I get asked quite few MS diet questions, so I thought it would be a good idea to put some of the answers in one place. Please leave a comment below if you have any more questions not already covered here, and I'll add them to the list! Don't be shy to ask, we can both learn more together, and other ladies who have the same questions, will also benefit.
Here are some posts you can start off with, that will get you moving in the right direction:
1. Why is the site 'only' for women?
The site is not only for women, men are welcome to use all the information on the site but I wanted to create a place specifically for women to connect with other women. In other words, this content is also for men, but the community is for women. Physically, MS affects men and women similarly with a few differences because of our different physiology. Some topics you just don't really want to discuss with men 🙂. My dream is to build a community of women like me, who face the same challenges as I do. Many of us are mothers and wives and have to deal with these challenges as well us our disease. It's good to be able to build strong friendships with other women so that we can be there for each other.
2. Is there a quick list of foods to avoid?
Yes, gluten, dairy, refined sugar, legumes, heated and saturated fats, caffeine - full list on The MS Diet page.
3. When is the best time of day to take supplements?
I prefer to take my supplements before breakfast. Usually, I start off the day off with a glass of water. Then, I have a tall glass of green barley. Right after this, I take all my daily supplements, together with a large glass of water. This gives my body the best chance to absorb nutrients, and also flushes in a lot of water to help hydrate and enable absorbtion. I usually make a smoothie or raw juice shortly afterwards to start to inject energy for the day.
4. When is best time of day to take raw juices?
Ideally, eating you should try eat fruit before any main meal. This gives your stomach times to digest the fruit before other components are added into the mix. I try give myself 20-30 minutes after my fruit / raw juice before I eat something more substantial. I do like to start the day off with a raw juice, but you can really do this at any point. I am moving towards one raw juice in the morning, and one late afternoon.
5. What are the best nuts to eat?
Almonds [vitamin E and magnesium], peacans [zinc], cashew [vitamin K + magnesium] - all raw and unsalted.
6. What ingredients should I add to my raw juice?
Anything green and raw! Some of the best ingredients: kale, spinach, broccoli, cucumber, beets, parsley, watercress, celery, and lettuce (the darker, the better). Ginger is also great for a kick-start to the day - its also very anti-inflammatory!
7. How many supplements and how much sun should I get to ensure my daily vitamin D dose?
Wearing sunscreen, or lots of clothing, hampers the creation of vitamin D from the sun. Your skin usually stops producing vitamin D after 20-30 minutes of exposure to direct sunlight. People with dark skin are less able to manufacture vitamin D from the sun. Vitamin D can never reach toxic levels if created naturally from sun exposure through the skin. Monitor yourself regularly and be careful not to burn.
If your levels are on the lower side, it is recommended that you take a supplement of 10,000iu per day initially (this usually translates to two small capsules). Once your vitamin D levels have reached optimum levels, you can reduce this supplement to 5,000iu per day. Currently, I am on 8,000iu myself, after being at 10,000iu for a couple months.
8. Should I be taking vitamin D or vitamin D2 - whats the difference?
When people talk about vitamin D, they are usually talking about D3. D3 is the form of vitamin D that you get from exposure to sunlight and is exceptionally important for our general health and modulating the immune system so that the number of MS attacks are reduced. There is also a D2 form which, it seems, is not as effective.
9. What are the best sources of each nutrient?
This is quite a comprehensive question, for now, this is what I have documented so far:
Other than that, use this handy nutrient search tool to help identify the top foods.
10. Why should I be taking supplements if I am eating healthy food?
In my opinion, its not really possible to get all the nutrients we need for a MS diet from food alone, especially on a consistent basis. Foods these days are grown in nutrient depleted ground. Also, we need specific nutrients on a daily basis, and to do that, you would need to be eating a lot of food, and then also ensure you know exactly how much of each nutrient you are eating from each piece of food. Supplements "fill the gap" and ensure your body is constantly supplied with what it needs. If you can found a reputable supplier, and understand the manufacturing process, then its a worthwhile trade-off against any "possible" effects in the future (which are very very low with quality supplements). Hope that gives you a better idea of how I see it.
11. What do I need to eat to ensure my supplements are being absorbed?
Water [water-soluble nutrients] and olive oil [fat-soluble nutrients].
12. How do I know which foods cause inflammation / do we have sensitivities to?
Everyone is different, but there are the usual suspects. Please see The MS Diet page for more details. You could also consider a food sensitivities test, which will give you some indication, but really, its best to avoid the as many foods that could cause further damage. Also, be aware of the Inflammation Factor of foods, this can provide some insight to foods your body is likely to be sensitive to.
13. Are bee stings / bee venom helpful to MS?
Although many people with MS benefits from this therapy, bee venom is currently not a conclusive treatment of MS, even though some report improvement in MS symptoms. For more information, you might want to read this.
14. Is coffee /caffeine really bad for MS ?
There is currently a debate about this, but my stance is "yes". The hormone adenosine is important for regulating the immune system and halting inflammatory reactions. It seems that caffeine can block the adenosine receptor and thus lower the effectiveness of adenosine for suppressing inflammation.
15. Other than fruits and veggies, what should I be eating?
As someone with MS, your body needs: vitamin A, B12, C, D, E, K, magnesium, Omega 3, 6, 9 essential fatty acids and zinc. If you have followed The MS Diet, you may also want to consider additional supplements to bolster your dietary intake of these critical nutrients.
16. Are legumes really bad for people with MS?
Legumes are controversial foods and have been known to cause a reaction in some people with MS. One of the main reasons legumes should be avoided is that they contain lectins which prevent our bodies from absorbing certain nutrients. They indirectly cause inflammation through activation of the myelin-sensitive T cells. Watch your symptoms carefully after eating legumes and obviously cut them out if you feel they are affecting you negatively. I have been absolutely fine with legumes in my MS diet, but after doing additional research lately, I have decided to eliminate them entirely from what I eat, just to be on the safe side. Not all beans are legumes, and not all legumes are beans, so make sure you are eating what you think you are eating. For more details, see The MS Diet page.
15. Is Weight Watchers diet something a person with MS should be following?
Weight Watchers is probably not the best option for someone with MS. Compare it to The MS Diet and see what elements you aren't avoiding, that you should and vice versa. A MS diet is specifically about not eating things and making sure other nutrients are consumed.
16. Do dried herbs really help? What nutrition do they offer?
Herbs do help, use them whenever possible. Coriander is rich in magnesium, and basil has a lot of vitamin A,K,C. The fresher the herb, the better!
17. How much water should I drink each day?
About 2 litres (68oz) or 8 average size glasses. Try to take it throughout the day, and not all at once.
18. Is lactose-free milk ok to use?
A dairy-free diet eliminates all of the foods on the lactose-free diet, as well as a few others. Since the problem is a reaction to the protein in milk rather than the lactose, someone with a milk allergy cannot consume lactose-free dairy products safely. Avoid milk derivatives such as sodium caseinate in nondairy creamers and toppings, as well as nondairy foods that have been cross-contaminated with milk proteins. MS'ers require dairy-free as we need to avoid milk protein, as opposed to just lactose.
19. Should I stay away from all forms of sugar?
As sad as it sounds, sugar is inflammatory and can contribute to leaky gut syndrome. Avoid it like the plague. Sorry to be the bearer of bad news!
20. Why should I avoid saturated fats? Isn't grass-fed meat actually high in omega-3 fatty acids, which helps to decrease inflammation? Isn't that what the Paleo diet says is actually beneficial?
Saturated fats are known to increase the permeability of the blood-brain barrier, allowing immune cells to attack the nervous system. Saturated fats can in fact also interfere with the conversion of essential fatty acids, which can lead to further inflammation. I am not fundamentally against grass-fed meat, but feel the cons out-weight the benefits, and so, I have eliminated them too. You might want to read The China Study for more detailed information on this.
21. Whats the best way to get vitamin B12?
Fish are good source of B12 - in order: Mackerel, Herring, Salmon, Tuna, Cod, Sardines, Trout, Bluefish. Stay away from all scavenger sea creatures like crab, lobster, and octopus, even though they are good sources too [scavenger meat contains toxins]. It's probably best to find a supplement to help you - I use B12 Methylcobalamin.
22. Which rice is best?
All rices should be fine [no gluten present and aren't legumes]. Red, Black, Brown or Basmati are low glycemic index [slow release energy], so try those first.
23. Is Balsamic vinegar / vinaigrette good for you? What's in it?
First, there is a difference between balsamic vinaigrette and balsamic vinegar. Balsamic vinegar is the reduction of cooked grape juice. Vinaigrette is made by adding a small amount of balsamic vinegar to olive oil and wine vinegar. Second, both can have a lot of additives like sugar, caramel and even gluten - all of which should be avoided.
Vinegar in general blunts sugar absorption, which helps stabilize blood-sugar levels and blood pressure. It also contains acetic acid, and like other acids, can increase the body's absorption of important minerals from the foods we eat, especially calcium, which is great for MS'ers.
On the negative sides of things, the stomach stops producing acid if too much vinegar is consumed. Also, too much acetic acid can stimulate the thyroid gland to pull phosphorous from the adrenal glands to negate the effects of acetic acid in the system. Depleted phosphorous results in impaired function of the adrenal glands and thus the entire endocrine system. The outcome of all this can include body odor, pains in the heart, rapid pulse, increased mucous production, and headaches. Repetitive use will also result in hardening of the liver.
On the whole, I don't think it must be avoided entirely, but make sure you know what the ingredients are and only use a little at a time. If you are going to use vinegar, try rice vinegar, as it is far more milder than normal vinegar, but if it says "seasoned rice vinegar" it has added sugar.
24. What oil should I be cooking with?
Most oils denature when heated and then become difficult for your body to absorb, including olive oil. However, coconut oil is far more robust and maintains it's molecular structure. You should not be getting any where near sunflower oil as this is the worst oil to be using on many levels.
25. How do you ensure you get enough calcium when avoiding dairy entirely?
Here are some foods to include in your MS diet: green leafy vegetables like spring greens, kale, broccoli, watercress, parsley (spinach is not a good source of calcium - it's high in calcium, but the calcium is bound to oxalates and therefore poorly absorbed); oranges; figs and black molasses; drinking hard water can provide 200mg of calcium daily, although soft water contains almost none; seeds like sesame seeds, sunflower seeds, almonds, and brazil nuts.
26. What are the best alternatives to kale if you can't get ahold of it?
You could try these nutritious vegetables, though not as potent as kale: anything green and leafy; spinach; broccoli; red romaine lettuce; chard; celery; cabbage; beet greens; turnip greens; mustard greens. Kale is easily grown too!
27. Should I be concerned if I am over-weight?
If you are planning to follow a good MS diet, then don't worry about your weight - it will naturally reduce by itself over time. Having MS should not affect your weight directly, unless you are not able to exercise and move around as you use to. Also, some drugs are known to increase weight gain. Stress and anxiety may also play a role in increasing your weight, so be aware of these factors. Some people have reported weight loss as a result of being diagnosed with MS, but this is not the norm. Too much weight loss too quickly could be a cause for concern, so talk to your doctor if you are worried.
If you do weigh more than you should, be aware that excess fat in the body absorbs fat soluble vitamins (vitamins A, D, E and K), taking it away from needed body function, which is particularly bad for someone with MS. Also, because fat-soluble vitamins are stored in the body for longer periods of time, they pose a greater risk of toxicity, if combined with overdosing of supplements.
28. You have specifically included 'barley' on the list of things to avoid in your MS diet as it contains gluten, yet you take 'Green Barley' as one of your supplements - is this a mistake or is this a different form of barley?
Gluten is not found in barley leaves which is used to make Green Barley (BarleyLife®). Green Barley is gluten free, and in fact, actually helps people deal with gluten intolerance.
28. Are pineapples good for MS?
Yes! Pinapples are mildly anti-inflammatory (one slice measures 33 on the Inflammation Factor), which is mainly due to the enzymes, pancreatin and bromelain, that break up protein molecules. These enzymes have been known to help reduce the level of circulating immune complexes (CICs). High levels of CICs occur in a number of autoimmune diseases, including MS. These immune complexes activate the immune system to attack the body, ultimately leading to tissue damage. Since Multiple Sclerosis inflames the nerve tissues of the nervous system, adding pineapples to your MS diet is a good way to reduce inflammation, or offset other foods that cause it. Pineapples are also a good source of vitamin C.
29. Is drinking alcohol in moderation 'okay' for someone with MS?
For me, my goal is to raise the bar past 'okay' when we talk about alcohol and MS diet. I am avoiding substances that 'might' not trigger instant MS symptoms, but 'could' upset the delicate balance I am trying to create within my cells. Substances like alcohol, anti-biotics, tabacco and aspirin might not have any immediate pronounced negative affects on your overall health, but can upset and even cause damage to the very sensitive processes in the body.
Micro-organisms in the stomach can be adversely affected when drinking alcohol - this contributes further to leaky gut syndrome (triggering an immune response and an attack on the nervous system). Remember, alcohol is a toxin. It alters your blood pH by altering your kidneys' ability to maintain your blood phosphate levels, which degrades the effectiveness of your body's overall metabolism. Some people with MS report that some of their neurologic symptoms, especially imbalance and lack of coordination, temporarily worsen after even one drink. Its also not a good idea to combine drink with other medications.
There is a highly publicised recent research study that implies "moderate" or "regular" alcohol drinking can reduce MS progression, but this was not an interventional study, and therefore was not able to eliminate other factors that could have contributed to this. It is interesting to note that the author of the study was quoted as saying: "This is really important, that lifestyle and diet can affect the course of MS.".
We need to strive to take things to the next level and ensure our bodies are getting the best environment to stimulate healing. Now, its up to you how you define 'moderation' - you might well get away with a glass here and there, and that might be fine for you. Wine does have good antioxidant properties, and can help reduce stress levels, however, my challenge to all the ladies is to give your MS diet the best chance of succeeding, and that means no alcohol.
Personally, I have chosen to not drink any form of alcohol. To obtain 100% perfection on the MS diet is a big ask with a lot of sacrifice, you need to decide whats best for you and what compromises you are willing to live with.
30. I've been getting mixed messages, are coconuts (coconut milk / cream / oil) inflammatory or anti-inflammatory?
Please see my post on coconut oil as a start.
Coconut milk / cream is best alternative to dairy you get, but does contain some saturated fats, which makes it slightly inflammatory. These saturated fats are plant-based, which is far better than animal-based. It also contains a lot of Omega 6 fatty acids, which can also be a cause for some inflammation, but are needed as part of a MS diet (as long as the balance to Omega 3 is good). There have been some studies where coconut oil actually reduces inflammation, but I think more research is still needed in this area.
Despite both of these shortcomings, I dont think coconut products should be avoided and should be ok if consumed in smaller portions.
31. Should I also avoid goat and sheep milk products?
Yes, you should also avoid them. I don’t eat goats or sheep milk products because they still have a protein in them that is very similar in structure to dairy. Goats or sheep milk products also have a high content of saturated fat, which would not be good for the MS diet.
32. What do I do if I'm losing too much weight?
33. Am I getting enough protein on this diet?
34. I'm worried that I should be taking medication as a backup. What are your thoughts on this?
I hope that answers some of your MS diet questions! If you still have more not already covered here, please drop me a comment below, I really love helping people by answering questions, especially as I learn more myself!
Love to hear from you!