In November we welcomed back, qualified Nutritional Therapist and Overcoming MS Facilitator Sam Josephs, giving you the opportunity to ask her your questions about following the Overcoming MS Diet.
This transcript was created with the support of a volunteer.
Karen Lee 00:01
Hello and welcome back to the Finding Hope with Overcoming MS webinar series, season four. We're so pleased to bring you tonight's session with Sam Josephs, who's a qualified nutritional therapist and an Overcoming MS Facilitator. My name is Karen Lee, and I'm one of the co-hosts for tonight. And I'm joining you from beautiful Devon in the UK. In a moment, I'll be inviting Sam and my co host for the evening, Kim to the stage. But before I do, I just want to run through a little bit of housekeeping just to keep the webinar running as smoothly as possible for you. So welcome to all of you watching this on replay in the future. But if you're joining us live, please do note that this session is being recorded. And you will receive a link to access the recording in the next week or so. You'll also notice that this zoom webinar, there is no video or audio component for participants. So however, it is still an interactive session. And if you want to, and we would like you to, submit questions, you can do that with the Q & A tab, which you'll find at the bottom of your screen. We're going to start with some pre submitted questions to go through. So you'll have time to think about what you want to ask and pop them in the q&a. If you have any technical glitches, which you know, we know these things do happen, try leaving the webinar and then re entering again using the link on your email. And we recommend that you use Chrome to get the best results to access this webinar. We've tried to make these sessions even more accessible. And today we're using the closed captioning service which looks like subtitles at the bottom of your screen. So you can either turn these off or on by clicking on that CC or the CC button that says show captions. And you can either select show subtitles or hide subtitles. At the end of the webinar, there is a short survey that will pop up. Please don't try and skip it,do just quickly fill it in, it won't take very long. It's really important that we get your feedback to make sure that these webinars are meeting your needs and the fact that you enjoy them. So just a couple of moments to fill that in before you go. This session tonight is going to run for about an hour and 15 minutes, just in case you need to plan for anything else. And so now without any further ado, I would like to welcome Sam and Kim to the stage. There we go, it's Kim and Sam. Hi can we just introduce ourselves for people who don't know us, before Sam gets stuck into the questions.
Kim Venter 03:20
Karen Lee 03:21
Do you want to go first Kim.
Kim Venter 03:24
Okay, yes, my name is Kim. And I live in West Sussex, in a little town called Loxwood. With my husband and my two teenagers, and I've had MS for almost 14 years. So I feel like I'm kind of old hat. And you know, kind of like I've been on this journey for a while. And yeah, so I ran a blog called MSI for life for a while. And I'm just, I'm just really passionate about how we can manage our MS through diet and lifestyle. Yes, that's me.
Karen Lee 04:10
Great. And yes Sam.
Sam Josephs 04:14
Yes, hello, thank you, and good evening. For those that don't know me, my name is Sam Josephs. I'm a registered nutritional therapist. And I'm working with Overcoming MS as a senior facilitator. My husband Danny was diagnosed with MS in 2002. So I don't have MS myself but I've been living with the condition for over 20 years. And I would say most people in my private one to one practice in North London are people who have MS. I also lecture and teach MS modules to upcoming nutritional therapists. I do workshops in various other topics. And I'm just delighted to have been facilitating a retreat a couple of weeks ago with Overcoming MS. Which was super, super rewarding. And yeah, a hugely fun and what's the word? deep and meaningful weekend, I think. Yeah.
Karen Lee 05:24
Great, great. And last one for me. So, I'm a retired intensive care nurse, I gave up when I got my MS diagnosis. I started OMS the day after I got my diagnosis, because I was already aware of it through a friend of mine because I was also already sharing my passion for eating a whole food plant based diet. So, I have an alter ego called the Sensitive Foodie. And I blog and create tasty recipes because I just love eating, and, and I'm an author as well, and an OMS ambassador. Funnily enough co-ambassador for the Sussex circle, even though I've now moved down to Devon, but I'm still involved in that circle as well. So great. So shall we get started? Are you ready, Sam? Yep, yep, fab. Okay, so question. The first one is, it's a really interesting question, actually. This person says, I'm sensitive to foundational foods like flaxseed oil, and like to know if there are alternative options. hempseed oil has got a different omega profile. What would be the recommended daily intake to align with Overcoming MS.
Sam Josephs 06:50
Okay, that's an interesting question. So I'm not sure what is meant by foundational foods. But yes, I think we're talking about the omega, the high intake of polyunsaturated fatty acids. So that's the 20 to 40 mils of flaxseed oil, as well as, if not on a completely vegan approach, three portions of oily fish. And I would say if you are getting oily fish three times a week on the diet, then that's a really good start in terms of getting good levels of Omega three. Without flax oil, you might want to think about other foods that are high in Omega three, walnuts, including portion of walnuts in your daily diet. Chia seeds, as well can be sprinkled in porridge in the mornings and included in the diet daily. The hemp oil question is an interesting one, because the amount of Omega three in hemp oil is about half that of what's in flaxseed oil. So in order to match it like for like, you would have to double the amount of hemp oil to get the same omega three, but in doing so you'd also be increasing the amount of omega six that you are consuming. So I'm not sure that I would substitute like for like, I think it's a great oil to be using in salads and cold, cold food preparations and drizzling and things. And certainly a really nice alternative to extra virgin olive oil, which is much higher in the mono unsaturated fat. So I would say definitely, there's a place to include it in the diet, but I don't think I would recommend taking it in the sort of supplemental levels of the flaxseed oil, it might be worth looking at algal oil. So that's a supplement. That is a plant based supplement taken from algae from the sea, high in the EPA, DHA, Omega three oil. Maybe just doubling up on a supplement of algal oil.
Karen Lee 09:04
Right. I was going to ask about the algae oil actually, is that as an alternative thing? Yeah, great, okay, thank you very much. The next question we've got is, this person would like some advice on how to stick to good habits. So like tricks of not falling into comfort eating, which isn't, tends to be non OMS or Overcoming MS compliant foods, especially with fatigue and low mood that people with MS get.
Sam Josephs 09:36
So it's all about making good habits. And I think also, if you are someone who knows that there are times in the day, when fatigue might be a problem and you might be reaching for snacks or unhealthier food options. Try and preempt that, either having a snack earlier, or for example, if you know that that three to four o'clock is a real weak spot for you in the afternoon, can you have a snack at two o'clock, something like a banana and a handful of almonds, something that's very easy, and portable, if you're not at home or around the kitchen, to just ride you through that time of day when you know you're more likely to slip into bad habits. I also think maybe not having food in easy reach that might cause you to slip. So be careful of what is in your cupboards, and in your fridge and thinking around that kind of thing. I think meal planning is a good one as well. And yeah, like batch cooking so that you make sure that if you are tired in the evening, you've got a soup for example that you froze earlier in the week that can be easily defrosted on the hob rather than reaching for sort of a ready meal once you pass Sainsbury's on the way home from work or something like that. What do you think sensitive foodie?
Karen Lee 11:13
Yeah, all really good good top tips. And I think it can be challenging. When you're, you know, you've got the if you've got kids, and you've got the kids snacks and things like that. So that can be a little bit of a problem. So trying to keep you away from those. And making sure that you've got your own snacks lined up, I think is quite handy. It can be quite hard can't it, to have that discipline. But yeah, all of those things. I always find that having lots of fruit in the house, hummus, rice cakes. Also, as well as having a small portion or portions leftover in the freezer. If you've got a real craving, if you've made, I don't know, some like sweet potato chocolate brownies or something that's quite, you know, healthy if you've got leftover, have them in the freezer as well, or even the little energy balls. And then you can you can dip into them rather than going in face planting the biscuit tin.
Sam Josephs 12:18
Yep, absolutely. And also I would add, encouraging your kids to enjoy the same cold sacks again to limit what is in the house. Indeed, yeah. Getting the kids on the dried fruit and nuts and those kind of snacks.
Kim Venter 12:36
Exactly. If you can't see it, then you won't crave it as much. So it's good. Yeah, yeah.
Karen Lee 12:46
Great. Okay. All right. Last question I'm going to ask at this moment, it's about limitation in the Overcoming MS diet of certain higher fat foods that are healthy, like olives and avocados, and nuts. These are the types of things that are encouraged in other MS focused diets. And so given that they're beneficial to people who've got MS. Do you think the amount should be reconsidered? Or, you know, what's the thinking behind this limitation of higher fat things like avocados.
Sam Josephs 13:30
Yeah, the Overcoming MS program recommends foods like nuts and seeds and avocado, and some of those higher fat foods are consumed in moderation. And the reason for that is because no single food is a single source of fat. And although these foods are predominantly the mono unsaturated fat, that don't affect the immune system in a positive or negative way, and can be very useful as an energy source and an anti degenerative protective bat. They will also contain a source of saturated fat. And the limit, I don't feel that the limit, I think the suggestion is that these foods are consumed in moderation. And that means, really in line with national recommendations. So I think national recommendations for our serving size of avocados is about a third of an avocado and I would say that it would be absolutely fine on the Overcoming MS program to have a half an avocado a day. You wouldn't be going over your saturated fat limits. Similarly, recommended portion of nuts is around 30 grams a day. But it can be helpful and depending as well on other foods and food sources in your diet. For example, if you're completely plant based and not including oily fish, that would be absolutely fine to increase that to 50 or even 80 grams of nuts as well, so I don't feel that there's a limitation, as such, around those higher fat foods, I feel that it's asking us to be mindful about including foods generally that are higher in calories and potentially do contain a source of saturated fat in moderation, but that moderation is completely in line with national recommendations aswell.
Karen Lee 15:29
Great, thank you.
Kim Venter 15:30
Okay, I'm gonna ask Sam a couple of questions now. The first one is, is it okay for people following the Overcoming MS diet to eat Heinz baked beans or similar? I checked the ingredients and can't find anything contrary to the diet. Okay, that's the first part of the question. And then the second part is also if you scrape the batter of battered fish, you know, the fish that you get with fish and chips? Is the fish then okay to eat? Or is it still not good for someone with MS to eat? So yes, let's tackle the baked beans first. What do you think Sam?
Sam Josephs 16:12
Baked beans? Yeah, absolutely. You're right, there's nohing in baked beans, that is contraindicated on the Overcoming MS diet. And whilst they do contain added sugar, and they may not be as helpful as your own homemade baked beans, which would have much lower sugar, and possibly even throwing in some fresh herbs, some extra garlic and sauteed onions. They're absolutely fine to include on the Overcoming MS diet. Exactly. When you say you know, you might be feeling fatigued. And you know, if you're going to reach for a food that's quick and easy, and very cheap, then Heinz baked beans are totally acceptable. The fish question is a very interesting question. And I have to say that I have been in that situation with my husband who's from Newcastle. And we have been up touring in Northumberland, where there's pretty much nothing else to eat apart from fish and chips all day long. And that is exactly what he did. He had the fish, but he took the batter away. And inside you've got lovely steamed white fish. If it's cooked well, at the right temperature, it's likely that the fish itself won't have absorbed any of the oil. I don't know if I can say any of the oil, but a significant amount of the oil. And whilst I'm not advising everyone to go out and eat deep fried fish and remove the batter, by any stretch, I do think that in case of emergency, as we like to call it, when you know it's that or go hungry. I think that actually, you know, of course it's better to have grilled fish where possible. But if you find yourself in that sticky situation, you're probably fine. The fish has been cooked with the steam action from the fish's own moisture rather than absorbing any of the oil. So reluctantly, I will say yes, but please don't go around telling everyone that you can eat deep fried fish as long as you remove the batter. That's not what I'm saying.
Kim Venter 18:35
Only in emergency situations. Yeah. That's great. Okay, the next question, how do you gain weight or keep from losing weight on the Overcoming MS diet, are vegan protein shakes okay? That's an interesting one.
Sam Josephs 18:55
Yeah so sometimes I find that people can put on weight, and I find that people can lose weight. And if you're losing weight, and you don't want to be losing weight, it might be that you're shifting to a reasonably low calorie diet. Once you take out the saturated fat, you are actually removing, you know, quite a big calorie source in the diet. And we need to remember that plant based foods are much less calorie dense than the animal based foods. You know, there's much less calories in a bean chilli than there is in a meat chilli, for example. So having bigger portions is one way to ensure that you don't lose weight. Also introducing snacks and maybe calorie dense snacks like we mentioned before, a handful of nuts and a piece of fresh fruit, mashed avocado with rice cakes, introducing snacks between meals as well is another good way to sort of protect against losing calories. And I would say that vegan protein shakes. So that's a protein shake. So normally a protein shake will be a whey powder, which is actually from dairy. So a vegan protein shake will come from soy or from hemp or from pea protein. And you're looking for one that's not too heavily processed, and one that doesn't have added sugars. And then that would be absolutely fine. You can stir a spoonful into porridge, you can make smoothies out of it. And that would be a way again to boost protein. But don't forget that this is a low saturated fat diet and the polyunsaturates are really important. So it shouldn't be that you're on a very low fat diet. So drizzling on the flaxseed oil, making sure you're getting that 20 to 40 milliliters, maybe having some nut butter on some of the rice cakes. And like I said the avocado making sure that the fat is still there. What do you think Kim ?
Kim Venter 21:06
Yes, I was just about actually saying nut butters are fantastic because they are so delicious. And they're wonderful as spreads. And there are quite a few good ones almond, cashew. There are quite a few other good ones. And I suppose you just need to make sure that you get the the ones that are good. The ones that don't have the bad oils in them. The palm oil. Not a great fan of palm oil. I prefer something without palm oil. And so yeah, brilliant, brilliant idea.
Sam Josephs 21:45
And you can stir it into your porridge as well.
Kim Venter 21:49
Or throw it into a smoothie even. And yeah, so nut butters are nice. I think that's a wonderful way to get the calories in. Okay, moving on to the next question. This person says I'm obviously not eating cheese, and have found apple wood vegan cheese to be a nice alternative. I noticed that the ingredients include coconut oil, should I be avoiding this completely?
Sam Josephs 22:26
Yes, you should. Coconut oil is saturated fat. So please, yes, I'm afraid if you can. I mean, you can do what you want. But we recommend because it's a source of saturated fat that you do avoid it. Nuush make a really nice cream cheese, which is great again on rice crackers. Lovely with smoked salmon or with vegetable slices. Do you guys have any recommendation for the cheese fakes?
Karen Lee 23:03
There's a, I can't remember what it's called. There's a cashew nut cheese, which is just cashew nuts. Which is a bit more of a it's been dehydrated more. So it's more of a solid one. Off the top of my head. I can't remember what it's called.
Sam Josephs 23:20
Does it come in a hexagon sort of box. Yeah, right. It's cost about 10. But I mean, it's extremely expensive.
Karen Lee 23:27
For special occasions only. Yeah, but yeah.
Kim Venter 23:34
I was gonna say but you can make your own cashew cheese. You can. So what I do is I just blitz up a handful of cashews with some water, maybe a bit of garlic, some salt and some nutritional yeast. And it becomes super cheesy. It's so so yummy. You've just got to get the quantities right, play with the quantity so it's not too runny. But that makes a really yummy cheese alternative.
Sam Josephs 24:01
Yeah, right. There you go. Ditch the coconut oil.
Karen Lee 24:05
Yeah. Well, there's also they have other rubbish in it as well, generally. So. Yeah. Okay, right. So the next question is, does it matter that old cast iron ovens will be patternised with food over time? So I think this is like, you know, the cooking dishes. And so and often that's going to be saturated fat embedded in the pan. I understand food may not be in direct contact with the sides or the bottom of the oven. Oh, right. Oh, it's in the oven. Not in a pan. But the food will be in that atmosphere. Does that matter?
Sam Josephs 24:44
No. If you're not consuming saturated fat, that's absolutely fine.
Karen Lee 24:49
Okay, right. Next question, and I'm sure this is one that everybody will ask at some point, can you suggest how to avoid the effects of a high fibre diet causing extreme flatulence.
Sam Josephs 25:02
Right. Yeah, so. So what happens when you're eating a high fiber diet is you're feeding your beneficial bacteria, because that's what they love. And that's what they are living on. And as they're eating it, and it's actually fermenting in your tummy and in your intestines, it generates bloating and gas. And that's the sort of the activity of the microbes. One of the ways around that is to introduce fiber much more slowly into the diet. So maybe not going full high fiber overnight, maybe looking at breads, for example, that are 50/50. Or maybe not having, you know, every week, the whole grain and switching it up. Bit by bit mixing brown rice and white rice, for example, to slightly reduce the fiber at first, what happens as you continue, and there was an interesting study, actually, they actually studied, they actually did a study looking at when people increased the fiber with beans and pulses, particularly, which seems to be one of the main offenders. And that's because it's a soluble fiber, which is this type of fiber that is more likely to cause wind. And they, they looked at a bunch of people who had increased fiber, they asked them to increase the fiber over 12 weeks. And lots of people really suffered with wind, particularly in the beginning, but by the eighth week, there was almost no complaints at all. So what happens slowly over a period of time is that your microbiome, that's the population of good and bad bacteria that live in the intestines, get used to the levels of fiber, and you start to kind of increase the right types of bacteria that are going to manage that amount of fiber that you're consuming, so you can stick with it. If the diet is giving you lots of flatulence, you can stick with it. But if people around you are finding it, all rather unsociable, then I would say maybe, you know, pull it back a little bit. Things like cabbage and broccoli, or particularly, maybe flatulent, think about different green leaves and lettuces instead. And maybe little by little, you know, introduce fiber slowly. What do you think?
Karen Lee 27:36
Yeah, I agree. And I think also, it depends where your starting point is, because I think if I think because we know that there's this connection between gut health and an MS, you know, embedded leaky gut and everything. I think, if you have your guts, not in a particularly happy place, it reacts really quickly to to these things. And it and I mean, I found once I ditched dairy, actually, it was way better even, you know, before introducing all of the other things. So think it's, it's kind of like what your starting point is. But yeah, just treading really carefully. eating fruit separately, or even all first is also quite helpful. Because because you've got the sugars in fruit. If they've been held up by a heavy meal, as you're being digested, that can create quite a bit extra bubbles going on. So I think eating fruit either first or as a snack, rather than as a pudding, that that can be quite helpful, because then sugar, even more so kind of sets the bacteria off as well. And they're having a party with the fiber and the sugar. And it's just like, whoa, here we go. So, but yeah, they're good. And also just making sure that everything, especially like with pulses is just making sure that they're properly soaked or properly cooked, or when you have intend to make sure that you rinse it really well. And those things I think can can help but just take take your time. And yeah, just bear with me.
Sam Josephs 29:18
think. I think also there's a possibility that if you're soaking and then cooking your own beans, it might be less impactful from a flatulence point of view than using canned varieties. And if you're really desperate, there is a supplement available in the UK called bean Assist, which contains the enzyme that breaks down the sugar or the starchy component of beans and lentils. So it might be worth having a look at that. It's called being assessed.
Karen Lee 29:53
Great. Good. Thank you. So next one is Should you adapt the Overcoming MS diet? If you have osteoporosis? And if so, how?
Sam Josephs 30:08
Um, no, I wouldn't hugely adapt the diet at all the diet the Overcoming MS diet is a modified Mediterranean diet. The best diet for osteoporosis is the Mediterranean diet. So I absolutely would say that the diet is nourishing your osteoporosis already being extremely high in its nutrient content and low in all the inflammatory factors as well. Amiga three is really good. For osteoporosis, you can pay special attention to foods that are rich in calcium, like the dark green leafy veg, the nuts, tahini, make sure that your tofu for example, is a calcium set tofu, so called your cauldron is a good one. But no, I wouldn't prunes, maybe including prunes. And the study that showed eight prunes a day, can be very beneficial to protect against bone loss. And this may be due to the effects that it has on the bacteria in the gut. But it's also prunes are also a really good source of a mineral called boron, which is really helpful for bones. So I would say no need to adapt the program, but you can pay special attention to the calcium rich foods.
Karen Lee 31:31
Fantastic. Maybe when the flatulence has died down before you have a proof. Right over to you, Kim.
Kim Venter 31:41
Okay, brilliant. So is it safe to eat sheep milk cheese, in light of recent research, that it does not have the same inflammatory effect as cow's milk? What do you think Sam? Yeah,
Sam Josephs 31:55
so this was a study that was done. I think it was just published this year where they've, they've seen that there is an immune reaction that is overexpressed in people with MS to cows and goats casein, which is one of the proteins in milk, but there seem to be less reaction from the casein from the sheep's milk. So that might be something like feta, I suppose, or cheese feta? The answer from an Overcoming MS perspective is no, it's still not okay to consume sheep's milk. sheep's milk still contains another protein called butyl, ruffling. And we know that butyl ruffling is structurally very similar to some of the myelin proteins and may be causing this process of molecular mimicry, whereby the body's immune cells when they're exposed to the milk, whether it's sheep, goat, or cow turns in on itself and begins to attack myelin. So until the research tells us something different than no sheep's milk is not recommended.
Kim Venter 33:08
Okay. Next question. I would like your guidance on whether eating legumes and gluten could lead to a leaky gut.
Sam Josephs 33:20
Okay, so this question is really around the idea so Google can be quite irritating to the gut. And there is some research around gluten and autoimmune conditions. And then legumes are a source of lectins. So lectins are a protein that is contained in all plants, but in quite high amounts in legumes and kidney beans, if for example, you you don't cook kidney beans properly. The lectins or the toxin that's in the kidney beans can actually be quite powerful in terms of causing reactions and and symptoms. But when you cook lectin when you cook sorry, when you cook lagoons, and beans, you are destroying a lot of the lectins. And whilst I don't think that they are responsible for causing a leaky gut, there is some discussion around whether they may aggravate the presence of a leaky gut. But I think one of the one of the wonderful things about a whole food plant based diet is you are providing your gut with everything that it needs to promote healing and protect against leakiness. And I'm not sure that there's any evidence as yet that is convincing, particularly in human trials and human studies that there's any connection between foods that are rich in lectins, namely the beans in beans and lentils are the ones that get a bad rap for being high in lectins. But most of the lectins are destroyed in the cooking process, rarely eating raw beans and legumes. And so they are completely say
Kim Venter 35:17
fabulous next time. The next question, would you recommend taking food which supports the immune? So would you would you recommend taking food which supports the immune system, for example, certain mushrooms and fermented food, as opposed to immune boosting supplements such as akinesia, for colds, okay, so, food as opposed to food, immune boosting foods as opposed to immune boosting supplements.
Sam Josephs 35:47
Yeah, 100%. supplements. Supplements are really there just to supplement or fill in the gaps. If you're on the Overcoming MS diet, you will be on an extremely immune supportive approach. The whole modified Mediterranean approach is based around supporting the immune system. So absolutely including lots of immune boosting foods, lots of colors, like you say, mushrooms, lots of high fiber foods, foods that nourish the healthy bacteria can be much more beneficial. And the way the body uses and metabolizes Whole Foods is very different to how it is when we give it a supplement. That might be one nutrient that's been extracted, and it's not there in its whole form. And akinesia, I think we have to be a little bit cautious around things like akinesia, which boosts the immune system. So if you've got an autoimmune condition, there is some thought around boosting the immune system not being something that we want to go ahead and do because it may boost MS activity, so absolutely food of supplements.
Karen Lee 37:07
Great. I just asked you two more questions from the ones that we've sent it have been sent in. And then we'll go to the live questions. So this is a quick one for you are naked bars and they're like an acceptable snack. Yes.
Sam Josephs 37:26
Right. Thank you bar is a great number of ingredients very small. If you're looking for a healthy, not faced bar, then just stay away from too many added sugars. Stay away from the chocolate chips. And try avoid the ones with peanuts. But otherwise, yeah, 100%.
Karen Lee 37:45
They've also started doing granola as well. They do the Blueberry Granola, so there's no oil in it. And last on this section, when increasing the speed or intensity of daily exercise, is there an easy way to work out how much more food we need to eat. So it's not to become calorie deficient.
Sam Josephs 38:10
By calorie deficient, I imagine the person is saying so that they're not going to be losing weight. They'll be meeting their calorific needs. Apps, there are some fantastic apps, I think there's one called Future there's one called My Fitness Pal. Ladies, do you use any apps? Like, you
Karen Lee 38:38
know, I've used my fitness power actually, for the other reason to lose weight, because I was overeating. And, but when I increased my exercise, I found that really useful because suddenly I could eat more again, because I just make some shifts. But I found that really interesting from a geeky side as well. That that was really helpful. But I guess the other thing is you just eat more. You know if you're hungry, then eat.
Sam Josephs 39:09
Yeah, and the other thing with exercise is if you are doing hardcore workout, you have a very narrow window after that period of exercise when you can carb load so you could have something like a tablespoon of honey. And that glucose goes immediately to the stores in the muscle to replenish the energy there. And that can also help in terms of boosting your calorific needs. Yeah.
Karen Lee 39:39
Great. Thank you. Kim. Have you got managed to have a look at the other ones coming in?
Kim Venter 39:48
Yeah, so let's start with the first one that's just that came in earlier. Can I eat sunflower seeds? Yes,
Sam Josephs 39:58
yes. So when we sunflower seeds, we're eating the whole seed, as opposed to drinking spoonfuls of sunflower oil, which would be very high in Omega six, but the whole seed, you have to consume an awful lot of it to get sort of huge amounts of omega six, so that's absolutely fine. And sunflower seeds are packed with minerals and vitamins as well. So definitely.
Kim Venter 40:23
Okay, fabulous. And then Rachel says, I've heard that a low carb, high fat diet is good for reducing inflammation, so helps with ns, the total polar opposite of veganism. What's best
Sam Josephs 40:43
I would think I think Rachael is talking about the ketogenic diet, which is very difficult to do with a plant based approach, not impossible. And there is some interesting evidence and studies around the ketogenic diet, which is a very high fat diet, low, very low carb diet, medium amounts of protein. It's a diet that was originally developed for epilepsy, and it helps to calm inflammation in the brain. However, it is not a diet that is easy to follow, you have to regularly measure your ketones in your urine, which is the breakdown product of burning fat, and it's a different fuel source from glucose. And also, following it long term can lead to various nutritional deficiencies, that increases your chance of anemia, it can be very taxing on kidneys. And it can have quite detrimental effects on the microbiome. As you can imagine, you are reducing a lot of the high fiber foods as well. So it isn't something that is sustainable, long term like the Overcoming MS approach.
Kim Venter 42:05
And then, Louie says, Please kind of ask if a little rapeseed oil in a pre prepared sauce is okay. Yes,
Sam Josephs 42:13
it is. Yesterday, I would say yes. Right. But the main ingredient, yeah. I'm thinking of like motto. I'm thinking of a quick cheap evening meal with a ready made tomato based sauce to go with the pasture or something and a little bit of rapeseed oil, absolutely fine.
Kim Venter 42:38
Have a tea can.
Karen Lee 42:39
Great. Thank you. It's so interesting. These questions, aren't they? So Jane has said she says I've been following the OMS diet recommendations for many years. But she's currently doing Zoe personalized nutrition, where they seem to recommend including more protein, fat, and fiber to minimize blood sugar spikes. Have you come across this? And if so, can it be combined with the OMS? dietary recommendations?
Sam Josephs 43:09
Yes, absolutely. It can be there we have. We're so we include protein, we include fiber, and we include good fats on the Overcoming MS. Diet. So absolutely those recommendations. It sounds like you just need a little bit of tweaking, maybe you've been maybe there hasn't been enough fiber, there's been some of the white products, white rice or white bread in the diet, they just need to switch the whole grain alternatives. Those kinds of things. Maybe there needs to be, you know, an extra portion of white fish a week or a few prawns going into your salad at lunchtime. But yeah, I'm sure there was only people will help advise around that. But 100% You can do it within the realms of the Overcoming MS diet, and it's a really interesting, so good luck with that.
Karen Lee 44:00
Great another another way of geeking out when it comes to measuring nutrients and things. And then Anna asked, is there any food or supplement that can help regenerate myelin?
Sam Josephs 44:14
That's really interesting. So the there was a study done on something called ursolic acid, which is found in rosemary, and other aromatic herbs like oregano, as well. And they actually found and this is just a study that was done on mice, but they actually found that it was able to suggested that it may have remained in eating properties, including fresh aromatic herbs in your cooking or doing a rosemary infusion, and drinking tea would be a nice way to get some of those benefits. The other area of interest around re myelination has been the intermittent fasting and the processes that happen during intermittent fasting. So intermittent fasting means that time restricted eating when you don't eat between dinner and breakfast the next morning and you allow that window to grow beyond 12 hours, so 12 to 14, even 1415 hours long. And it's thought that it may allow for some re myelination because your body is constantly the processes are constantly there to try and remind innate, so it's just enabling that. The only other one that springs to mind is medicinal mushrooms and the Lion's Mane mushroom, which has neurotrophic factors. So it increases something called BDNF, which is brain derived neurotrophic factor. And so that, whilst it wouldn't be remodeling, eating, it might be helping to grow new neural pathways for neuroplasticity, which is the same benefit that you will get if you're exercising and using high intensity training as well. Great, thank you. I don't know if you guys have heard of anything else. Whether we myelination, NIH,
Karen Lee 46:16
NIH, Rosemary traditionally was it's always been used for brain power, hasn't it? I've read somewhere that scholars used to have the sprig of rosemary when they were writing or doing exams and things like that. So I think it's been traditionally known as good for the brain. So that's really interesting. The fact that that, yeah, great. And a pretty quick one is shot book popcorn compliant.
Sam Josephs 46:44
That's a really tricky one, because I love popcorn. I would say it's one of those Amber foods, and it completely depends on the quality of the popcorn some of the sort of posher? What do they call things like popcorn? Yeah. Picturing? I would say not ideal, because yes, they've got some flour and chances I think sunflower oil has been used. And chances are, it's gone to quite a high temperature. But given the quantity that you eat, and given the fact that there's probably not much some flour itself, sunflower oil itself on the actual popcorn, I would say it was probably one of those Amber foods. Although you can get little popcorn makers that you can use at home and they don't use any oil. You can just pop your own. And then you can flavor them with whatever you like. I think, Karen Have you got a did I hear somebody talk about a recipe for popcorn? Was it UKM? Did you mean I?
Karen Lee 47:50
It wasn't me?
Kim Venter 47:53
I used to have one of those air poppers and they were brilliant. Yes. That was fantastic. I really and then you can put such lovely, you know, flavors and herbs and spices. Yeah,
Sam Josephs 48:06
I remember somebody talking about using nutritional yeast plates crashing up nutritional yeast flakes and making like a cheesy popcorn with some home pop popcorn.
Kim Venter 48:17
Yeah, that's a really good. Yeah, that's a good Christmas present to put on your list. Okay. Right. So the next question is, how bad is a small amount of dairy. And as I've just completed the ZOE Project Project, which shows that dairy is a key, but it isn't good for MS. So how, what I
Sam Josephs 48:43
mean, my stance is I'm, I've read the papers that all demonstrate the evidence around what dairy has the potential to do to the MS brain. And I'm adamant that a little bit of dairy is like having a little bit of attack on your myelin sheath. So if you're okay with that, then you can include dairy, but I think that given the myelin sheath is being attacked anyway. We don't need to put fuel on that fire. And I would say dairy is off the menu 100% of the time. 24/7. And if you just say I'm just gonna have a little splash in my coffee, but other than that I'm dairy free. Just that little splash of milk in your coffee is sending those signals for your immune system to attack and destroy your myelin. So no, and especially when there's so many great alternatives now it's just not necessary.
Kim Venter 49:51
Exactly. Okay. Next question. From Mia. I would love to know when trying to prevent Family from getting MS. What are the most important elements of the day to start with? I worry about my sister's diet, but the OMS diet would be a complete change. And I suspect too overwhelming for her. Yeah,
Sam Josephs 50:14
I would, I would just say if somebody doesn't have MS, and they want to make sure that they are living a healthful life, so they are minimizing their risk of MS, I would say focus on the whole foods. Focus on increasing fresh whole foods, fresh plant foods every day. Don't rely on meat as your and dairy as your main source of protein in the diet. Think about and introduce and explore and experiment and enjoy beans and lentils, nuts and seeds. Because this is this is so close to the Mediterranean diet, which is the most well studied and healthful diet, anywhere in the world. If we can move everybody towards following that kind of pattern. You know, everyone's going to benefit from it, particularly people if we wanted to prevent them from any chronic condition or any chronic disease. So oily fish, lots of plant foods moving away from processed foods. Yeah, lots more plant proteins. Those would be my recommendations.
Kim Venter 51:31
That's great. And, and a daily vitamin D supplement. Yes. Yeah, making sure they that they remain high in vitamin D, I think. Okay, next question from Jennifer, can you help me understand breads and take foods as whole options? Also, what about fish in tins? Like water? Packed albacore tuna?
Sam Josephs 52:01
The first part of the question is can you repeat her reds
Kim Venter 52:06
and baked foods as whole options.
Sam Josephs 52:14
So yeah, so So with breads as as the maybe this person is asking about whole foods rather than the highly processed foods so bread has really come under supermarket bread has really come under the spotlight recently as being a highly processed food because it's got so many additives to give it that exceptionally long shelf life if you buy a loaf of bread in a baker's, or even in the bakery section of the supermarket is never going to last as long as the plastic wrapped. Hovis or kings male bread that you buy off the shelf shelf. And those breads are packed with unhealthful oils, like palm oil that we're trying to avoid. And I would say steer clear and choose your bread from the bakery section. instead. avoid wasting it, you can slice it and freeze it, there's no need to let it go off. But yeah, so just avoid so. So for baked goods. Similarly, anything that you're buying in a packet in the supermarket is going to be packed full of unhealthful oils that have been pumped in just to ensure a longer shelf life. So you're much better using recipes from the Overcoming MS website in which there are loads and even the sensitive foodie looking for recipes there for home baked goods. And then the second part of the question
Kim Venter 53:46
a fish in tins like tinned tuna. Yeah, so
Sam Josephs 53:50
so. tins all tinned fish is really great, cheap, accessible, quick and easy part of the Overcoming MS diet. The only thing to be aware of with tinned tuna is that if it's if it's tinned tuna, although it's a low fat protein, and it's perfectly fine to include it on the Overcoming MS diet. It doesn't count as an oily fish. It's lost its oil in the counting process. That's not the same with the macro and the tinned salmon and the other fish but that does count for the tinned tuna so you can include it. But don't count it as one of your servings of oily fish.
Kim Venter 54:35
Okay, Karen, over to you. Okay,
Karen Lee 54:38
um, I'm hoping I'm up to date. I had a slight technical hitch. Here. Perfect. Yeah, good. Okay, so I think I'm upset with the questions but So Sam, what would you consider to be the best or the healthiest alternative to cow's milk in tea and cereal and everything?
Sam Josephs 55:01
I think it's a question of taste. I am as a menopausal woman, I am using soy milk, because I like to get my soy which is very good for us ladies in menopause. And it's also higher in protein and some of the other plant milks. But I think it's entirely up to personal preference. I tend not to use rice milk because I find it's quite sweet and it's quite thin. I like my oatmeal King tea. But I find soy milk is nice during coffee, ladies opinions, thoughts recommendations for good plant based milk?
Karen Lee 55:44
Yeah, I mean, I'm with you with the soy and the end to the menopause. It it really does help and, and I like and the unsweetened oat milk, particularly when it's nice and creamy. And you can use that in sort of if you're making creamy desserts and things like that, because because it's still quite sweet. It means you don't need to add in that much sugar into it. Someone tried to persuade me recently that P milk was the best milk in tea. And I tried it but not convinced. But I think that's more of a matter of taste. How about you can
Kim Venter 56:25
or almond milk is a wonderful, it's very tasty and quite can be quite like rich actually not too watery. Like some of the other vegan milks can be. And then oatmilk especially if you have coffee in the morning, there's that amazing barista version, which frothed up quite nicely. Yeah, so that's quite I don't know if you know about that version. That's the oatmilk. Burris Oh, am I am I I'm not a new teammate. No, no, no, no, we're listening.
Sam Josephs 56:59
Kim Venter 56:59
Okay. Yeah, so that would be my that would be my recommendations. Our mentor, or the ote ote set a nice brand? Yeah, yeah.
Sam Josephs 57:12
Okay, we've lost Karen, again, she's dipped out. So I don't know if they've got questions.
Kim Venter 57:18
But a couple of questions. Okay. Let's have a look.
Karen Lee 57:23
Kim Venter 57:24
sure we're talking about alcohol consumption. Can Can we please talk a bit about alcohol consumption? And if it can impact MS.
Sam Josephs 57:35
If you if you get drunk in then you might fall over, which is not helpful. If you've got MS. I would recommend, especially if you have balance issues, alcohol in moderation. No joking aside, there's no studies to suggest that alcohol increases your risk of getting MS. Yes, alcohol is a toxin. So we have to think about the toxic effects on the body. But the holism study actually demonstrated that those people that do enjoy a small glass of alcohol, three or four times a week, actually do better than people who are completely teetotal. And whilst they don't believe that that necessarily has anything to do with the alcohol itself, it's more about the relaxation and the lifestyle that may come with that. There is alcohol is is fine. Fine within moderation. Again, sensible heads, everybody. The nutritionist did not say it's okay to go out and get blind drunk.
Kim Venter 58:53
Cool. That's great. You're back, Karen.
Karen Lee 58:54
Oh, I don't know what is going on with my tech tonight.
Kim Venter 59:00
You carry on?
Karen Lee 59:02
Okay, well, I can't see any more questions because I disappeared again. So and also I just noticed. Oh, no, we still got a bit of time. So if there's mine, I'll, I'll get back to you.
Kim Venter 59:17
I'll pull up a question. So I like this question about sugar. What about sugar in any form? So is it Okay, should we rather be looking at maple syrup or honey stevia as alternatives. So yeah, if we can talk a bit about sugar and what we should be consuming how much Oh, well,
Sam Josephs 59:43
we shouldn't really be adding sugar too much to our to our daily diet. Sugar has pro inflammatory effect on the body, which is not helpful. If you have a chronic inflammatory condition like multiples process the difference between, let's just look at sugar, honey and maple syrup. I think you said in terms of what is happening metabolically. As you digest and absorb all three of those, it's a very similar effect. It will cause a rise in blood sugar, which will cause a rise in insulin output and a rise in the inflammatory mediators that follow that metabolic effect. So adding a spoonful of brown sugar or a spoonful of white sugar or a spoonful of honey to your porridge potentially has the same impact in that respect. However, honey and maple syrup are both more nutritional than sugar. And they can bring with additional B vitamins, minerals like manganese in Maple Syrup, even some protein, I think in honey and some of the antibacterial effects so they are more nutritious. So I would always choose to sweeten things at home with those kinds of things. Being mindful to the fact that I'm still adding sugar. You mentioned stevia. So stevia is a natural sugar alternative, which doesn't cause a blood sugar spike. And so for that reason, it's finding its way into lots of products at the moment, I personally think it has a really revolting bitter taste, and can't stomach it at all. But I think some people aren't sensitive to that taste. And it's very, very sweet as well. So you don't need to use much of it. And it doesn't affect me in the same way. So that would be a nice substitute the artificial sweeteners like canned Ral, and sweet Tex and things, because they are these artificial chemicals. There is some controversy around how they may be really bad for brain tissue and our brains and are definitely, definitely best avoided. Has that answered the question? Was there? Yeah,
Kim Venter 1:02:19
absolutely. Absolutely. Yeah. So yeah, sugar, inflammatory. Diseases, use it as a treat. Yeah, right. Just if you need to have if you need to have a bit, just have a little bit and rather go for a healthier option. And see a stevia I agree with you. Not a great taste there. Really? Yeah. Okay. Karen, kind of hand over to you. Do you have some questions that have come through for you? Yeah,
Karen Lee 1:02:49
there are? Um, well, just as a couple of things that are related to the sugar question. And it's interesting, isn't it? And that debate comes up. One is, is coconut sugar. Okay.
Sam Josephs 1:03:02
Yes. Short answer. Yes. So we avoid the coconut meat, and the coconut milk and coconut cream, because that's the saturated fat. But coconut water and coconut sugar are both completely permissible because there is no fat in them. And coconut sugar has a much lower propensity for that blood sugar spike. So again, it is it provides sweetness without too much of a too much of a blood sugar spike. So yeah,
Karen Lee 1:03:38
yeah, it's also slightly less refined, isn't it the way that it's it's actually made the way that it comes from the coconut palm tree in the first place. So it's also more expensive as well. But yeah, I get asked that question a lot, because I tend to use that. And then the sugar and alcohol. How's that different?
Kim Venter 1:03:58
Yeah, it's not a question.
Sam Josephs 1:04:02
It does affect the body in the same way. And I always you know, it's always nice to have a glass of red wine with a meal instead of three vodka and tonics instead of a meal. Because when you have your alcohol together with a meal, you are reducing the impact of that pure sugar source, which is the alcohol because you've got a well balanced meal in front of you with good fats, protein and fiber, which will slow down the release of the sugar in the alcohol and help to kind of level out that effect. So try not drinking on an empty stomach and enjoy your alcohol with meal.
Karen Lee 1:04:46
Wise and sensible. Yeah, cool. Um, I was just wondering, maybe if we can go back to some other really quite interesting questions on the The ones that were sent in. Kim, do you want to ask
Kim Venter 1:05:07
Gerber as well? Absolutely. Okay, so shall we talk about meat? So can you please explain the issues in consuming meat? As regards to MS? Does the problem lie in the fats? Or is it the proteins? That is never the problem? And then is wild meat. Okay, as wild animals don't get the opportunity to build up fat? That's a great question.
Sam Josephs 1:05:35
Yeah, really good question. So the evidence for the Overcoming MS program came about through the research of Professor Jelinek. And one of the areas of research was around looking at large population studies or epidemiological studies, with large populations and dietary patterns. In areas where there was lower levels of chronic disease, more longevity. And studies like the China Study, indicate that population tends to live longer and without chronic disease when there is less or no meat available. And so that's sort of one of the sort of the the idea is to hold in the background around the meat. The second thing is yes, there is a saturated fat element to meat. Particularly, you can see the visible white fat on me that is pure saturated fat. But even some, like the white chicken breast, for example, which is very low in the saturated fat still contains decent levels of omega six fat and that omega six is the arachidonic acid. So that's the pro inflammatory fat, that's the pro inflammatory Omega six fat. So yes, meat contains pro inflammatory fat as well. From a general health point of view, red meat is is classed as a class two carcinogen. Processed meat Mi is a class one carcinogen, so processed meat, for example, is classed as likely to cause cancer as smoking, whilst red meat is classed could well cause cancer. And these this is classified by the World Health Organization. So it is well recognized that meat is not a healthful substance to include certainly on the sort of level and frequency with which we are consuming it in the Western world. There are there are other mechanisms, the links with cardiovascular disease, for example, some of the bacteria that digest and break down some of the components and the proteins in meat can actually produce a substance called Tao which stands for try me thoroughly mean oxide, something which, which is really damaging to the vasculature, the blood vessels within the body. And people with MS are already at higher risk of cardiovascular disease. And there is evidence that people with MS are at much higher. Yeah, much more likely to have weaker blood vessels. And so me again, it's not, it's not helpful in terms of supporting MS. There are other things other elements called ag ease, which are advanced glycation end products, which are a type of oxidation process that happens when you cook meat, particularly dry cooking meat. And these substances again, cause damage within the body and can promote those inflammatory pathways. So I mean, there are I don't know ladies, have I missed any
Karen Lee 1:09:37
way yeah, it's just create so many inflammatory factors, all of these inflammatory cytokines that that everybody seemed to hear about during COVID You know, these processes are going on all the time, aren't they? And it's just because it creates that inflammation is making your body work so much harder, as well. And 21 All those nutrients that you're eating to help you heal or not to, to have to start fighting fires somewhere else. So yeah, yeah, yeah.
Sam Josephs 1:10:10
And I think it's an interesting question about the, you know, the wild meat because it is much lower in saturated fat. But again, it's also that question of putting something on a pedestal? Look, I mean, if you had a piece of wild meat once a year or something, then I'm sure it wouldn't, in the course of your MS hugely affect the trajectory. But again, do you want to put these kinds of foods up there, you know, on a pedestal? Or do you just want to embrace and really enjoy and maximize and all these other lovely healthful foods that are available? Well, and
Karen Lee 1:10:51
that and the bacteria in meat, you know, even when you've cooked it, there's still bacteria in there. And that's not the friendly kind for your gut. So you're working really hard to look after your microbiome to help it to heal to look after these friendly guys. And then if you if you're having foods that have I love this word putrefactive bacteria in and then and then it kind of upsets all that as well. So it's gut health is is, you know, so important. That as well as all of the inflammatory stuff and the imbalance of fats and everything.
Sam Josephs 1:11:30
Yeah, absolutely. Yeah. I hope there's the ones that the question that was a big one, yeah.
Kim Venter 1:11:35
Let's see. Do we have time for one more question? I think we do. We do one more question. Okay. So this one is is a lovely one. So. So talking about women who are Peri menopausal and menopausal. menopausal woman, how do we make sure that we get enough calcium without dairy products? So how would you suggest for compensating for for them in the diet? And what are the tips on diet? Can you give us about menopause? Okay, well,
Sam Josephs 1:12:16
again, the Mediterranean diet is one of the most supportive for menopause and the Overcoming MS. program being a modified Mediterranean approach again, is directly supportive with the the number of you know plant based foods and high fiber foods. That calcium so we touched on calcium before just being you know, without dairy, it's just making sure you're getting lots of those nuts tahina, almonds, in particular, the dark green leafy veg, you know, loads of calcium in broccoli and actually a whole abundance of all the other minerals and vitamins that you need to also help calcium locked into bones. But being mindful of the negative, sorry, my dog's quietly choking behind me I'd be gone here, being mindful of the other factors, negative factors, so don't drink tea and coffee with a meal because they bind to calcium and excreted from the body. Leaving our either side of a meal if you're going to drink tea and coffee, don't drink fizzy drinks. Again, fizzy drinks contain phosphoric acid, and you can leach calcium from the bones in order to buffer that. Out had another the prunes is a good one again, for bones. But I just thought of something else for but there but the thing making sure that you include lots of soy soy soy is one of the sort of most biologically available proteins on a plant protein on a plant based diet. Aside from fish, so in the Overcoming MS program, including lots of tofu Ed, mommy, miso, soy milk, soy Yaga, we've already mentioned Karen, the soy milk because soy foods can really these are phyto estrogens, these are plant a source of plant based estrogen so these can really boost the body's own natural reserve of estrogens when your ovaries are actually declining in production. So including a good sized portion of soy foods every day in the diet is really helpful. ground flaxseed so flaxseed oil we're getting anyway. But ground flaxseed itself again is another phytoestrogenic food so you could be mixing that into your smoothies. You could be sprinkling that into your porridge. I'm thinking Have I missed anything
Karen Lee 1:15:00
Yeah, just Yeah, calcium set tofu again,
Sam Josephs 1:15:03
seems that data and making sure you keep up with your vitamin D supplements, because that's really key for absorbing calcium. But when we go into menopause as well, and thinking about bone health, Omega three, and good protein as well, and low saturated fat, all those things are very supportive for men and for menopause, and for bone and heart and brain health on the other side of perimenopause, in menopause itself, so, so you kind of got it covered. If you're already an absolute top star pupil on the Overcoming MS. Program, you should really be ticking all the boxes for for menopause support as well.
Kim Venter 1:15:49
Fantastic. Thanks, Sam. Okay, so we've addressed. And I just want to say, a big, big thanks to Sam for today's session. I think it's been amazing. And so helpful. Thank you for your wonderful knowledge that you've shared with us, Sam. And we hope that you all enjoyed the session. And just as a reminder, you will receive a link to the recording via zoom next week. And so and I also want to say thank you so much for Karen, for CO hosting with me. It's just, it's just been left. Okay. Oh, so just to benefit from your wonderful knowledge. And then a big thanks to our technical team, Shawn and Jake, who have been behind the scenes, no one, no one else has known that they've been there. And they are from the staff team. And they've they've, they've organized this whole thing and they've been supporting us from the background. We will be back next month on the fifth of December where Brett Drummond from MS. Translate will be joining us to share his observations from the latest MS research presented at the ECTRIMS conference. And he will also be joined by Alex Holden, CEO for air for Overcoming MS. And you can actually register for this right now on the OMS website, Overcoming MS website. Also, please don't forget that if you have the time, we really appreciate your feedback in the survey as you exit the webinar. So yes, that is all from us tonight. And thank you so much for joining us. And we hope you have a lovely rest of your evening. Thank you. Yes, thank you ladies.
Sam Josephs 1:17:42
You did a great job.
Kim Venter 1:17:46
Oh, thank you. So did you. Bye everyone. Bye bye.