS ambassador for Bristol in England. So firstly, welcome, Jenna. 

 

Jenna Cox  00:45 

Hello. Thanks for having me. 

 

Geoff Allix  00:47 

So to start off, we normally start off with introducing yourself. So could you introduce yourself? Tell us a little bit about your diagnosis and Overcoming MS journey. 

 

Jenna Cox  00:58 

Yeah, of course. So yeah, my name is Jenna Cox. I’m a registered nutritional therapist. And as you mentioned, I’m the joint Bristol Circle ambassador here in the UK. And I was diagnosed with relapsing remitting MS in 2016. And it started I’m sure, everyone will sort of be familiar with the way it started. It started with some numb hands on fingers that I thought was maybe a trapped nerve. Asked my GP. I went to an osteopath. I think I’ve also heard that other people went on this same little journey as I did. And I was hoping that with some manipulation, that I would get that nerve back, but it just progressed really. So I was also really fatigued at the time. I remember I was working on a university campus, and just walking from one end of the campus to the other. I just wanted to cry by the time I got there, just with how tired I was. So, which was yeah, very unusual. And then how did it progress? So a few days later, I woke up with one side of my body numb, tingling. So from sort of face, tongue, which was really strange. Leg, feet, toes, all the shebang. So I tried to get doctor’s appointment. couldn’t do that. But I phoned 111. And they sent an ambulance.  

 

Geoff Allix  02:20 

Did you think you had a stroke or something?  

 

Jenna Cox  02:23 

Well, I mean, I wasn’t sure. I mean, My instant reaction, even at this age, you know, I’m 40 now, but I was younger, then was to phone my mom, just to tell her I had all these symptoms. But yeah, it was really scary. That was I wasn’t scared before that. I just thought it was I would think it was a trapped nerve or something. But yeah, as you said that I thought maybe could be something like a stroke. But I didn’t have anything else. I felt really fine within myself. Yeah, they sent an ambulance. And they did some, you know, the initial tests, and they were fairly confident that it wasn’t a stroke or anything. But saw my GP got a referral to the mini stroke clinic for an MRI. And he said, if you get any double vision at all, then go to A&E. So I went home, the next morning had double vision. So off to A&E, I went, and that’s when all of the tests started. Really lots of tests, lots of different tests. That day, next day MRI, the next day results from the MRI, which were abnormal, and a whole list of things it could be and actually MS was one of the more positive things on that list.  

 

Geoff Allix  03:31 

How bad was it when you were told you had MS? Do you think? Well, actually, it’s not that bad, because you start thinking about the things that could be causing these things. And you start thinking, Oh, it could be a brain tumor, and all that really like anything, actually, it’s not that bad. When you consider what it could be causing these symptoms. 

 

Jenna Cox  03:51 

Exactly. A brain tumor was on the list that the doctor read out to me when she had this scan of my brain on her computer screen full of white marks. And she said, Well, it could be lots of it could be lots of cloths, lots of brain tumors. And you just think, well, if it is I think I’m a goner. So it was later on, I had a lumbar puncture later that day, and that was when the neurologist actually came down. She calmed me quite a lot. Actually, she did, she said is likely to be inflammation, as you described it in a really simple way. It’s likely to be inflammation, there’s medication you can take to reduce the inflammation and to prevent it from happening again. And I thought well, that’s a nice, that’s nice. I can cope with that. That sounds reasonable to me, rather than things like brain tumors and things. And then I had more symptoms had another MRI and that’s when that’s when my my diagnosis came. So yeah, very quickly, I started researching what I could do. I found OMS on the internet and I it really resonated with me how I how I wanted to live anyway, like all the different pillars looking after my house in different ways. I was also eating less meat anyway for environmental reasons and some for health reasons and yeah, it resonated with me. And I thought, right, I’m gonna do this and off I went.  

 

Geoff Allix  05:07 

So did you adopt it all straightaway or bit by bit? 

 

Jenna Cox  05:12 

Pretty much straightaway. I think I needed that too. And I think other people have said it as well, to feel a high was doing something quite often if you give me a problem, then I’m going to go away and try and find a solution for it. And I think I needed it for to give myself some hope that, that I was doing everything that was in my power, that I wasn’t, you know, going to go down without a fight. And I changed my eating habits straightaway. But it was easier for me. I know, for some people, if they’ve got families that they’re taking care of it can be quite tricky. 

 

Geoff Allix  05:43 

I think it’s just a personal thing. I did it the same way. I did it all at once but then I know other people have said, they just said, Okay, what am I gonna go? What’s the sort of biggest thing? Okay, we’re gonna go with dairy. And then I’m gonna go with, get rid of red meat. And then I’m gonna, and they did it. And they did. But I think it’s a personal thing, really. And it doesn’t really matter. I think if people do it that way, it’s really, if you think that by adopting everything all at once you’re likely to fail, then it makes sense to do it. Let’s try doing it step by step or do what you can do. It’s definitely best to do what you can do than to do nothing.  

 

Jenna Cox  06:19 

Yeah, exactly.  

 

Geoff Allix  06:21 

Did you find particular pillars easier or harder to adopt? 

 

Jenna Cox  06:26 

I didn’t actually find the diet that tricky. Actually, I found that reasonably easy because I am interested in cooking anyway. And I almost found it was it was like a good challenge. And you know why? My partner but he’d found you know, that that was something he’s a really good cook. And so it was new things for him to try and my family or got involved with the exercise was quite active anyway. So that was good. I would say probably the meditation, I did, actually, really, at the beginning, I was much better than I am now I used to do it when I got home from work is to my yoga and my meditation. I would say that’s the one that if I fall off the wagon, that’s me falling off the meditation wagon. I’m much better if I go to classes and things like that, or guided meditations, someone to keep me a bit more accountable with that. And the medication as well. I started medication as well, when I when I got diagnosed, it was quite different than I don’t know if you’ve noticed a difference in attitudes. But yeah, I know that they go more hard and fast now with meditation. 

 

Geoff Allix  07:30 

Yeah, no. I mean, I was similar sort of timing to you. And they would go with the minimum. Almost it was like the other end, wasn’t it? It was like, Okay, we just start you out. And only if you have lots of, so I had to fail on the first thing before I was offered something stronger.  I didn’t fail because it wasn’t working because it didn’t have any relapses. But because it took my white blood cell count too low. And that was on Tecfidera. And and then they said, Okay, we need to take you off that and they say so technically. Now, that’s failed, because it didn’t do what it’s supposed to do. And it so therefore, that means you’ve had a failed one, so you can have something stronger if you want. I’d always said I’d rather hit it so hard, early, and then they put my lemtrada, which you normally had to fail. And I don’t think it’s the case now that you can go straight on to one of the stronger ones. I think maybe So yeah, that’s different. I mean, we’re in the UK. So it’s based on what country you’re in as well. I know. I think in America, for example, I think it’s pretty much based on who your neurologist is, how, what their attitude is, and around the world. I know, it’s different, different places. And the cost differences, of course, because, yeah, we’re almost unique, or not unique, but certainly the NHS in this country is we don’t have to worry about the what those drugs might cost. Well certainly I know, in a lot of countries they do. So you’ve you’re a registered nutritional therapist, and you actually work with people with MS. So what does that entail? Do you use that sort of promoting Overcoming MS or just sort of more general healthy lifestyle? 

 

Jenna Cox  09:19 

That’s right. And, well, I’ve always been interested in in human biology, and certainly in my 20s, after my 20s I realized it wasn’t as invincible as maybe I thought I was going to be because my MS came really in my early 30s. So yeah, I decided to retrain and when I was retraining, it was all what do I want to do? Do I want to support people with MS. Do I want to support other health issues? I’m really interested in women’s health as well. And I think I do. My passion lies with with multiple sclerosis and helping people on that journey. But I think it’s also useful to sort of see people more holistically that we’re not just MS. Definitely not the only thing that’s going on in our bodies. So yes, I would help with looking at the diet for things that would be more helpful with the with the MS journey. So things that we’re familiar with, it’s like saturated fats, reducing processed foods, reducing meat, upping plant intake, looking after gut health and things. But also looking at food allergies, intolerances, there was a really interesting study about allergies. And that people with allergies have 1.3 times higher relapse rate and greater disability activity than those without allergies. So again, these this is not causation necessarily, but it’s just I think it’s quite an interesting association, and food sensitivities very much linked to gut health. So I might be helping people through those food sensitivities and improving gut health to hopefully increase the variety of foods that they can eat, as I said, we’re not just MS. So I might see people who have MS. But they may be interested in weight management, or osteoporosis or gut health, maybe they have reflux or bloating or constipation, things like that. Though, that’s been my passion lies to help people with MS. I think it’s important to look at the look at the bigger picture, really, the whole health. 

 

Geoff Allix  11:18 

I was certainly told by my neurologist not to think about MS things, but also think about other things. Because the last thing you want to do with MS is get something else. So you don’t really want to have MS and type two diabetes. That’s not it’s a really bad idea. So yeah, yes, I do think it’s a good for MS. But just really look after general health as well, because it will be worse for you. Because you’ve already so yeah. 

 

Jenna Cox  11:46 

Some things are more common as well, when you’ve got MS, you know, you’re more likely to get other things as well. So that’s always part I think of the picture. 

 

Geoff Allix  11:53 

And you’ve written an ebook on dairy free swaps. So I think that’s probably that’s probably the biggest thing people talk about is cheese. Because there’s a lot of milk substitutes now but but but she there is cheese is getting there, but then a lot of those high saturated fat and so but that so an ebook on dairy free swaps of milk products. So could you tell us a bit about that? And and what are some of the good swaps? You can do? 

 

Jenna Cox  12:22 

Yeah. So you can find the guide on my website. So it’s Jennacox.co.uk. And it’s my favorite dairy free swops that I found over the years I’ve sort of put together and I love cheese just like you and like lots of people are there. And I think it is really hard to find a good alternative that’s low in saturated fat that’s not really expensive. So there are some good cashew nut ones out there. But they’re really expensive. I don’t know if you’ve tried them.  

 

Geoff Allix  12:49 

Well, that’s my Christmas treat whenever it is. I have like, Yeah, but they are expensive. But yes, they’re good, though, aren’t they? I mean, some of them are really good. But yeah, I mean, you’re going from I mean, I don’t know what’s cheeses. I don’t I don’t actually know what cheese and supermarkets costs anymore. But certainly it doesn’t cost as much as the stuff I’m buying at Christmas, because it’s really expensive. But it’s Christmas. 

 

Jenna Cox  13:14 

Yeah, good alternatives. Give them a try. Really have a look at the look at the guide. I think silken tofu, so I think it’s a bit of a revelation. Not as many people use silken tofu, but that blended up with things like nutritional yeast, lemon juice. What else? Apple cider vinegar, maybe some garlic maybe a bit of mustard can be just quite a tangy sauce that can be used in so many different dishes. So I like it with blended soaked porcini mushrooms to make a nice mushroom sauce. Or I can add it to curries or dahls to make things really creamy. And it’s like an extra source of protein as well. What else there’s a really nice, warm, cashew nut based sort of nacho cheese. It’s quite tangy nacho cheese that can be good on like Mexican tray bakes or in tacos. And I think it’s good to have something sweet as well that you can go to blended. I don’t know if you blend up frozen bananas at all. 

 

Geoff Allix  14:13 

Oh, to make ice cream. 

 

Jenna Cox  14:14 

Yeah, they can really creamy don’t they? Yeah. Different flavors, you know, add cocoa powder and hazelnuts or other fruits that you might enjoy. So yeah, they’re just some ideas that I’ve been using over the years that have taken me a while to find. 

 

Geoff Allix  14:28 

Yeah, yes. They take a lot of blending. I’d say if anyone tries that. Yeah, it’s not a quick whizz up it’s you’re gonna be learning for a while. 

 

Jenna Cox  14:36 

Blending in and pushing it down. Blending maybe a bit of liquid but yeah, I think the result is  

 

Geoff Allix  14:43 

it’s amazing. Yeah, yeah, if you add cocoa powder, it doesn’t really taste that banana-y. It’s quite a It does taste really chocolatey and you can make something really, really good. Yeah, and it’s just bananas. So it’s really healthy. No oils or additives I think we’re ready. Good. Yes. First as well. So chop up the banana since in slices freeze them.  

 

Jenna Cox  15:07 

Exactly. That’s a good point. I actually didn’t tell that to somebody. And they did try and just blend the whole the whole banana in there. And it was taken quite a lot of time to chop it up first. 

 

Geoff Allix  15:16 

I’ve been through that journey. I’d say just as sort of a plug to the Overcoming MS Circles. There’s a lot of tips people, but there’s a lot of recipes on the Overcoming MS sites as well. So have a look. Because there’s loads because people will have been through. Yeah, we’ve been through this journey. And, and so yeah, have a look at the tips recipes on there, because there’s loads of stuff. So you mentioned women’s health. And so one of the things that come up is, especially with if we’re avoiding dairy is things like people talk about calcium where you can get your calcium from. And so one of those things is bone density and osteoporosis. And firstly, Why are women more at risk? And is there a significance with people with MS as well? 

 

Jenna Cox  16:12 

Yeah, so you’re right, people are sometimes worried about their calcium intake, but you can get calcium from lots of places in the in the in the diet, it doesn’t have just to come from dairy. So green leafy vegetables are particularly high in calcium, tahini, almonds, calcium set tofu. And the Mediterranean diet, which the Overcoming MS diet is really sort of a change on the Mediterranean diet is modified. That’s actually really good diet for for looking after bone health to getting lots of those minerals, vitamins and minerals that you need. You need magnesium and boron it calcium. So yeah, it’s a great place to start anyway for good bone health, but your osteoporosis. So that’s a condition that’s characterized by weak and brittle bones, that can lead to fractures. And often there aren’t any symptoms until fractures occur. And it doesn’t even have to be from trauma. So it can be just spontaneous fractures, which is quite strange. But there may be some symptoms, so maybe some back pain, some stooping, maybe some loss of height, but you won’t necessarily know it can be found DEXA scans you can have and you might not even know you’ve got osteoporosis until you have a scan. So yeah, women are more at risk of developing osteoporosis, and it’s largely linked to, well, first of all, we start off with thinner and smaller bones. So we have a lower bone mass to begin with. And the role of estrogen, the role of estrogen in stimulating that bone formation, and inhibiting the bone loss is really important. So during the perimenopause and menopause, when we have that steep decline of estrogen that can disrupt the balance and accelerate the bone loss in osteoperosis. So we can lose bone at a much faster rate than the men particularly in the few years after, after the menopause. And there are other factors in there as well with calcium deficiency, vitamin D, smoking, medications and things. And the there is a significant link to multiple sclerosis, as well. So it can be impacted by the disease itself, but the disease course and also the medications that we use to treat the acute relapses. So we often hear about Multiple Sclerosis, and the central nervous system, so the brain and the spinal cord, but it can also affect the autonomic nervous system. So that’s the nervous system that controls things that we don’t think about, like our breathing, our blood pressure. And we have the two branches, the sympathetic and the parasympathetic. So the sympathetic you might hear fight and flight, parasympathetic, rest and digest. So both of those can affect bone health. So if we have an overactive, sympathetic nervous system that can lead to excessive breakdown of the bone, and the parasympathetic if it’s underactive, then that can hinder the bone formation. So both of those come into play, and both of those can be affected by multiple sclerosis. And then we’ve got things like reduced mobility, which could lead to a loss of stress. So we need we need stress on the muscles and on the bones to help us with that bone formation. So if there is lack of mobility that may be a factor to be concerned about, and medications as well. So steroids that are used to treat relapses, they can contribute to, they can have a detrimental effect on bone health. 

 

Overcoming MS  19:54 

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Geoff Allix  20:11 

So when you train muscles you also the bones themselves are actually getting stronger. From exercise, there was never that you don’t see it for you that you’re there to your to, to like running on a leg? Well, actually, you’re not able to make your leg stronger, it will also make the bones stronger that supporting or is that right? 

 

Jenna Cox  20:31 

Yeah, exactly. That’s exactly right. So we should all really be doing some, you know, if we can do some resistance exercise, whatever that might look for us. Because obviously, we don’t, we don’t all have the same abilities to be able to do the same activities. But just incorporating that resistant exercise in what you can do. I think it’s a really, really great place to start. And just you know, if you’re if especially if you’re a woman, you’ve got multiple sclerosis, maybe you’re menopausal. And it might be worth speaking to GP about how you might be able to monitor that. And if you get offered a DEXA scan or something or something like that. 

 

Geoff Allix  21:06 

And so what you mentioned, so PMS, let’s put so what so just to go through some of the terms what is so I know I’m sorry, middle aged man, but what is so PMS and PMDD? What what are those terms? And can you do things to help with the symptoms? Is there lifestyle things that you can actually do?  

 

Jenna Cox  21:30 

so PMS premenstrual syndrome. And I’ll do that one first and then come back to PMDD. So premenstrual syndrome is really common, actually. So maybe about 75% of women or menstruating people may experience PMS. So that’s the the few days leading up to menstruation or even a couple of weeks, because it’s after ovulation. So it’s after, we have follicles with our eggs in and then the egg will escape from the follicle ready to be fertilized and this follicle behind is called the corpus luteum. And this secretes progesterone, and this progesterone is the function that is to maintain the uterine lining. So if this egg gets fertilized, it can implant for pregnancy. So we have an increase in progesterone. And then if there’s no pregnancy, there’s no implantation of of the egg in the uterine lining, the progesterone will go down. And so it’s thought that it’s the fluctuations of these of the these reproductive hormones likely to be progesterone for women who are particularly sensitive to those fluctuations may experience the worst symptoms. And but the actual mechanisms are still a little bit unknown as to why and also it can, it can change between cycle to cycle or between women and women. We have physical symptoms. So it might be cramping, bloating, headaches, sore breasts, the list goes on, or more emotional symptoms. So maybe being tearful, anxiety, low mood, irritability. Don’t know if I said that one twice. Yeah, and the low mood is also linked to serotonin, because during this period of time, there may be a lower level of serotonin as well in the body. And serotonin is involved in lots of things. Yes, mood is definitely involved in regulating mood, but also sleep and appetite and bowel movements. Yeah, all sorts of things. So yeah, not not too much fun. And it’s very common. And then I said, I’ll come back to PMDD. So PMDD is premenstrual dysphoric disorder. So people joke that that site PMS on steroids, really, it’s a more severe form of PMS, and is thought to affect maybe 5% of menstruating people. And it’s has a real impact on people’s lives. So the the feelings that people might get for two weeks up to their period, so you know, it’s 50% of their time. So it’s really significant. And it could be feelings of depression, anger, but real, you know, strong anger, irritability, hopelessness, anxiety, suicidal feelings. So yeah, it can have a significant impact on people’s lives. And then I think you asked it if there were things we can do. 

 

Geoff Allix  24:30 

Yeah, I mean, it’s, I mean, obviously, you know, we’re not saying don’t see your GP or doctor, but is there other lifestyle things that you can do?  

 

Jenna Cox  24:40 

Yeah, absolutely. And lifestyle and with diet. So with lifestyle, yes, it means speak to the GP, especially PMDD can have such a massive impact on your life. And with lifestyle, I mean, the things that we often hear so you know, exercise if you can do moderate intensity exercise and stress relief stress can make PMDD and PMS worse. So the things that we might be doing anyway with with our MS. So meditation and yoga to reduce those stress levels, getting seven to eight hours of quality sleep a night there supplementations as well. So there’s a herb called Agnes Casitas, which has been found to relieve symptoms, as well as calcium, magnesium, B6, be careful with B6 because it can cause some nerve damage. But then a lot of the OMS diet actually would help with some symptoms of PMS. Because you know, you’re reducing those processed foods, you’re reducing that salt intake from processed foods to help with the bloating, you’re increasing Omega three to reduce the inflammation and as a focus on whole grains and fruit and vegetables and things. So you know, it’s already a good place to start. But you know, we can go further with that. 

 

Geoff Allix  25:59 

I think that’s one of the things actually is it is to be clear, it’s a plant based whole food diet. That’s if you go down to the supermarket vegan aisle, probably not a good place. 

 

Jenna Cox  26:11 

Not a good place for anyone to be. 

 

Geoff Allix  26:14 

It’s I know, there’s two things to veganism because there’s if you’re looking after animal welfare, and that’s the be all and end all of why you’re a vegan, then yes, the stuff down there is not animal products. So if it’s a moral issue for that, then obviously, but if you’re doing it for a health basis, then I think it really the whole food part of it is really important, isn’t it? I just think that when you look at these substitute meats, and you look at the ingredient list, and it’s about 200 items long and you don’t recognize any of them, then you think that’s not food. 

 

Jenna Cox  26:49 

Exactly. You just pick up a kind of chickpeas instead, or maybe some tofu or something like that, rather than yeah, as you say, something’s a little long as your arm.  

 

Geoff Allix  26:58 

And so on that diet, you’ve you’ve also written about probiotic foods. So what are probiotic foods? Firstly, and how do they impact the gut microbiome? And how does that affect people with MS? 

 

Jenna Cox  27:13 

Yeah. So I think, first of all, I think the microbiome hopefully everyone’s really heard of that now. Because it’s got a really good PR team behind it. I think everyone’s talking about it. Similar to I think kale or maybe a few years ago, it’s kale or seem to be everywhere, and everyone was talking about kale. But I think we’re talking about gut health, which is really important. It’s really promising. And so yeah, the gut microbiome is comprises of your bacteria, viruses, funghi. We have microbiomes elsewhere as well, like on our skin, for example. This one will just talk about the gut. So it’s really important and 70% of your immune system is in your gut. So gut health, it does play an important role in in MS. And I’ll get to the probiotics in just a second. But there are just a few. There are lots of studies out there with linking gut health to MS. And I think it’s just that area of research is just going to get more exciting. I think as the years go on. Some of it is animal research, which I know is animal research, we have to treat it with caution. But there have been some mice studies showing that maybe the MS is triggered by proteins in gut bacteria that activate T cells. So the T cells are immune cells involved in the inflammation, and MS. And maybe the proteins in these bacteria are similar to the proteins in the myelin sheath. So we’ve got some, perhaps got some molecular mimicry going on. It’s an animal study. But you know, it’s interesting nonetheless, there was an Iranian study, a small study, so it’s only been about 40 people who supplemented with a yeast called saccharomyces boulardii. And they showed a reduction in in symptoms, pain and fatigue reduced as well as inflammatory markers. So there’s one called high-sensitivity, C-reactive protein. They had a reduction in that one as well. So I mean, that’s promising again it’s small study. And these associations, not necessarily causations got to be careful there. But I think it’s just shows that this area is just really exciting. So yeah, people with MS anyway have been shown to have dysbiosis so that’s an imbalance in their gut bacteria compared to healthy people. Now, it’s that classic chicken and egg, isn’t it? We don’t know is the MS causing the dysbiosis the imbalance of gut bacteria, or is the gut bacteria imbalance causing the multiple sclerosis. But anyway, it’s I think it’s really important to take care of our gut health and we can do that through probiotics, so in food, so it’s fermented foods. So we’ve got I mean, for me all these off, so 

 

Geoff Allix  29:55 

I eat a lot of things that start with kale now.  

 

Jenna Cox  30:04 

Interesting, that’s not the probiotic. So yeah, sauerkraut, kimchi, miso, yogurt. We’ve got kefir. Yeah, the water kefir, if you’re not, if you’re not eating dairy, you can buy water Kefir or make it I make my own yogurt as well. Kombucha. Exactly. Yeah, I like kombucha. I try to have my Friday night kombucha. So yes, dairy free yogurts. So I would say look for live cultures. Not all of them have live cultures in. Some of the pasteurized so they won’t be refrigerated or anything. And yeah, I’ve got a guide on my website. Sorry, it’s very UK focused. But it’s got different my favorite brands and where you can find them in supermarkets.  

 

Geoff Allix  30:49 

You can make yourself so that’s somewhat time consuming sometimes like, like sauerkraut basically almost makes itself. Michael Greger was on an episode of this, he did say there’s a lot of salt in that, which is true. 

 

Jenna Cox  31:04 

There is a lot of salt, have you ever tried making it? 

 

Geoff Allix  31:07 

Yeah, I make sauerkraut, kimchi, kombucha, my wife makes water kefir and I make kombucha. 

 

Jenna Cox  31:16 

Yeah, I only do the water Kefir myself. I did try sauerkraut once. But you really have to pommel it, don’t you the cabbage. 

 

Geoff Allix  31:25 

It just takes a long time. And you just need to leave it for quite a long time. Yeah. And then Kimchi to sort of variation on that. But yeah, there is a lot of salt in it. So that’s a worry I have about that. So there is a huge amount and what just as a sort of an aside to that don’t know, this is a human nutritionist. But what about probiotic tablets? Are they a good thing? Or is you know, if we’re just saying, you know, chemicals and things unnecessary, potentially bad? Is there a probiotic tablet a good sort of use that as a catch up as well? Or? Or would you say it’s better to use diet?  

 

Jenna Cox  32:03 

I think that’s a really good question. I would say, if we start with starting with diet first for everybody. And that’s probiotic foods if we can get that fermented foods in there, but also prebiotics. So you want to get the food that the bacteria feeds on. So you don’t want to just put the bacteria in there and then have nothing for them to feed on. So there’s lots of plants, fiber, prebiotic foods, like onions, leeks, and garlic and Jerusalem artichokes and asparagus and things like that. So yes, I will go food first. And then with a common question about probiotics, because there’s so much out there about probiotics, what we should take and what we shouldn’t take. And I think I tend to approach that as a person by person. Case by case anyway, to see what people’s symptoms are, what other symptoms people have got, and then try and use more targeted strains. So the studies that we have, there are very particular strains of bacteria that are shown to be successful, in particular, you know, doses and things. And so I would look at what strains and what are they being used for? So a bit more targeted. But yes, I think they absolutely do play a role in our health, but I would say more case by case and targeted, you can research in PubMed and see see what studies are out there and the evidence for them. 

 

Geoff Allix  33:31 

And another thing that comes out is cardiovascular events. So we talked about sort of a few different things, women’s health and gut health, but what’s the link between MS and cardiovascular issues? And, and does again, the Overcoming MS diet help to mitigate any of those problems? 

 

Jenna Cox  33:55 

So I don’t want to rain on everyone’s parade. But you know, we should we do have a high prevalence of osteoporosis, and also cardiovascular issues. So that might be a higher prevalence of heart disease and blood pressure abnormalities, heart rate issues, and dyslipidemia. So that’s the the fats in your blood. So that’s cholesterol and triglycerides. Now, there are a number of factors that might be at play there. So it could be that the chronic inflammation in Multiple Sclerosis affects the blood vessel. So integrity, making them more susceptible to the build the fairing up of the arteries is what we call atherosclerosis. When when cholesterol, embeds in those vessels, the rest of the walls the endothelium, and oxidizes and then causes these plaques that can move around the body causes all sorts of problems. And so it could be linked to that sort of inflammation, which is why we have higher rates of it. Women a higher rates of heart attacks then the men, women with MS. And also, the highlight of I said about dyslipidemia, about having high rates of the high levels of cholesterol. And that’s sort of a bio directional thing, really. So we may have higher rates of cholesterol triglycerides. But also, if you have higher rates of cholesterol and triglycerides, it’s actually linked and it’s associated with worsening disability. So I think there’s a big picture there of looking after our heart health. And yeah, as you say that OMS diet, I think, again, it’s really good place to start is low in saturated fat, saturated fat is linked with increased LDL cholesterol, bad cholesterol. We don’t have red meat. So that will help with our blood pressure, because it will be lowering that sodium. Omega three is obviously grateful for anti inflammatory purposes. It’s high in fruit and vegetables getting us antioxidants, and vitamins and minerals. The gut microbiome, that speaks to our our blood pressure. So we want to keep that really a good diverse range of bacteria. Yeah, and low in processed foods in general, you know, low in salt to help with our blood pressure. And yeah, lots of fiber. 

 

Geoff Allix  36:23 

Do all women have a higher risk, or just women with MS have a higher risk of cardiovascular? 

 

Jenna Cox  36:29 

Yeah, so women have a higher risk. And it’s linked to, again to menopause. And so it’s the decline that we have in estrogen after the menopause. So estrogen helps to keep our blood vessels more flexible, and relaxed for smooth blood flow. And also estrogen encourages the removal of this LDL the bad cholesterol from the bloodstream, so that all reduces has a protective effect. And it reduces the rates of atherosclerosis, but when with the declining levels of estrogen, that’s when it can be a bit of a problem. And also estrogen has anti inflammatory effects. So it protects us against the buildup of those of those plaques, but also it estrogen, the menopause is associated with a redistribution of body fat. So I’m sure many people many women of maybe that age who will think oh, yeah, I know about that. Because the fat can be more abdominal. And the fat can be more visceral around the organs. And that can be a risk factor for heart issues, cardiovascular issues, also a risk factor for diabetes, which in turn is a risk factor for heart issues. And so yeah, it’s all linked. And unfortunately, women, we seem to have got a bit of a raw end of the deal on that one with decreasing estrogen levels. 

 

Geoff Allix  37:57 

And you’re more likely to get MS as well.  

 

Jenna Cox  37:59 

We’re more likely to get MS. 

 

Geoff Allix  38:02 

Oh, no, that’s terrible. And then there’s all the sexism and things.  

 

Jenna Cox  38:07 

Yeah, exactly. But this podcast isn’t long enough to get into all of our woes. 

 

Geoff Allix  38:13 

There are other podcasts about problems with women in general, women’s problems not problems with women. So just to say, I think that was fascinating information. And I think actually, I mean, my biggest takeaway was really, that, that living by following the Overcoming MS protocols is actually really doing a lot of the stuff that we should be doing for our health anyway. So what could you give us sort of the final takeaway, some advice that you’d give yourself as a newly diagnosed person? Who’s, you know, just starting to look at following the program? 

 

Jenna Cox  38:57 

Yeah. I think everyone’s really different. And we all come from different backgrounds and cultures and cooking abilities and interests and things. So I don’t think there’s one general advice for everybody. But I think everyone you know, says you’re running your own race, and everyone has to do it. As you’ve mentioned at the beginning, like you know, you have to do as you want to do it. I know the website has a fantastic Six months to Overcoming MS course which is great if anyone sort of struggling to make those changes. But I think I would say to people is to this is what I didn’t do. So this is, you know, this is actually actual genuine advice is finding recipes, finding foods, finding dishes, finding new ways of doing things before you cut things, maybe completely out. So I was left quite a few days feeling quite hungry because I just didn’t know what to eat instead. Or maybe I was taking like a chia seed pudding for breakfast or something to work, and I was hungry by 10 o’clock because it just wasn’t enough for me, but you know, since I’ve added so many things to my diet, so I think adding so many things in, crowding things out, so I didn’t really have oily fish before, we had salmon occasionally has mainly white fish if I if I ate fish, so I think find different recipes for using sardines and anchovies and salmon and mackerel and things that might help if you don’t have fish and you haven’t chosen to go to eat oily fish, then investigate different types of tofu. So might be firm, tofu, tempeh, silken tofu, get some recipes for those. There are so many different types of beans and lentils, different types of lentils, different dips, you can make different colors you can make. So I think it’s flood your diet. And with loads of great recipes, there are loads online. So you know, OMS recipe book, there’s so much I think, get all that information behind you. And then it’ll be much easier I think to crowd the things are maybe less helpful to your health out of the diet. And I don’t think that you would miss things as much because it’s quite exciting just finding all these new things to eat. Really? Yeah, I think I’ll probably be my advice. I don’t know. Do you have any any other advice? 

 

Geoff Allix  41:23 

I think I did exactly the same as you. Because you you just look at it as excluding things that you say, Okay, there’s always things I can’t eat. That’s really good advice. Because I should have done that. I didn’t think first what can I eat? I just thought, what can’t I eat and that was kind of, I just took out things from my diet. And I was just left with the stuff that I used to eat minus meats and processed foods and dairy. And also this cookbooks by Ashley Madden, who follows Overcoming MS. She’s got two cookbooks out. And so there’s a whole load of yeah, there’s loads and actually, it’s really delicious. Once you start eating whole foods, you’ll find that it’s really lovely. 

 

Jenna Cox  42:03 

So yeah, miss things. No, I don’t, I don’t. And there are great people to follow on Instagram as well. You know, they might be plant based. You know, some people I don’t know if there’s specific OMS people but I follow a lot of plant based influencers or chefs or content creators. And I take screenshots I have a folder on my phone, I have a physical folder and get some new stationery, everyone loves new stationery, you know, just get all your recipes together. So you’re never left thinking, What can I eat? What can I cook because you’ve always got ideas there. And you know, you can plan out your week, get geeky, get a spreadsheet going or however you want to do it. Get planning so you’re not going to wander past a lovely smelling shop with lots of beige food and be really tempted to go in there and get something I plan out if you don’t get hungry. And yeah, and experiment and enjoy learning some new dishes and some new skills. 

 

Geoff Allix  42:58 

Okay, check out the show notes. It’s Jennacox.co.uk Is your website, isn’t it? But yeah, the links below. And thank you very much for joining us, Jenna Cox. 

 

Jenna Cox  43:10 

You’re welcome! Take care. 

 

Overcoming MS  43:12 

Thank you for listening to this episode of Living Well with MS. Please check out this episode’s show notes at overcomingms.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 Geoff Allix. 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