Download the multiple sclerosis healthy lifestyle guidelines

THE MULTIPLE SCLEROSIS
HEALTHY LIFESTYLE
GUIDELINES
Andrew Larson, M.D., FACS, FASMBS
Ivy Larson
T
hose of you who know our full story and have read
our books know our interest in nutrition began after Ivy’s
diagnosis with multiple sclerosis (MS) in 1998 at the age of
twenty-two.
Ivy was diagnosed at the University of Miami while
Andy was still a medical student at the University of Pennsylvania. Although Ivy had just had an episode of urinary retention that had landed her in the emergency room (she was
wearing a catheter when she was diagnosed), her neurologist
said she was in the early stages of the disease.
From the beginning, Ivy was given hope that she
had a good chance of living well with MS by modifying her
lifestyle, particularly her diet. Although Ivy was given the
option of beginning one of the disease-modifying FDA-approved medications for MS, for various reasons Ivy chose to
try a natural approach to managing the symptoms of her MS
first. Large studies published in prestigious medical journals
such as the Journal of Neurology, Neurosurgery, and Psychiatry and Lancet (2) and smaller-scale studies published in less
widely known journals (3), basic science studies (4) and
high-quality epidemiological studies (5) have all linked real-life human (not rat, not chimpanzee, not mouse)
multiple sclerosis with dietary changes. While the lifestyle modification and nutritional therapy approach has
worked well for Ivy for over a decade (Ivy is now 38 years old), we acknowledge MS is different for everyone
and that not every person with MS will do as well as Ivy. However, if you or a loved one you know has MS it is
important to realize that whether or not you chose to take medication has absolutely nothing to do with whether you adopt a healthy lifestyle. Without a doubt every person with MS should live as healthy a lifestyle as they
possibly can. Lifestyle modification is not a cure for MS, but as of right now, neither is the medication. As soon
as someone is diagnosed with MS they should immediately be told by their neurologist that MS is an inflammatory disease and that following an anti-inflammatory diet and lifestyle should become an important part of
their disease management plan. Sadly, the vast majority of neurologists never mention lifestyle modification to
their MS patients.
In addition to being inflammatory, MS is also an autoimmune disease. The disease process damages the
protective fatty myelin sheath that surrounds the nerves in the brain and spinal cord. When the immune system
goes into overdrive it produces an inflammatory response that strips away the myelin and causes nerve scarring.
The scarring (or “sclerosis”) impairs the transmission of nerve impulses and it’s what causes the numerous different symptoms of MS. The central nervous system can sometimes regenerate damaged nerve tissue— but only
if there is minimal demyelination. A key way to reduce MS relapses is to reduce the inflammation that causes
the demyelination in the first place. Controlling systemic inflammation with diet and lifestyle should be a top
priority for every MS patient.
Together we have spent over a decade researching holistic nutrition and lifestyle modification for the
management of MS as well as numerous other inflammatory conditions. The good news is, we have concluded the anti-inflammatory lifestyle someone with MS should follow is the exact same healthy lifestyle anyone
should follow who wants to live a long and healthy life. In other words, the anti-inflammatory “MS diet” we
promote is really a just a healthy way of eating that would benefit just about anyone, so it is something the
entire family can do together and it is a way of living that our entire family adheres to, including our son Blake.
Additional lifestyle factors that reduce inflammation and that are also desirable for anyone who wants to feel
their very best include exercise, stress management, proper sleep and targeted nutritional supplementation.
THE MULTIPLE SCLEROSIS HEALTHY GUIDELINES 2
Basic Anti-Inflammatory Diet & Lifestyle
Guidelines for MS:
• Eating a nutrient-dense and anti-inflammatory diet based on unrefined whole foods with a special emphasis
on plant-based foods (fruits, vegetables, beans, legumes, whole grains, nuts, seeds, etc.) and a de-emphasis on
land animal foods (beef, chicken, eggs, etc.) The consumption of high-quality, wild fish is also encouraged due to
the highly anti-inflammatory omega-3 content found in seafood.
• Significantly reducing saturated fat from animal foods and completely eliminating trans fats (these fats are
thought to stimulate the Th1 response, the release of myelin-damaging inflammatory chemicals by immune
cells)
• Eliminating dairy (including low-fat dairy.) A number of different studies point to the idea that the proteins
in milk can cause the body to have an immune reaction and make antibodies to the milk protein. The link between type 1 diabetes and milk consumption is well documented in respected medical journals such as The New
England Journal of Medicine (6.) Cow’s milk consumption has also been linked to multiple sclerosis (7.)
• Increasing intake of anti-inflammatory omega-3 fats from seafood and vegan sources (particularly flax and
chia seeds). Note: The omega-3 fats in fish and plant foods are not the same, so it is important to include both in
your diet.
• Eliminating pro-inflammatory and highly refined omega-6 oils from your diet (soybean oil, “pure” vegetable
oil, corn oil, sunflower oil, safflower oil, grape seed oil, etc.) Start reading the ingredients list of every packaged
food you purchase and avoid those with added omega-6 oils.
• Manage stress. The importance of stress management cannot be over emphasized as there is no doubt that
stress precipitates relapses in MS. People respond to stress and manage stress in different ways, so it is important
to find a stress management program that works for you. Ivy finds massage, yoga and other exercise extremely
beneficial but meditation, biofeedback and deep breathing have also been shown to be effective stress-busters.
The most important thing is to come up with a stress management program that works for YOU and stick to it.
• Dramatically increase your consumption of phytonutrient-rich fruits and vegetables. Try eating fruit with
breakfast, drink a green smoothie with fruit every day, eat vegetable-based soups, enjoy a large salad once a day,
include large servings of vegetables with dinner, etc.
• Aim to get the majority of your protein from plant foods such as nuts, seeds, beans and “whole” soy rather
than animal foods such as chicken or beef. When you do eat animal foods take extra care to eat only the absolute
highest quality and “cleanest” sources possible. For example, you want to choose wild fish over farmed fish, select
“pastured” eggs and chicken over “free range” and be sure the beef and lamb you eat have been grass fed or raised
on pasture rather than raised on corn or grain. Animals that are fed healthier diets will have a more favorable
and anti-inflammatory omega-3 to omega-6 ratio. Note: Every single plant food on the planet contains protein.
As long as you eat enough calories, you will not be protein deficient even if you were to eat a 100% vegan diet,
which we are not recommending by the way.
THE MULTIPLE SCLEROSIS HEALTHY GUIDELINES 3
Basic Anti-Inflammatory Diet & Lifestyle
Guidelines for MS (cont.):
• Eliminate empty-calorie processed carbohydrates in the form of flour, sugar or refined grains such as white
rice or white pasta. Opt for unprocessed “whole” carbs instead such as potatoes, corn, fruits, vegetables, unrefined whole grains like oatmeal, barley, bulgur, etc. For optimal nutrition look for flourless sprouted whole
grain breads such as Food for Life brand (note: sprouting releases all the vital nutrients stored within the whole
grain.) Get rid of all added and hidden refined sugars in your diet; start reading the ingredients list of every
packaged food you purchase and avoid those with added sugar. Eat fruit-based desserts and sweeten your food
lightly with unrefined and natural sweeteners such as raw honey, yacon syrup, coconut palm sugar, date paste
and pure maple syrup; these natural sweeteners do not contain a lot of vitamins or minerals but they at least
have anti-inflammatory phytonutrients and are thus not total empty calorie foods. Avoid artificial sweeteners
and “diet” soda.
• Adhere to a regular fitness program combining cardiovascular exercise with strength training, flexibility/
stretching and stability/ balancing exercises. You can try Ivy’s personal 30-minute workout in her Full Fitness
Fusion DVD or consider hiring a personal trainer to help you create a customized workout program tailored
to your needs. Note: It is important to avoid getting overheated when exercising as doing so can bring about
extreme fatigue and other unpleasant MS symptoms.
• Get plenty of sleep every night. Most people with MS need more sleep than the average person, sometimes
as much as 2 to 3 hours more each night. If you find yourself particularly exhausted in the day try taking a
short nap. Many people with MS have a difficult time falling asleep and staying asleep and if you find this to be
a problem consider taking a natural sleep aid in the form of valerian or melatonin. Valerian is a sedative herb,
used for centuries. Look for standardized extracts of valerian and take one to two capsules a half hour before
bedtime. Melatonin is a hormone that regulates the wake/sleep cycle and other daily biorhythms. We like sublingual tablets (to be placed under the tongue and allowed to dissolve); take 2.5 mg at bedtime as an occasional
dose, making sure that your bedroom is completely dark. A much lower dose, 0.25 to 0.3 mg, is more effective
for regular use.
• Nutritional supplements (specifically with omega-3 essential fats and vitamin D-3) Note: See page 10 for
more information on nutrition supplements.
• Make an effort to get more of your dietary fat from “whole” food plant sources rather than added oils. For
example, olives will have a more complete nutritional profile as opposed to olive oil and flax seeds are a better
choice than flax oil. Other good “whole” fats include avocados, nuts, seeds, nut butters and olives.
• Trash the trans fats. We can’t think of anything “edible” that is worse than trans fats. The U.S. National
Academy of Science’s Institute of Medicine (the organization responsible for advising the U.S. government on
health policy and responsible for determining the RDI for vitamins) concluded there is NO safe level of intake
for trans fats. Trans fats increase inflammation, decrease sensitivity to insulin, increase your bad LDL cholesterol, decrease your good HDL cholesterol, impair artery dilation, and increase your triglyceride level. Whether or
not you have multiple sclerosis is beside the point, nobody should eat trans fats. Period.
THE MULTIPLE SCLEROSIS HEALTHY GUIDELINES 4
Rule Out Food Sensitivity
One thing we tell everyone is to consider testing for food sensitivities and food allergies if after adhering to an
anti-inflammatory “whole foods” diet for at least 5-weeks you see little or no improvement in overall energy and
well-being.
For example, while gluten-free diets are not necessary for most people with MS (and has not been necessary for
Ivy), if you have an allergy to wheat—or to any other food for that matter!---your body will be subjected to an
undesirable inflammatory response every single time you eat that food. The only way to “cure” a food sensitivity
or food allergy is to avoid the culprit food.
Today, going gluten free is a popular treatment for many autoimmune diseases including MS. But is there proof
that this approach works? Not exactly. While there is no scientific evidence that gluten-free diets will help MS
or all other autoimmune diseases, we do believe that a certain percentage of people with autoimmune diseases (including MS) may have undiagnosed wheat / gluten sensitivity. Therefore, some people with MS will see a
definite improvement in how they feel if they eliminate wheat / gluten from their diets. Should you therefore tell
everyone with MS to follow a gluten-free diet? No, because that would be unnecessarily restrictive. Before you
eliminate gluten or wheat from your diet you should get tested because if you are already on a gluten-free diet,
the tests can be falsely negative.
And of course wheat / gluten is not the only food in the world that can potentially be a problem. Some of the
other foods most commonly associated with food sensitivities include corn, soy, dairy and eggs.
Oh My Wheat!!
It is our theory that one of the reasons gluten has become a problem for so many people is because
wheat is ubiquitous in the modern diet, not to mention the vast majority of the wheat consumed is
highly processed. Even if you are not wheat or gluten sensitive it is important to only eat unrefined
whole grain sources of wheat and to vary the grains you consume so as not to consume an excess
amount of wheat or any other single grain.
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A Better Food Pyramid
Our anti-inflammatory Clean Cuisine food pyramid below will help provide a visual guide as to which foods to
eat more of and which foods to eat less of. You do not need to follow the pyramid exactly rather use it as a guideline.
THE MULTIPLE SCLEROSIS HEALTHY GUIDELINES 6
The Original MS Diet Developed by Roy
Swank, M.D.
The initial diet for multiple sclerosis Ivy’s neurologist suggested she follow was outlined in The Multiple
Sclerosis Diet Book written by neurologist Roy Swank, M.D. Dr. Swank was the first researcher to discover
a correlation between the consumption of fat—specifically animal-based saturated fat—and the incidence
of MS. Swank’s research on the relationship between diet and MS dates back to 1948, long before modern
disease-modifying drugs were available. Over the course of a nearly fifty-year career, Dr. Swank worked
directly with thousands of MS patients and his MS diet (which is very low in animal-based saturated fat)
has been proven to reduce the frequency and severity of exacerbations in MS patients. After a period of five
years, study patients who followed his multiple sclerosis diet were actually better off functionally than when
they were first diagnosed with MS. At twenty years, most of the control group patients were unable to walk,
whereas the typical Swank diet patient was fully mobile and experiencing only mild symptoms.
Managing Your MS Symptoms with Diet
The purpose of dietary modification for the management of MS is multifactorial:
1. Anyone with any autoimmune disease should consume as many nutrient-dense calories and as few
empty-calories as possible in order to optimize the immune system. Specific to MS, a broad spectrum of
nutrients is essential in order for the brain to repair itself.
2. MS is a disease made worse by inflammation—the immune system has different ways it can damage
the brain and there are major variations in the amount of damage inflammation causes. Each time you
have an exacerbation or flare-up the inflammation that occurs has the potential to cause debilitating
symptoms. And yet by modifying the foods you eat to include more anti-inflammatory foods and fewer
pro-inflammatory foods you can help prevent the inflammatory flare-ups that cause MS symptoms. You
are not “curing” MS with diet; you are simply controlling the symptoms and helping to prevent future
damage.
3. Eating a nutrient-dense and anti-inflammatory diet is also the best diet for weight management
and maintaining a healthy body weight makes living with MS much easier. Additionally, it is important
to avoid overeating excessive amounts of empty-calories as doing so can put the body’s inflammatory
process into overdrive.
4. Getting the proper nutrition and avoiding empty calories is essential for having energy and combating the overwhelming fatigue so many MS patients find debilitating.
THE MULTIPLE SCLEROSIS HEALTHY GUIDELINES 7
6 Diet Steps to Reduce Inflammation
Following the 6-steps to reduce inflammation in the guidelines below will dramatically improve your overall
health, boost your energy and help you maintain a healthy body weight whether you have MS or not. These are
diet guidelines from which your whole family will benefit.
1. Become a “Fishy Flexitarian”
We encourage you to lean towards a mostly plant-based diet by eating less animal foods (meat, chicken, eggs,
dairy, etc.) and eating more unrefined “whole” plant foods (fruit, vegetables, beans, nuts, seeds, whole grains,
etc.) We find it easiest to stick to a “flexitarian” way of eating by consuming animal foods at just one meal a
day; for example, on many days we are vegan until dinnertime. Pastured eggs are the one exception to this
rule and can be eaten for breakfast or lunch. One of the primary reasons we encourage you to reduce your
consumption of animal food is because animal foods contain a type of saturated fat that is pro-inflammatory.
Additionally, the protein itself in animal foods has been linked to an increase in the production of a hormone
called IGF-1 (insulin-like growth factor 1). IGF-1 is one of the body’s important growth promoters during
childhood, but after puberty and into adulthood, high levels of IGF-1 are associated with increased inflammation, more oxidative stress, accelerated aging, and decreased sensitivity to insulin, which makes it more difficult to manage body weight. (8) Increased levels of IGF-1 have also been linked to the promotion of cancer
cells.
Note: To keep IGF-1 levels low, it is also improtant to avoid refined soy in the form of soy protein isolate; stick
to unrefined “whole” soy in the form of tofu, tempeh, edamame beans and soy milk instead.
THE MULTIPLE SCLEROSIS HEALTHY GUIDELINES 8
2. Got Phytonutrients?
Phytonutrients (also called phytochemicals) are only found in unrefined plant-based “whole” foods. You’ll
find phytonutrients in fruits, vegetables, nuts, seeds, whole grains, beans, legumes, whole soy, etc. Phytonutrients act as potent anti-aging antioxidants but they are also essential for reducing inflammation. The best
way to get more phytonutrients into your diet is to eat more plant-based food in their whole, natural and
unrefined form.
Simply swapping cow’s milk for plant-based nut or seed milks (such as hemp or almond milk) is a deliciously nutritious way to boost phytonutrients. If you have a Vitamix or other high speed blender you can
easily make your own fresh nut / seed milks as well as rich-tasting nut/ seed creams and even decadent but
100% guilt-free ice creams, custards and puddings (Note: a Vitamix will also allow you to sweeten creamy
desserts like pudding with nutrient and fiber-rich “whole food” dried fruits such as dates rather than refined sugar; to sweeten with dates blend a bit of water with pitted dates to make sweet and delicious “date
syrup.”)
We also suggest making “whole food” green smoothies once daily by blending a green leafy veggie (such
as parsley, kale, spinach, cilantro, etc.) with any frozen fruit (such as cherries, pineapple, mango, strawberries, etc.) It really is amazing the assortment of delicious green smoothie combinations that can be made
without even a hint of a “lettuce-like flavor” including Chocolate Strawberry, Mango Spice Cake, Blueberry
Ginger Cocktail, and more! We include these tempting green smoothie recipes and more in our Superfood
Cookbook and Clean Cuisine book as well as on the website.
It is also a good idea to try and eat at least 1 raw green salad each day in addition to a raw fruit with breakfast and to consume vegetables with both lunch and dinner (fruits and vegetables are among the richest
sources of phytonutrients.) As an extra phytonutrient booster you can even take whole-food based supplements made from freeze-dried fruits and vegetables (such as Green Vibrance) that offer a concentrated
source of phytonutrients. Note: We offer plenty of plant-based phytonutrient-rich recipes and meal planning ideas such as always keeping a big pot of vegetable soup on hand and using frozen vegetables properly
on our website and in our book.
THE MULTIPLE SCLEROSIS HEALTHY GUIDELINES 9
3. Spice it Up!
Instead of seasoning your foods with excess amounts
of oil try experimenting with spices such as turmeric,
cinnamon, cumin and cardamom. Spices not only
taste amazing but they are loaded with anti-inflammatory phytonutrients and each spice offers its own
unique health-promoting properties (for example
cumin has detoxifying activity, cinnamon lowers
blood sugar, and turmeric has potent anti-inflammatory benefits.) The list of health promoting properties
intrinsic to spices is endless. And it’s not just spices;
herbs are also a very healthy way to add flavor -- and nutrition -- to your food.
We not only eat our spices, we drink them too! Ivy is particularly fond of her daily Turmeric-Ginger Detox
Tonic, which takes just minutes to make and can be prepared in large batches to keep for several days. She also
often stirs a ½ teaspoon of cinnamon into her Orange Spice tea, which is absolutely divine when lightened a
bit with almond milk. And freshly grated ginger is delicious in decadent Chocolate Spice tea lightened with
coconut milk. There are countless interesting and anti-inflammatory spice/ tea combinations to concoct if you
use your imagination (and taste buds!) Note: If you have a sweet craving try a cup of spiced tea instead of reaching for a cookie. It is incredible how satisfying spiced teas can be.
4. Balance Your Omega-6 / Omega-3 Ratio
The ideal ratio for keeping inflammation
under control is about 2 or 4 times more
omega-6 fat than omega-3 fat. Unfortunately, the average person eating the SAD (Standard American Diet) eats approximately 20
times more omega-6 than omega-3 fat. This
is a totally out of whack ratio that increases
inflammation and decreases sensitivity to
insulin (thus increasing risk of obesity, type
2 diabetes and heart disease).
Following these simple steps will help optimize your omega-3/ omega-6 ratio:
• Eat wild fish 2-3 times per week
• Supplement with a pharmaceutical-grade fish oil containing EPA/ DHA (2 -4 grams a day). - Our Clean Cuisine AM/PM formula supplements meets this criteria. With almost all other
brands you will likely need to double or triple the serving size. Read the label.
• Eat vegan sources of omega-3 fats (such as chia seeds, ground flaxseeds or walnuts)
• Eliminate processed omega-6 rich vegetable oils and packaged foods containing these oils (such as
cottonseed oil, pure vegetable oil, soybean oil, corn oil, sunflower oil, etc.)
• Eat omega-6 rich foods in their “whole” and unprocessed form (such as “whole soy” like edamame
beans or tempeh, nuts, seeds, nut butters, etc.)
• Supplement with a super good anti-inflammatory omega-6 fat called GLA in the form of evening
primrose oil (1,300 mg a day is a good starting dose) or borage oil.
THE MULTIPLE SCLEROSIS HEALTHY GUIDELINES 10
5. Go for the “Whole” Shebang
Despite the popularity of trendy low-carb diets, the truth is “whole carbs” from unrefined plant foods are extremely healthy and slimming too. Packed with fiber and a broad spectrum of vitamins and minerals, whole
carbs are also a good source of anti-inflammatory antioxidants and an assortment of phytonutrients. “Good”
whole carbs to eat everyday include fruits, vegetables, beans, legumes, potatoes, corn, whole grains and sprouted
whole grain breads and sprouted whole grain pastas.
Although “whole carbs” are good, you should completely eliminate any foods made with refined carbs. This
includes refined flour of any sort (a key word to look for on the ingredient list of any packaged food is “enriched
flour”—if it is “enriched”, then you know it is processed). The only flour that is not processed is one that say
“whole.” You also want to avoid any food with added sugar, especially packaged foods containing high fructose
corn syrup as this is a red-flag ingredient that lets you know the rest of the ingredients are surely low-quality as
well. Carbs like flour and sugar are easy to overeat because they are devoid of fiber, and, when overeaten, these
empty carbs are converted by your body into saturated fat, which increases inflammation. These “bad” carbs are
also easily converted into body fat, which in and of itself promotes inflammation
THE MULTIPLE SCLEROSIS HEALTHY GUIDELINES 11
6. Enjoy Bean Cuisine
Right up there with fruits and vegetables, beans and legumes are among the healthiest, most disease-preventing,
detoxifying and anti-inflammatory foods on the planet. Why? Because they are bursting with inflammation-reducing antioxidants and phytonutrients as well as being one of the richest sources of fiber on the planet.
Adding just ½ cup of beans or legumes to your diet daily will dramatically boost your fiber intake by approximately 8 to 11 grams. To really put the outstanding fiber profile of beans in perspective, the average American
only eats approximately 11 grams of fiber a day. The National Cancer Institute recommends at least 25 grams of
fiber a day (we strongly believe you should eat a lot more fiber than that but 25 grams is a good start.) Simply increasing your fiber intake can lower inflammation and even reduce C-reactive protein levels, which is a measure
of inflammation in your bloodstream. (9)
Beans and legumes are also an incredibly nutrient-dense food and a nutritional storehouse of vitamins and
minerals including B vitamins, calcium, magnesium, iron, zinc and potassium. And don’t forget about protein!
Unlike conventional animal food sources of protein such as beef or milk, beans and legumes are packed with
hormone-free, steroid-free and antibiotic-free ultra “clean” plant protein.
Did you know beans can help fight belly fat too? Carrying extra body fat is inflammatory in and of itself, but
beans and legumes can help you fight the battle of the bulge. A Canadian study of 1,475 men and women found
that those who consumed beans regularly tended to weigh less and have a smaller waist circumference than
those who did not eat them. The regular bean eaters were also 23% less likely to become overweight over time.
(10) Bean eaters weighed, on average, 7 pounds less and had slimmer waists than their bean-avoiding counterparts yet they consumed 199 calories more per day if they were adults and an incredible 335 calories more if they
were teenagers. It is important to note here that all calories are not equal.
Not only are beans and legumes low in calories, high in nutrients, slowly digested and super satisfying, but nearly
half of the starch in these “superfoods” comes from a special type of starch called “resistant starch” that is not
fully digested. Resistant starch is as close to a “miracle” starch as it gets. Considered a functional fiber, resistant
starch actually resists digestion, meaning the calories in resistance starch cannot be stored as fat. And, because
resistant starch skips digestion you end up with lower blood sugar and insulin levels—and better ability to burn
fat–following a resistant starch-rich meal.
Many varieties of beans and legumes exist, so there is sure to be a bean for everyone! Beans are also incredibly
versatile and can be added liberally to soups, chili, salads, side dishes, whole grains, hummus, burritos and more.
We are especially fond of bean burgers and Ivy even makes a killer black bean brownie (and yes, they really do
taste like the real deal dessert classic.) We also have plenty of additional “bean cuisine” recipes on our website
and an entire section dedicated to beans in our Clean Cuisine book.
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The Anti-Aging Perks of Clean Cuisine
We believe knowledge is motivational. The more you understand about the
intrinsic and far-reaching benefits of an anti-inflammatory “Clean Cuisine” diet
and lifestyle the more motivated you will be to modify your diet and change
your life. Watch the video in the link below where we explain in more detail how
our anti-inflammatory program can help slow aging to improve the way you
age, look and feel.
THE MULTIPLE SCLEROSIS HEALTHY GUIDELINES 13
Frequently Asked Questions
Did Ivy ever take any of the FDA approved disease-modifying medications
used to treat MS?
No. Ivy did initially take medications for symptoms (such as ditropan, baclofen, amantadine, effexor, valium,
etc.) but she no longer takes any medication. We are not opposed to the medication if Ivy’s symptoms ever
become severe, but for now she has been able to maintain excellent health by following an anti-inflammatory
and nutrient-rich whole foods diet, exercising regularly, taking nutritional supplements, getting adequate rest
and controlling stress. However, if you do take one of the disease-modifying medications for MS you should still
modify your diet and follow an otherwise healthy lifestyle; it’s not an either-or decision—you can do both!
Does Ivy have any MS symptoms today?
The short answer is no. However, she will occasionally experience mild bladder problems (such as urgency and
frequency) and muscle spasms in her right leg. If Ivy allows herself to get overexerted, overstressed, overheated
or doesn’t get enough sleep she will get extremely fatigued.
What does Ivy do for MS fatigue?
Without a doubt, the very most important thing Ivy does to manage MS fatigue is making sure to get a good
night sleep. If she does not get enough sleep then nothing else seems to help.
However, she notices a definite improvement in energy when taking maca (also called Peruvian ginseng) on a
daily basis. Maca is a nutrient-dense “super food” and an excellent source of vitamins, amino acids, plant sterols, minerals and essential fatty acids that has been traditionally used in Peru to relieve stress, increase stamina,
boost libido and combat fatigue. Maca can be eaten in many different ways but Ivy prefers to use gelatinized
organic maca powder. Gelatinization is an extrusion process that removes the starch within maca, thus yielding
a more concentrated powder that is easier to digest and absorb. Ivy blends her maca powder into smoothies,
teas, water, chocolate desserts and hot whole grain cereals. Without a doubt the maca definitely seems to help Ivy
overcome fatigue. Maca is also beneficial for relieving menstrual issues and menopause. It eases cramps, body
pain, hot flashes, anxiety, mood swings, and depression. Note: If you are pregnant or lactating you should avoid
taking maca.
Other than your own books, do you have any additional books or resources
you recommend for MS patients?
We highly recommend The Better Brain Book by neurologist David Perlmutter, M.D. Dr. Perlmutter’s Health
Center is located in Naples, FL. He is available for phone consultations if you do not live in the area. Overcoming
Multiple Sclerosis by Dr. George Jelenik is another excellent book (Dr. Jelenik is a doctor but he also has MS—his
story is amazing.) Dr. John McDougall is currently conducting research on diet and MS. For more information
visit his website.
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Does Ivy take nutritional supplements?
Yes. Ivy has taken nutrition supplements almost from the first day of her diagnosis with MS. In our very first
book, The Gold Coast Cure (HCI Books, 2005), we outlined her supplementation regimen and although we have
since made minor adjustments, for the most part the basic regimen is the same. One thing we have learned a
lot about over the years is that just as the quality of ingredients in packaged foods can vary tremendously from
company to company, so can the quality of ingredients in nutrition supplements. We feel strongly about going
for quality over quantity. We would much rather you take ZERO supplements rather than supplement with a
low-quality product. Many high-quality supplements on the market do exist, but you do need to do your homework. We have found many health food store employees to be particularly knowledgeable and helpful, especially
when it comes to identifying high-quality supplement products.
Finding a superior quality multi-vitamin is good start because a basic multi-vitamin will help fill nutritional
gaps. Just as we encourage you to read the ingredients list on the packaged foods you buy, you need to do the
same thing with your nutrition supplements too. Here are a few things to be aware of when looking for a multivitamin:
• You do not want a supplement that contains synthetic forms of vitamin E (dl-alpha-tocopherol). *You don’t even want one that contains just one of the natural forms of vitamin E (d-alpha to
copherol). Ideally, you want your supplement to reflect the way vitamin E is found in nature in real food, in the form of mixed tocopherols. When you hear about research linking vitamin E supplementation to negative health outcomes, it is important to note that in addition to other flaws, the research in those studies did not take into account the type of vitamin E that the sub
jects were taking. Supplementing with a reasonable dosage (not mega-dosing!) of natural vitamin E in the form of mixed tocopherols not only is safe but is an important strategy in reducing over
all oxidative stress, which slows the aging process.
• The same thing for carotenoids; research has actually linked taking isolated beta-carotene to in
creased risk of lung cancer (in smokers anyway), but isolated beta-carotene is not something you would ever find in nature in your food. In food, you would obtain mixed carotenes. That’s exactly what you want to look for in a supplement.
• You want to avoid supplements con¬taining synthetic folic acid and instead look for one contain
ing folate, which is the form naturally found in foods like green vegetables.
• Balancing the fat-soluble vitamins A, D, and K is also critical. This is because when you take one fat-soluble vitamin you increase your body’s need for the other fat-soluble vitamins. For exam
ple, one of the roles of vitamin D is to activate osteoblasts (bone-building cells) to increase bone density while one of the roles of vitamin A is to promote bone breakdown so that new bone can be laid down. Although these processes seem to oppose each other they are both necessary to maintain bone health. Vitamins A and D work closely together and if you take one you need to take the other. Also, taking vitamin D will increase your need for vitamin K2 (Note: Vitamin K2 is not the same as the vitamin K1 that is easy to get from dark leafy green vegetables; K2 is not
easy to obtain from the typical diet.) There is an intimate relationship between fat-soluble vita
mins, and they all play a vital role in optimizing health. Unfortunately, mainstream foods do not supply adequate amounts of vitamins A, D or K2, so supplementation is especially important.
• Unless you are under the supervision of a physician and being treated for a specific problem such as anemia or are pregnant, it is not wise to take supplemental iron. Although iron is crucial for oxygen transport and other physiological processes, in excess iron is an oxidant that may contribute to cardio
vascular disease and cognitive decline in older adults.
THE MULTIPLE SCLEROSIS HEALTHY GUIDELINES 15
• Copper is another nutrient that is often added to multi-vitamins in relatively high quantities, which can potentially lead to toxicity. Additionally, studies have shown excess copper to be associated with a
lower antioxidant status and reduce immune function.
• And of course the bioavailability of the nutrients in your supplement is also important because if your
body can’t absorb and use what you ingest then why bother taking it? For example, minerals have a wide
range of bioavailability, depending on the form they are in and what they are bonded to; chelated min
erals are the absolute best because they are well absorbed by your body. As another example, if your sup- plement contains vitamin C, it also needs to contain bioflavonoids or you won’t be able to fully absorb the vitamin C. Bioflavonoids also boost the activity of vitamin C once it has been absorbed.
There are additional supplements Ivy takes above and beyond her high-quality multi-vitamin, which we discuss in more detail in our Clean Cuisine book. However, because we were finding it a hassle to buy multiple
supplements from different companies every month in order to create what we felt was the “perfect” balance of
nutrients for Ivy, we developed our own line of Clean Cuisine Essentials daily supplements that incorporates
everything you need for the day (including the omega-3 fats, EPA and DHA, as well as evening primrose oil) in
convenient AM and PM packets. To see the complete breakdown of every nutrient in our Clean Cuisine Essentials AM/ PM packets CLICK HERE.
Are probiotics important for people with MS?
Yes. Probiotics are important for everyone, especially anyone with an autoimmune disorder. In addition to the
Clean Cuisine Essentials AM/ PM packets, Ivy also takes a probiotic supplement. Probiotics are important for a
healthy immune system for everyone, whether you have MS or not. You should not only supplement with a probiotic but you should also be consuming non-dairy prebiotic and probiotic-rich foods on a daily basis.
Unfortunately, numerous factors can disrupt the balance between “good” and “bad” bacteria in your gut, and
therefore interfere with your body’s natural ability to heal and detoxify itself. Helping to restore intestinal integrity, probiotics work round the clock to balance the “good” and “bad” bacteria within your GI tract, which can
easily be upset by chlorinated water, poor elimination of waste, stress, oral contraceptives, a diet rich in refined
foods, poor digestion and much more. Antibiotics can also wreak havoc on the gut flora. By the way, Andy
always tells his patients and family members that they should take antibiotics as infrequently as possible and if
they do need to take them then it is important to simultaneously supplement with a high quality probiotic, which
they should be taking anyway.
As with multi-vitamins, not all probiotic supplements are created equal from a quality standpoint. Your body
does not always absorb the probiotics that the label claims it has. Many mass-market probiotic supplements
contain a limited number of good bacteria and are manufactured in such a way that the good bacteria may not
survive (such as being exposed to heat, moisture, and light) or contain fillers and added sugars that interfere with
the body’s ability to absorb them.
Here is what to look for in a probiotic supplement:
• A brand that contains strains of bacteria that have been clinically documented for their effectiveness.
These include Lactobacillus, Bifidobacterium, and Saccharomyces.
• A dairy-free probiotic because cow’s milk allergy is one of the most common.
• A brand that is sold refrigerated to maintain shelf-life because heat is an enemy of probiotic viability.
THE MULTIPLE SCLEROSIS HEALTHY GUIDELINES 16
***Note: We have our own line of Clean Cuisine Probiotics but we also highly recommend Shaklee Optiflora, a
unique, two-product system (Optiflora Prebiotic Complex and Optiflora Probiotic Complex) that delivers guaranteed live probiotics Bifidobacterium longum and Lactobacillus acidophilus, along with the prebiotics FOS and inulin
as well as gammatocopherol, a nutrient associated with colon health.*
Dr. Ohhira’s Probiotics is another excellent brand and contains 12 strains of friendly bacteria, including E. faecalis
TH. Dr. Ohhira’s award-winning brand was developed by Japanese microbiologist Dr. Iichiroh Ohhira, PhD, and, to
our knowledge, is the only manufacturer that relies on a natural fermentation process using ancient Japanese traditions. We are sure there are other good probiotic supplements on the market but we know for sure these brands are of
exceptional quality.
Clean Cuisine
Complete Supplement System
THE MULTIPLE SCLEROSIS HEALTHY GUIDELINES 17
What is the connection between vitamin D and MS?
Several studies suggest that vitamin D may lower the risk of developing multiple sclerosis, as well as lessen the
frequency and severity of symptoms. The Nurse’s Health Study found a protective relationship between vitamin
D supplements and multiple sclerosis risk, as was reported in Neurology in January 2004. And in a newer study
published in Neuroepidemiology, data from participants enrolled in the Multiple Sclerosis Surveillance Registry suggested that exposure to vitamin D before multiple sclerosis onset may slow disease-related neurodegeneration and delay progression to disability.
According to Michael Holick, PhD, MD, director of the Vitamin D, Skin, and Bone Research Laboratory at
Boston University School of Medicine, if you’re born below 35˚ latitude, located approximately at Atlanta and
live at this latitude for the first 10 years of your life, you have a 50% reduced risk of developing multiple sclerosis. In addition, he reports that women and men who increase their vitamin D intake to more than 400 IUs per
day reduce the risk of developing multiple sclerosis by approximately 40%. Note: We believe 400 IU of vitamin
D is not nearly enough for most people, especially those with MS.
Do Get Your D!
As a general recommendation, we suggest a baseline supplementation of 2,000 IU of vitamin D3 daily,
which is the amount contained in our Clean Cuisine Essentials AM/ PM daily supplements. However,
some people may need even more. We strongly urge anyone with MS to have their doctor test their
vitamin D levels with a blood test. Unfortunately testing is not standardized, so it is possible to get
different results from different labs and some neurologists are satisfied with results in the low-normal
range between 30.0 and 50.0 nanograms of 25-hydroxy vitamin D per milliliter (ng/mL) of blood. We
suggest you find a neurologist who will work with you to get your vitamin D levels in the high-normal
range between 50.0 and 70.0. Also, be sure to supplement with D3 as opposed to the more common,
but less bioavailable form, D2.
What would you do if Ivy were having an MS flare-up?
Ivy has been diagnosed with MS for over 15 years now and there have definitely been a few times over the years
when we thought she might be having an MS-related problem. Although we are not opposed to putting Ivy on
the disease-modifying MS medications if and when we ever feel her health is in jeopardy, but we know that the
medications do not come without serious short-term and potentially long-term side effects. We prefer to exhaust
all aggressive natural remedies first before resorting to powerful immune-suppressing pharmaceuticals.
One very potent natural treatment we have used on several occasions when Ivy felt her health was compromised
is intravenous glutathione. We learned about this treatment from Ivy’s neurologist, David Perlmutter, M.D., a
nationally-recognized expert for his work in treating neurological conditions with integrative medicine. Dr.
Perlmutter is the author of several books, including The Better Brain Book, and he has shown promising results
treating a number of patients with his glutathione protocol.
continued...
THE MULTIPLE SCLEROSIS HEALTHY GUIDELINES 18
The first time Ivy tried intravenous glutathione was in Dr. Perlmutter’s office in 2005 right after our first book
was published (the foreword of the book was written by Dr. Perlmutter) and immediately upon returning
home from a multi-city national book, which left her feeling completely exhausted. We were certain the intense
stress and grueling book tour schedule was contributing to MS activity and so Ivy immediately went to see Dr.
Perlmutter for advice. The first thing Dr. Perlmutter advised right there in the office was to start an IV of glutathione. Miraculously the results were practically immediate. The “brain fog”, exhaustion and overall lack of
wellbeing Ivy felt was dramatically alleviated within one-hour of the glutathione treatment. She has since used
intravenous glutathione on and off during periods of extreme stress or when she is feeling particularly run
down. And (knock on wood!) it has never failed to help.
What exactly is glutathione? Nicknamed the “Master Antioxidant”, glutathione is present in every single cell of
your body. It has a number of critically important jobs:
•
It dramatically reduces inflammation.
•
It protects and preserves the brain and other body tissues.
•
It helps the liver detoxify chemicals.
•
It recycles vitamins C and E which protect the body from free radical damage and premature aging.
•
It assists with detoxifying heavy metals from the body.
•
It protects the skin and lens, cornea and retina of the eye against radiation damage and oxidative stress.
•
It is vital to white blood cells and enhances immune response.
The downside to glutathione therapy is that it can be a hassle to find a doctor or nurse to administer it intravenously. A much more convenient (albeit not nearly as effective) alternative is to supplement your diet with NAC
(N-acetylcysteine), a modified form of the amino acid cysteine that helps the body synthesize glutathione. It is
available as both a dietary supplement and as a prescription drug. If you decide to supplement with NAC you
will want to take 400 mg a day.
He who has health has hope,
and he who has hope has
everything.
Arabian
THE MULTIPLE SCLEROSIS HEALTHY GUIDELINES 19
Proverb
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References:
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Bates D, et al. “A double-blind controlled trial of long chain n-3 polyunsaturated fatty acids in the
treatment of multiple sclerosis.” J Neurol Neurosurg Psychiatry. 1989 Jan; 52 (1): 18-22.
2.
Swank RL, Dugan BB. “Effect of low saturated fat diet in early and late cases of multiple sclerosis.” Lancet. 1990 Jul 7; 336(8706): 37-9.
3.
Nordvik I, et al. “Effect of dietary advice and n-3 supplementation in newly diagnosed MS patients.” Acta Neurol Scand. 2000 Sept; 102(3):143-9.
4.
Gallai V, et al. “Cytokine secretion and eicosanoid production in the peripheral blood mononuclear cells of MS patients undergoing dietary supplementation with n-3 polyunsaturated fatty acids.” J Neuroimmu
nol. 1995 Feb; 56(2): 143-53.
5.
Esparaza ML, et al. “Nutrition, latitude, and multiple sclerosis mortality, an ecologic study.” Am J Epide
miol. 1995 Oct 1; 142(7): 733-7.
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M. Knip, S.M. Virtanen, K. Seppa, et al. “Dietary intervention in infancy and later signs of beta-cell auto
immunity,” New England Journal of Medicine 363, no. 20 (2010):1900-08.
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D. Malosse, H. Perron, A. Sasco, and J.M. Seigneurin, “Correlation between milk and dairy product con
sumption and multiple sclerosis prevalence: a worldwide study,” Neuroepidemiology 11, nos. 4-6 (1992): 304-12.
8.
Bartke A, “Minireview: role of the growth hormone/insulin-like growth factor system in mammalian aging.” Endocrinology 2005;146:3718-3723.
9.
Ajani UA, Ford ES, Mokdad AH. “Dietary fiber and C-reactive protein: findings from national health and nutrition examination survey data.” J Nutr. 2004. May;134(5):1181-1185.
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Papanikolaou Y and Fulgoni VL “Bean consumption is associated with greater nutrient intake, reduced systolic blood pressure, lower body weight, and a smaller waist circumference in adults: results from the National Health and Nutrition Examination Survey 1999-2002.” J Am Coll Nutr. 2008 Oct;27(5):569-76
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