S6E8 Webinar highlights: your opportunity to ask a qualified nutritional therapist about the Overcoming MS diet with Sam Josephs

20:11 “Highly processed foods sometimes irritate the gut lining, which can affect our friendly bacterial populations. We’re only just starting to understand the detrimental effects of some of these unknown food chemicals, not to mention high levels of salt, and high levels of sugar, all of which on a metabolic level are not good for us. Salt can cause excretion of calcium, which we’re trying to retain. The sugars can cause metabolic issues, things like becoming overweight and obese.”

42:35 “It’s important not to rely too heavily on one grain or another. But to keep that variety because each grain has a different nutritional profile and will be broken down differently in the body. The more variety you have with your grains, the more you’re encouraging healthy bacteria which indirectly calms MS activity so think about different rice: what about wild rice [or] the red rice? What about buckwheat? Have you tried quinoa yet?”

03:05 “Some people do the five-two diet, which involves eating normally five days of the week, and then just eating dinner on two days of the week, consuming much lower calories. You could fast overnight for 16 hours and then eat your food in a much smaller window of eight hours. It could be done as a water fast where you don’t eat anything at all, and just drink water one day a week or a couple of days a month.”

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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 platform so you never miss an episode. And now let’s meet our guest. Today’s episode features highlights from the Your Opportunity to Ask a Qualified Nutritional Therapist about the Overcoming MS diet with Sam Josephs Webinar, presented by Overcoming MS facilitator, Sam Josephs and Overcoming MS Project Delivery Manager Jake Connor, recorded live in front of our global audience as part of the finding hope with Overcoming MS webinar series to join us live for the next webinar. Or watch the original presentation, head to our website overcoming ms.org.

 

Sam Josephs  01:10

For those of you that don’t know me, my name is Sam Josephs. I am a registered nutritional therapist. I qualified back in 2008. And I have a particular interest in Multiple Sclerosis because my husband Danny was diagnosed in 2002. So since being a nutritional therapist, word has really got out about my personal connection to MS. And I now see a high proportion of my clients are people from the MS community. So it’s something I’m dealing with every day. Our sort of personal journey with OMS started really, when the book was published, sort of early teens, I think it was the early sort of 2012, something like that. And we’ve been more and more compliant on the OMS program culminating with our first retreat in 2018 when Danny went completely OMS friendly. And since then, since 20. Yes, since 2018. I’ve been a part of the facilitator team, with running retreats. And speaking at public events, hosting webinars, this kind of thing.

 

Jake Connor  02:40

Do you know anything about fasting and fasting mimicking diets for people with MS?

 

Sam Josephs  02:46

Yes, short answer. First, intermittent fasting has been gaining huge amounts of popularity in the media, I think lots of people are familiar with the concept. So it can be it can be done in a few different ways. Some people perhaps want to do something like the five-two diet, which involves eating normally five days of the week, and then maybe just eating dinner on two days of the week, consuming much lower calories, it can be done as a time restricted eating pattern, so you could fast overnight for 16 hours and then eat your food and a much smaller window of eight hours. It could be done as a water fast where you don’t eat anything at all, and just drink water one day a week or a couple of days a month. So there are lots of different ways to introduce the idea of fasting. But it’s really gaining a lot of credibility. And there’s a lot of research behind it now about how it’s generally very good for our health. It’s very good for cardiovascular health, which often ties in as well with brain health. And then more specifically, there have been some very convincing studies with mice with animals using the MS model in mice and putting them on a intermittent fasting pattern, maybe just allowing them to eat every other day. And they’ve really shown some quite dramatic effects. They’ve been able to reduce inflammation, reduce the damage of the neurons, and actually reduce the demyelination mechanisms that are going on as well. There’s been less studies done on people but there’s still been a good handful of studies that haven’t run for very long, maybe just a couple of months and not very large groups of people. 30-40 people, usually with a relapsing remitting type of MS. And these people have also shown improvements in fatigue, improvements in quality of life. In one study improvements in disability scores as well. One of the latest pieces of research that was just recently presented at ACTRIMS, which is the big conference for MS. Neurologists and all latest research demonstrated a really positive benefit for people doing something like the five, two programs, so five days of eating normally two days of fasting, and really showed improvements in cognitive health. So I think short answer is yes, it is a very useful adjunctive tool to managing MS. And one of the easiest ways to do it, I think is time restricted eating, which has been shown beneficial as well.

 

Jake Connor  05:58

I’m trying to get all of my calcium intake from oily fish with bones in, for example, half a portion every day, as well as many vegetables, fruits and nuts and seeds. And I can’t eat soy, is it a good idea for me to also find a clean, oil free vegetable based milk that’s fortified with calcium, or is that as risky for us as taking an actual calcium supplement, given the amount of vitamin D3 we take.

 

Sam Josephs  06:30

So that’s, that’s quite interesting. I mean, vitamin vitamin D increases the absorption of calcium, so people following the Overcoming MS program will have very good levels of vitamin D, because that is one of the arms of the program. So calcium absorption from the plant based foods, and other foods like fish with small bones will be well absorbed. I don’t think that you would be at great risk if you were to take a small calcium supplement, if you’ve been advised that your calcium levels were low, or if you’re at risk of osteoporosis. I don’t see that the vitamin D would have such a powerful effect to take calcium levels to a dangerous point at all. Certainly, using fortified milks is another nice way to bring calcium into the diet. I found that the Blue Diamond brand for almond milk is quite nice one that doesn’t have extra oils and is fortified with calcium. So yes, I would say it would be a good way to boost calcium if it’s something that you believe that you’re low in or you need to increase.

 

Jake Connor  07:50

And so with the amount of oily fish nuts, seeds and vegetables that I’m eating, I’ve realized I’m actually getting about four or five grams per day of Omega-3 if I’m if I’m absorbing my foods efficiently. So would it be okay for me to also have a tablespoon or two of flax oil as well?

 

Sam Josephs  08:11

Yes, definitely. So even though you’re doing really well to include lots of foods that are rich in Omega-3. First of all, the fact that you have MS means that you are going to find it more difficult than someone without MS because of your genetic profile to actually absorb and break down and metabolize the Omega three that you’re consuming. And the Amiga three that’s available in plant foods, not the oily fish, but from the plant foods is again, much harder to actually break down and convert into the active component of Omega-3 for the anti inflammatory effects. So I would say that, although you may believe that you’re consuming four or five grams of Omega three, you’re unlikely to be actually assimilating that much into the body. So absolutely, I would supplement the diet with extra flaxseed oil.

 

Jake Connor  09:13

So the next one is quite an interesting one. So this person is from Denmark, and they’ve said that there are very few meat and dairy free options at restaurants and typically there’s only one vegan option and it’s usually dahl with coconut milk. So this person has said How bad is coconut milk compared to meat and dairy and can you eat coconut milk once in a while or is it better to just totally avoid it?

 

Sam Josephs  09:40

Okay, so coconut milk is very high in saturated fat, which is why it’s not recommended as part of the Overcoming MS diet. However, it does not contain the arachidonic acid which is the inflammatory fat that is contained in red meat. So in that respect, I would say it was preferable to the meat. Again, the reason we avoid dairy is not just because of saturated fat component. But it’s because of the process of molecular mimicry whereby some of the proteins in dairy mimic myelin and could potentially facilitate the T cell attack on myelin. So if we’re weighing up goods and bad’s, I would say, definitely choosing coconut milk. Occasionally, when you’re out with a dahl curry for dinner is a really good beneficial choice over meat and dairy, and you want to be able to go out and eat and you want to be able to go enjoy socially with your friends. And really across the week if your overall saturated fat intake is very low, then really, you know, one curry with some coconut milk here and there would be absolutely fine.

 

Jake Connor  11:00

The next question that we’ve got is from somebody who said, I drink fortified soy milk as part of my diet and felt quite confident that I was getting additional vitamin D through this, I have about 700 milliliters to one liter daily. However, I recently realized that this is actually vitamin D2 wonder what the difference is to be free. And is it actually valid to count in my daily intake?

 

Sam Josephs  11:25

Okay, interesting question. So I’m not sure if this person if you’re taking a vitamin D supplement as well. And you’re hoping to just boost your overall vitamin D intake by having the fortified milk. But the difference between D2 and D3, they both have to be converted in the liver to become active. And the D3 does that much more efficiently and does it much longer, it has a much longer life at doing that. So it’s much more efficient at raising vitamin D levels and storing vitamin D levels long term. So vitamin D2 is genuinely not considered as efficient or as active as vitamin D3, I think the most important thing to do is to test your vitamin D levels if you’re concerned, because if you test them and you can do it very easily, I think most countries will offer a home test kit, a simple blood test and check your levels you’re aiming for something more than 150 nanomoles, which works out at more than 69 nanograms in the American, Australian version of vitamin D measures. And so that’s really the best way is to work out what your levels are, and then to supplement but you’re correct in thinking the amount of vitamin D that you’re getting from fortified soy milk is nowhere near close to what we recommend on the OMS program, which could be up to 10,000 international units a day.

 

Jake Connor  12:59

This next person has said that they are 55 years old, and they have MS and they’ve been following the Overcoming MS diet for several years and they’re doing quite well on it. And they have said I know the Overcoming MS diet normally provides enough calcium but I have osteoporosis so my recommended daily intake is higher. And then they’ve said it’s 1200 milligrams. Even with a healthy and varied Overcoming MS diet getting to this amount or anywhere close is impossible without eating dairy. My GP says that eating I should eat dairy, but obviously the Overcoming MS diet says definitely not to what should I do?

 

Sam Josephs  13:40

I’m afraid I would disagree with the GP, I would say because you have MS we would not recommend that you consume dairy because as I said, it may well be instigating further inflammation and attack on the myelin sheath directly through the process of molecular mimicry. And there’s also a lot of conflicting evidence around whether dairy actually does improve osteoporosis. What we see in the literature we see big population studies where we know that those countries that consume more dairy, have higher rates of osteoporosis. There are lots of studies, some showing that there is no relationship between high dairy consumption and robust bones and stronger bones and osteoporosis. And in fact, I think it was the nurses cohort study. So this is a huge study running over a long period of time. Over 77,000 self reporting. People actually demonstrated that by those people that were consuming more dairy drinking an extra one and a half glasses of milk daily. Were at greater risk of hip fracture, so for someone who is battling osteoporosis, really, I think probably a calcium supplement, but a calcium supplement together with those other minerals that are very important to help lock calcium into the bones. So you’ll be getting good levels of vitamin D to absorb the calcium from the diet. But it might be worth looking for a good quality bone support nutritional supplement that gives you extra vitamin K, the boron, the magnesium, all those other minerals, and vitamins as well, that help protect against osteoporosis. And those minerals are often in a lot of the plant foods where we find calcium, which is why studies have shown that like for like 100 grams of dairy foods versus 100 grams of kale, you actually get more kale and you absorb it better into your bones. Sorry, you get more calcium from the kale and absorb it better into your bones than you do from the dairy foods. So it’s as much about controlling your excretion of calcium, which happens when you have a very high protein diet, a diet that’s very rich in animal proteins. So having a more plant focused diet, like the Overcoming MS diet actually protects against calcium loss. So again, it again, maybe discuss testing calcium levels with the GP. But I would feel confident and reassured that if you were eating a very healthy plant focused whole food diet, like the OMS program, you will be getting enough calcium along with all the other nutrients. And then there’s always bone support supplement there.

 

Jake Connor  16:48

Are there different types of saturated fats? And is it true that people on the Overcoming MS diet should limit their intake of avocado and fatty fish due to saturated fat?

 

Sam Josephs  17:00

Yes, so there are different types of saturated fat, but together they’re all collectively known as saturated. But the interesting point to remember is that foods that are considered fatty, are genuinely never just completely one type of fat, there will always be a combination of all the different fats they are labeled as being a polyunsaturated fat or a saturated fat due to the domination of whichever fat is most prevalent. So you’re absolutely right, there is some saturated fat in an avocado. But the primary fat in an avocado is mono unsaturated fat. And this type of fat is also found in olive oil, nuts and seeds. And it has a very anti-degenerative effect on the body. In terms of portion size, because there is a small amount of saturated fat, maybe one and a half grams of saturated fat in half an avocado versus about seven, seven and a half grams of the mono unsaturated fat, we say limiting avocado portion sizes to about half an avocado in one setting and maybe sort of three times a week, or three to four times a week. Similarly, oily fish is predominantly the good fat, the Omega-3 fat but yes, there is some saturated fat. And it seems to be with the studies, the holism study, which was looking at 2500 people all around the world found that those people that were eating three portions a week, were the ones that seem to be experiencing less disease progression and exacerbation of symptoms. So sticking to three portions of oily fish a weel should be the way forward.

 

Jake Connor  18:57

I’m just starting on the Overcoming MS diet. And similar to the coconut milk question that we went through before, how detrimental is it to have occasional processed food or fast food etc.?

 

Sam Josephs  19:11

Okay, there’s a big difference there. I think between processed food and fast food. For me fast food is generally something that will be deep fried. And so that’s something that I would think we’ll try and steer clear of as much as possible. It has. It’s not good for anybody in our population at all anywhere, and particularly because of the bad fats because of the oxidation of fats. The inflammation and degenerative properties that they bring would really be best avoided. So for me fast foods, I would say try and leave them as much as possible. And for people starting out on the OMS diet, it might be that they’re cutting down or reducing frequency, and that’s fine. As long as you’ve got your eye on the end game, which is trying to completely eliminate the fast foods, I think that’s fine. The highly processed foods, really, they have a lot of chemicals that we don’t really know what the effect is, we know that they sometimes irritate the gut lining, that they can affect our friendly bacterial populations. And we’re only just really starting to understand the detrimental effects of some of these unknown food chemicals, not to mention high levels of salt, high levels of sugar, all of which on a metabolic level are not good for us, the salt can cause excretion of calcium, which we’re trying to retain. And the sugars can cause metabolic issues, things like becoming overweight and obese. But having saiid that, it’s difficult to eliminate them completely from our diet, because of the way the supermarkets are structured, because of the way that we are fed this opportunity for a quick fast get a meal together. So I would recommend looking at some of the labels, and you might find in a supermarket sort of various highly processed foods can be switched for a different brand, that might be similar in terms of the speed of which it can provide meal, but might be lower in the number of ingredients, we’re looking, you know, just how many things are packed into it. So I think, again, ideally, we’re looking to avoid them as much as possible and stay on a whole food diet. But if there are times when it’s going to be very stressful, you’ve got to get a quick meal together, that stress can be really detrimental as well. So occasionally, you have leave it up to the individual and the individual choice because I’m not looking at the food label. But yeah.

 

Jake Connor  21:56

I know egg yolks aren’t allowed on the Overcoming MS diet, I presume this issue too saturated fat? Is this correct? And if so, would it be okay to eat an egg? Egg Yolk every now and then, for example, in ramen when eating out?

 

Sam Josephs  22:12

Yes, you’re absolutely right. Saturated fat is contained within the yolk of the egg, whereas the white part of the egg is very high in protein, very low in saturated fat, there isn’t a huge reason to avoid eggs in my opinion. So if you’ve had a good, really great OMS friendly week, the occasional egg yolk in a ramen, But similarly, enjoying the egg white and leaving the egg yolk if you prefer as well.

 

Jake Connor  22:46

So this person has said that they follow the Overcoming MS diet as it seems to help reduce their fatigue. And they’ve said I’d like to understand more about the relationship between dietary fats and my symptoms. Is the inflammation a chronic condition? Or is it an acute reaction to what I’ve eaten that day or very recently? And could you say what would happen to my body if I ate steak, for example, once a month?

 

Sam Josephs  23:11

The inflammation that’s going on is is a chronic state of inflammation that is created by the mechanisms of multiple sclerosis. And the regulation of the T cells, you have more of the pro inflammatory T cells that are more active, and there are much less of the regulatory dampening T cells. So the state that people with relapsing remitting MS are in is a chronic state of inflammation. Having steak once a month means that you’re bringing into the body quite high levels of a pro inflammatory fat. When someone with MS consumes a meal, they are much more likely to consume the saturated fat component of that meal before they consume before they assimilate the polyunsaturated part just because of the way the genes are in the way the uptake of fats occurs in somebody with MS. So the fat is then taken up and it’s put into the cell membranes of all our cells. And those cell membranes need to be mostly Omega-3 because it’s nice and pliable and flexible oil because it’s unsaturated the saturated ones are saturated and they’re very rigid. And if they’re taken up into the cell membranes, they make cell membranes very rigid. And that means the communication between the cells can be dampened can be impeded. And the signals that the cell gives off will be more pro-inflammatory as well. So it’s, it’s about thinking about how you assimilate fats into your body. So I think if you’re trying to give up read me thinking about doing, having red meat just once a month is a really good way to start. But maybe seeing if you can reduce it a bit more over time, can you go to once every six months? Can you just try once? You know, again, it’s trying, it’s it’s kind of finding that balance of thinking long term, where you’re going to be with the Overcoming MS diet.

 

Jake Connor  25:39

So this next one, for those of us taking 7500 to 10,000 IU of vitamin D3, is it necessary to is it necessary to also take magnesium and vitamin K? And if so, which vitamin K and how much?

 

Sam Josephs  25:59

Is it necessary to take magnesium? No, not necessarily. And vitamin K reasonably small levels, 150 micrograms is usually sufficient. We get vitamin K in lots of leafy green vegetables, we get it in whole grains like oats and asparagus, it’s quite easy to come across in the diet. So if you’re following the Overcoming MS diet, and you’re eating a whole food, plant focused diet, you’re going to be getting lots of vitamin K as well. But the reason we combine vitamin K with high levels of vitamin D is that it prevents the calcium building up in soft tissues. So there’s a supplement by Seeking Health, which is 5000 I use of vitamin D together with vitamin K, it’s one of the best ones that I found one of the highest levels. So that’s the one that that I like to use. Because you are people call Vitamin K is like a gatekeeper. It stops the over absorption of calcium going to the wrong places.

 

Jake Connor  27:11

Is there a limit for the amount of egg whites per day or per week?

 

Sam Josephs  27:16

No, not as such. eggwhite can be really helpful ingredient for binding foods and recipes and things. But then similarly, an egg white omelette can be a nice an egg white omelet or scramble. Could be a nice breakfast or lunch. I’m gonna say that any food if you eat it in crazy amounts or too much of it, probably there’ll be something that will be negative. So just put a little caveat on that. I’m not sure how many egg whites this person’s thinking of consuming, but kind of unlimited within reason. Yeah, yeah.

 

Jake Connor  27:55

My understanding is that the Overcoming MS diet does not include meat in order to eliminate saturated fat, which is obviously what we’ve discussed. And however, even a vegetarian diet includes saturated fat so is it possible to follow the principles of the Overcoming MS diet whilst including some meat and this person said they struggle with weight loss and find it difficult to consume enough calories.

 

Sam Josephs  28:18

Yes, the saturated fat content is an important part of why we exclude red meat. But generally land animals and consumption of land animal meat has been linked to and associated with general poor health outcomes in large population studies. Which is one of the reasons why it’s not on the OMS program. Again, the type of fat this arachidonic acid, which is actually an Omega-6 fat, not a saturated fat, and as quite high levels of it in all meat again, is pro inflammatory so it’s not as simple as just being saturated fat content. If you look at the saturated fat content of a chicken breast without the skin is actually quite low. So if you are struggling with weight loss, and you believe that including small amounts of meat is going to protect against losing muscle mass is going to protect against losing too much weight, then skinless white chicken breasts once in a while, would be something that I would say would be appropriate and would be okay. The actual saturated fat content is reasonably low.

 

Jake Connor  29:45

Somebody has said I find that the intake of carbohydrates and sugar and then in brackets (fruit) causes spasticity. Are there any any study on studies on this that you know of as I find that the spasticity is relieved with sports, electrolyte, drying and increased water intake, magnesium capsules an Epsom salt bath. Yeah, yeah.

 

Sam Josephs  30:12

So, no, I don’t know about any connection between fruits and spasticity, but it is a very uncomfortable and serious symptom of MS. This is when the muscles become very tight and constricted. So absolutely something like electrolytes, particularly magnesium, which is the relaxing mineral, the calcium helps muscles contract and magnesium helps muscles release. So yes, certainly using magnesium products would be a good way to counteract that. Epsom salt bath has magnesium sulfate, which is absorbed transdermally through the skin, which is which is really nice for people. Some people can be sensitive to too much magnesium in supplement form because it can have the effect of loosening the bowl. So Epsom salts, transdermal it can be a nice way to get good levels of magnesium and to reduce spasticity. But I’m afraid I don’t know of any connection between fruit and spasticity.

 

Overcoming MS  31:23

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Jake Connor  31:40

Is the Overcoming MS diet, something that can be easily integrated into a very busy schedule?

 

Sam Josephs  31:46

Yeah, and I think that I hear that a lot from people as well. It’s something that overwhelms people when they’re new to the program. For people that have been doing the program for some time, they’ve already learned some tips and tricks and hacks that sort of easy to make meals. Something like a quick vegetable tray bake. Chop some vegetables, sprinkle with a little bit of olive oil, sprinkle with some water, season, throw in some herbs. And then open a tin of chickpeas, rinse it, chuck those in as well. And bake it, those kinds of quick, easy meals take a bit of exploration and adjustment. Sometimes at the beginning of the program we’re overwhelmed with thinking about recipes and following recipes say that people that are new to the program and struggling with time and things try and mimic as much of what you were previously doing. Making small tweaks, you know, mashed potato, all you do is a bit of olive oil and a little bit of plant based milk instead of your regular. You know, there are just so many ways to keep eating some of your favorite easy meals. But by making simple substitutions to speed things up. Batch cooking is another way to do it. But I like using the occasional jar of sauce or tin of beans as a quick hack that can you know that can speed things up. I’m certainly useless at remembering to soak beans overnight and then cook them for hours and I don’t operate like that I come down and I’m like right well, what are we gonna we’re gonna talk about really quickly. But I appreciate that it’s it’s difficult when you’re starting the program, it feels overwhelming because you feel like you’re perhaps in quite a different pattern from where you used to be. And if you’re anxious about you know, buying the ready meal you used to buy because you feel like you should be cooking from scratch or have a little think about what was that ready meal. You know how actually easy is it to mimic something at home, can you throw a load of veggies into a tray stick a piece of cod on top bung it in the oven? You know there are some quite easy ways and then what I also do to minimize, you know energy expenditure is to make double. If I’m going to the trouble of making a meal, I’ll make double so that I’ve either got one or two portions to freeze for later in the week. Or it’s something that can be picked up for tomorrow night’s dinner or something that can be used for lunch. Later in the week or the next day. soups are really good. They are quite quick. You can just use up any leftover old wilting vegetables and herbs. Throw them in make a big batch of soup and freeze it and then you’ve always got that emergency meal. You just need a crust nice chunk of crusty bread to go with it or you could just boil some rice and add some rice to it or you to have a salad on the side. So, having a few sort of emergency easy, easy meals.

 

Jake Connor  35:05

This person has said, is there any difference in the fat contained in fresh coconut that can be sprinkled on food as opposed to coconut oils and cooked coconut. So this person is Indian and their dishes use lots of fresh grated coconut.

 

Sam Josephs  35:23

Yeah, so the fresh grated coconut still contains the coconut oil. The oil is obtained by compressing the flesh. And the coconut milk I think comes from boiling up and cooking the flesh. So yes, there is still fat in the coconut flesh, which I don’t think they want wanted to hear. But again, if you are used to cooking like this, and this is a staple part. Are there ways that you could perhaps reduce the amount that you use. So could it be like a tomato based curry instead? And could you perhaps just use much smaller amounts of freshly grated coconut just as a little garnish on top to help bring that flavor of coconut into the meal? Are there ways that you can look at reducing the actual portion because if you reduce the portion you’re reducing the fat content as well by by limiting the amount that you’re eating.

 

Jake Connor  36:29

Brilliant. Thank you. So this next question this person has said they’ve lost seven kilograms on the Overcoming MS diet and don’t want to lose any more and they eat a banana and nuts every day. But can you suggest any calorific foods or snacks that might be suitable.

 

Sam Josephs  36:48

Nuts is a good one seeds are a good thing as well dried fruit, seed mix trail mix those kinds of things. Olives, olives are very rich in the mono unsaturated fat so they can help give you a feeling of being fuller as well. Olives combined with nuts, other good snacks, things like a tin of salmon, a tin of cannelini beans, a dollop of soy yogurt some fresh herbs a bit of seasoning, lets it all up and turn it into a kind of dip. And it’s you know, it’s reasonably high in calories you stick your vegetable crudite in it, you know, or some nice crackers, or some nice crusty bread. Nut butters as well on toast is another good calorie rich food that’s Overcoming MS compliant as well. And I think sometimes you need to look at the actual portion sizes. And if you’re losing weight, you might be somebody who needs to have breakfast, a small snack, lunch, a small snack, dinner, a small snack so you might be someone who’s not used to eating or bigger plateful and, sort of protect yourself like that. Also smoothies, smoothies or a good mid afternoon kick. You can add a dollop of almond nut butter in there you can put chia seeds, flax seed, ground flax seed, oats, those kinds of things in together maybe with a bit of yoga and some berries and blitz all of that up. It’s really maybe just to look at the quantity of what you’re consuming because a lot of the food on the Overcoming MS diet is naturally lower in calories so we can eat more of it.

 

Jake Connor  38:39

Are hemp seed hearts a good source of Omega three and could you comment on omega three / Omega six ratios in certain foods?

 

Sam Josephs  38:48

Yes, hemp and hemp seeds or hemp hearts are a good source of Omega three. And I think hemp is one of those foods that’s a very good balance of three, six and nine. So they are they are a great food tooing Klum? Well, like I was saying before no food is really all one fat or another. And omega six fats are also anti inflammatory and anti degenerative unless we get too many of them, which can happen in a typical Western diet because of kind of the adulteration of the food chain and the reliance on refined carbohydrates and those kinds of things. So the standard American and British diet that we all follow tends to be very high in Omega six, which tips the balance to becoming pro inflammatory. So it was even more difficult to get the Omega three to address that balance. But really, we’re looking at something like the typical American diet. It’s about 20 to one ratio of omega six to Omega three. They say the Paleo caveman was probably living with a ratio of one to one. So in today’s society in an ideal society for the perfect Overcoming MS friendly body, we would be looking at something maybe Omega six to Omega three four to one.

 

Jake Connor  40:16

If someone struggles to tolerate flaxseed oil, which alternatives would you suggest and in what quantities?

 

Sam Josephs  40:23

 I would suggest eating fresh walnut daily, I would suggest having whole flax seeds or ground flax seeds daily as well and I would definitely suggest the oily fish three times a week. Hemp seeds and maybe even trying the hemp oil a cold pressed hemp oil, which is a really nice balance of three, six and nine. So all of them anti degenerative oils. Omega nine is the mono unsaturated fat like olive oil, the Omiga six component is there, but together with the other fats, we can assume it will be more anti inflammatory. So I would say have a go with cold pressed hemp oil instead of flaxseed oil if you can’t tolerate it, but the words can’t tolerate it make me wonder if it’s something that’s literally tolerating, as in can’t tolerate it because it’s causing really bad gastric upset or tolerate it as in the flavors just awful don’t like it, because if it’s the latter, there’s a good chance the flaxseed oil is rancid. And the one that you’ve chosen needs to be looked at. You should be buying a nice tasty flaxseed oil that’s fresh, bottled in a glass bottle, a dark bottle kept in the fridge. So if it’s the latter, if it’s the taste that you can’t tolerate, then have a go with a few other brands.

 

Jake Connor  41:56

Are there better and worse whole grains?

 

Sam Josephs  41:59

A whole grain by definition is a good thing because it’s in tact. It has fiber in it has protein in it has essential B vitamins and minerals like zinc. I’m wondering if this question is driving towards the gluten versus non gluten grains. For some people, gluten grains could be a less beneficial wholegrain. That’s where the questions going. But I think that one of the real benefits of the Overcoming MS. program is the fact that there is this emphasis on whole foods, plant based foods. And what’s really important is not to rely too heavily on one grain or another. But to try and keep that variety there because each different grain has got a different nutritional profile, and will be broken down differently in the body and can help to encourage the growth of a much wider variety of friendly gut bacteria as well. So the more variety you have with your grains, the more you’re encouraging healthy bacteria which is indirectly calming MS activity so think about diffewrent rices. What about the wild rice, the red rice? What about buckwheat? You know, have you tried quinoa yet? Just thinking all the different options and yeah, each time you’re introducing these different foods or encouraging variety in the microbiome, the healthy bacteria.

 

Jake Connor  43:29

I am I’m finding by eating a lot of flaxseed oil, I am having more frequent cold sores. Do you know how much lysine is safe to take per day especially when I have a flare?

 

Sam Josephs  43:43

If you’re having a flare of lysine, I think the recommendation is three grams. So they usually sell the supplements of lysine in 1000 milligrams or one gram tablet size. And if you’re someone who’s prone to cold sores, then you could take a gram every day. And when you have a flare you can increase that to a gram three times a day.

 

Jake Connor  44:09

Based on the current situation with the cost of living increases, what would be some go to dinners that you might recommend to a family or those wanting to cook on a budget?

 

Sam Josephs  44:20

Okay, well the plant based meals are obviously going to be some of the cheaper ones and I make a really tasty bean casserole which is essentially onions, garlic, celery, carrots, tins of chopped tomatoes, and then some tins of butter beans, but then I can either just add some chili flakes and make it a bit spicy. Or I’ve got a little jar of Chipotle, which I sometimes add and that makes it nice and sort of hickory smoke so you can sort of play around with the flavors of it and kind of make it a bit different. You could change the beans in it but they essential ingradients are really cheap tomatoes, carrots, celery, onions, garlic. Then I also add to it anything that I’m trying to use up that’s kind of going a bit wilty in the fridge. It could be some chard, it could be some kale, aubergine that’s starting to look a little bit wrinkly, some red peppers. And then again I was talking about I’m a big fan of these tray bakes with fish because again, you can just change it up by using whatever veggies you’ve got in the fridge and putting a piece of fish and it doesn’t have to be a very expensive piece of fish, it could just be a piece of cod. It doesn’t have to be very large piece of fish, trying to shrink the portion sizes and then adding extra veggies on the side. So I’ll have a nice tray bake, maybe green beans, cherry tomatoes, maybe something like courgette, whack it in the oven, put a fish on top, few herbs. And then I’ll just do some rice on the side some brown rice and then I’ll do some extra greens as well something like some steamed broccoli and cauliflower. So the veggies are all really cheap getting all the stuff from the greengrocers and just kind of filling the plate with those cheaper foods and shrinking the portion of the more expensive proteins which is often fish or seafood. But also looking in the freezer section so you can buy these things frozen. It’s much cheaper to buy a piece of frozen fish than it is the fresh, it’s much cheaper to buy frozen prawns and throw them into a big batch of shredded vegetables for a stir fry which I just do with water and soy sauce and ginger and garlic. And then just having that with some brown rice. And I also put cashew nuts, a few sprinkle of cashew nuts on top sprinkle of sesame seeds on top. So kind of boosting the protein and also the variety in the diet but keeping the actual cost of the meal down the expensive part of the meal like the prawns keeping that cost down. Using frozen veggies for a lot of these dishes as well because they are according to some studies fresher than some of the stuff that’s sat on the supermarket shelf for 10 days.

 

Jake Connor  47:16

Thank you so much for your time. That was brilliant and just so informative.

 

Sam Josephs  47:21

Thank you. Thanks very much. And thanks everyone. For the questions. It’s always really good to share as much as possible and help clarify things for everyone.

 

Overcoming MS  47:32

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 Geoff Allix. Our videos are edited by Lorna Greenwood, and I’m the producer Regina Beech 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.