Multiple Sclerosis (MS) Diet: Best Foods, What to Avoid, and Key Supplements

Transcript:

Melanie: Welcome to Dishing Up Nutrition, and we are brought to you by Nutritional Weight & Wellness, where we break down nutrition science in ways that actually make sense for your everyday life. Today's episode is about what to eat for multiple sclerosis, and if you're living with multiple sclerosis or someone you know who has multiple sclerosis, you might want to share this podcast, send it to them, tell them you're thinking about them.

Because our goal today is to make things very practical and hopeful and focus on what you can do so you feel a little more empowered what to eat, and maybe some key supplements to support your body if you have that diagnosis. My name is Melanie and I'm a registered and licensed dietitian, and I'm here with Brandy today.

Brandy: Hey Mel. Good to be here.

Melanie: Good to see you.

Brandy: I think this is such an important conversation. MS impacts a lot of people. In the United States, nearly 1 million people have that diagnosis, and thankfully there are medications, you know, as treatment options now.

Melanie: Mm-hmm.

Brandy: But like you mentioned today, what we'd like to do is empower our listeners to think about how their food choices, their lifestyle habits, different supplements can actually help support the progression, you know, reduce the progression and maybe even help you put that MS into remission.

Melanie: And you might have been told if you have been diagnosed with MS, that there's nothing you can do.

Brandy: Mm-hmm.

Melanie: But we've seen it in clinic.

Brandy: Yeah.

Melanie: Be arrested where nothing progresses for years. We do believe that nutrition has a big impact.

Brandy: A hundred percent.

Melanie: So, Brandy, you want to introduce yourself?

Brandy: Yeah. My name is Brandy Buro. I'm a licensed and registered dietitian here at Nutritional Weight & Wellness; been here for about five years now, coming up on my five year anniversary.

Melanie: Yeah. I'm so glad you're here with us. What a great part of the team you are.

Brandy: Thank you. You and I don't get to chat much because you are in the Eagan office and I'm in St. Paul where out paths don't cross all that much. But special day to do the podcast with you.

Melanie: Yeah. Seeing each other face to face instead of just email.

What is MS?

Brandy: Right. Well, as we get started with today's show, I just want to do a quick refresher about what is MS? What exactly is happening in the body with multiple sclerosis? Well, multiple sclerosis is an autoimmune condition. Basically the immune system is attacking itself, and in the case of MS, it is attacking the myelin, which is the protective coating around the nerve fibers in the brain and the spinal cord.

I think a great analogy for me to picture this, thinking about electrical wires, myelin is like the insulation around those wires, and when that insulation gets damaged, nerve signals can slow down or become disrupted, and that can result in sort of unpredictable symptoms in MS.

Melanie: That's a really good analogy.

Brandy: Yeah. So it's just like electrical wiring. It's not going to work if there are gaps or cracks in it, the signal is going to short and then things aren't going to work as well.

Melanie: So without proper signaling from the brain throughout the body, that disruption can lead to symptoms like fatigue and muscle weakness, balance, motility issues. Maybe it starts with numbing, tingling, vision problems and brain fog. These are all symptoms that happen, and MS basically is helping the body trying to repair that protective coating. And believe it or not, diet and lifestyle can actually promote remyelination. And when we look at the research overall, there isn't one specific MS diet that differs from the way that we would recommend eating under any other condition. The general principles of eating real food in balance, they still apply. It's not, it's not any different magic.

Brandy: Right.

Melanie: But those with MS might have to be extra careful with their diet. You're in the thick of it now, and so you have to really think every bite matters. Everybody's harming or healing. There's really no in between.

Brandy: Mm-hmm.

Melanie: And you want to focus on foods that calm inflammation because it's an inflammatory disease.

Eat an anti-inflammatory diet

Brandy: That's right. So let's talk about the mechanisms. How might diet influence MS? Well, like Mel mentioned, when you're dealing with MS, what we're trying to do is fight systemic inflammation. That is the end goal. MS is an autoimmune condition, so it involves immune cells attacking the nervous system. Certain dietary patterns can either increase or decrease inflammatory signaling in the body.

Melanie: It's kind of individualized, don't you think too?

Brandy: It can be very, yeah, it can be very individualized. But there are some, you know, basic steps anybody can take to reduce inflammation.

Melanie: Yeah.

Brandy: So think to yourself what might be inflammatory dietary patterns? I think we can agree on some things there.

Melanie: For sure.

Brandy: Do you think ultra processed foods and fast foods are inflammatory? Yes.

Melanie: If you've listened to us for 15 minutes, you know the answer is yes.

Brandy: And sugar, you know, if you listen to us, for another 15 minutes, you'll know sugar is highly inflammatory.

Melanie: Yeah. It's like sandpaper on the body.

Brandy: Great analogy. And I would say refined carbohydrates like chips and pasta and, and crackers and even cereal…

Melanie: Muffins.

Brandy: Very similar to sugar.

Melanie: Yeah. It just converts rapidly to sugar, right?

Brandy: That's right. And manmade fats like vegetable oils or deep fried foods, all of these things can increase inflammation in the body. One food I'd like to bring up is gluten. Anytime we're dealing with an autoimmune condition, I'm talking about gluten. This is one of the first things we here at Nutritional Weight & Wellness often recommend that a client eliminate from their diet if they have an autoimmune condition. We know that someone with an autoimmune disorder should be 100% gluten-free.

Melanie: Mm-hmm.

Brandy: There is a strong correlation between gluten damaging our intestinal lining and then our body having an immune response. So gluten is not doing a lot to keep that immune system calm.

Melanie: No. Right. No. For anybody.

Brandy: Exactly. More often than not when somebody has an autoimmune disorder, when they remove gluten, their symptoms start to improve as long as they’re gluten-free 100%.

Melanie: Mm-hmm.

Brandy: Along with incorporating nutrient rich real foods into their diet.

Melanie: Yeah. That was really well put.

Brandy: This isn't something that when we talk about a gluten-free diet, this isn't something that you do temporarily or maybe half-heartedly and maybe it's slip back into old habits.

Melanie: It's really heartbreaking when you have a client saying, so when can I start eating bread again? Because it feels, you know, pretty habit disrupting from what your usual is.

Brandy: Mm-hmm.

Melanie: And you really can't go back.

Brandy: You, you really to have the best outcome, it's 100% gluten-free for life.

Melanie: Yes.

Brandy: The nice thing though, is eliminating gluten, a natural side effect of that is you are usually eliminating a lot of processed carbohydrates, which we've already established are inflammatory. So there's, you know, it's not all bad.

Melanie: It's not bad. You're really decreasing your risk of all disease when you're eating this way.

Brandy: That's right. And something I think makes it a little easier to commit to is thinking about gluten-free eating and this real food diet as your medicine to treat MS and prevent it from getting worse.

Melanie: Mm-hmm. It's your treatment plan.

Brandy: That's right. And on the flip side, you know, we talk about what to avoid, but we should also be thinking about what foods are we encouraging? What should we be eat more of?

Melanie: Really good.

Brandy: Because there's still plenty to eat. We want to think about anti-inflammatory foods that are going to support that myelin. So what comes to mind?

Melanie: Real foods.

Brandy: Real foods. And I like to go towards color. You know, if you're eating in color, deeply pigmented fruits and vegetables.

Melanie: Yes. Fruits and vegetables. So we're not talking about the color that comes with numbers. Red dye number 40. Yellow dye number “hoop de who”. No, we're not talking; no one should eat numbers. So we're talking about natural foods that occur in nature that are brightly colored.

Brandy: Exactly. The more color, the more antioxidant content. Antioxidants are going to help fight oxidation and damage to cells. We also want to focus on high quality animal-based proteins, minimally processed proteins like eggs and pasture raised chickens, wild caught fish, and healthy fats, of course. Natural oils, olive oil, avocado, nuts, seeds, coconut.

Melanie: And you have to watch those nuts and seeds because you want to make sure they're not roasted in some sort of inflammatory oil.

Brandy: Right.

Melanie: Because when you pick them off the shelf, they look like real food. Roll it over, read the label and make sure it's not treated with safflower, sunflower, soybean oil, you know, cottonseed, peanut. We want to avoid those processed Franken fats.

Brandy: That's right. Yeah. That can be a source of hidden refined oils. So the only ingredient you should see is the nut or seed that you are intending to eat.

Melanie: And some salt maybe.

Brandy: And a and a little salt would be fine, but all of these foods, fruits, vegetables, meat, healthy fats, these foods are going to help you fight inflammation. Whereas the processed foods increase inflammation, and it honestly just puts stress on your body. When you're dealing with an autoimmune disease, our goal is to take as much stress off the body as possible.

Melanie: You know, and for those of you that are thinking, well, autoimmune diseases run in my family.

Brandy: Mm-hmm.

Melanie: This is just a good way to start preventing.

Brandy: Right.

Melanie: Your risks, because if you feel like it runs in my family and you're doomed, that's really not true.

Brandy: Mm-hmm.

Include omega-3 fats

Melanie: So let's talk more specifically about foods to focus on after an MS diagnosis. Because you go into it thinking now what? We have ideas and one thing is omega-3 fats are one of the biggest ones to focus on. They're anti-inflammatory. They support nerve membranes. Some great sources to include are going to be fatty fish like salmon, sardines, anchovies, mackerel.

We prefer most of our omega-threes to come from animal sources that provide EPA and DHA, which are the forms best used by the body. And this is important because the myelin itself is about 70 to 80% fat. So those healthy fats really do matter.

Brandy: Absolutely, makes a lot of sense. And it matters that we're getting good quality fat, and there is a type of omega-3 fat that is especially important in this process. And that's DHA. You did mention the EPA and DHA. Those are kind of the primary omega-3 fats that we benefit from.

Melanie: Mm-hmm.

Brandy: But DHA is a major structural fat in brain cell membranes. And that myelin, so DHA actually helps the myelin become a little more flexible, so it's more resistant to damage. But it can also help repair that myelin if it has been damaged.

So, DHA from that fatty fish, extremely important for somebody with MS. Some people I recommend supplementing with DHA, just as kind of an insurance that you're getting…

Melanie: Especially if they have that, the diagnosis of MS.

Brandy: Mm-hmm.

Melanie: I agree. And I kind of do as heavy as, as their budget will allow.

Brandy: Yeah.

Melanie: Because it has been really, really helpful.

Brandy: Or we may even talk about like a really high quality omega-3 supplement that has a good amount of DHA in it.

Melanie: A really good starting place.

Brandy: Yeah.

Melanie: Yeah. And a large study in Sweden published in the Journal of Neurology, Neurosurgery and Psychiatry, found that people with MS who ate more fish had a significantly lower risk of their disability worsening. So for an MS supportive plate, we love to see fatty fish show up several times a week. And what might that look like?

Maybe baked salmon with roasted veggies and a drizzle of olive oil or avocado oil. Might be sardine smashed with avocado and lemon spread on gluten-free seed crackers. I like to use sardines like tuna, not the sardines of our youth where you open the can, you see the eyes and the whole fish.

It's just not the same. And then mackerel, herring as part of a hearty salad with greens, olives, and vinegarette. You can use those sardines and you can make a really good Caesar dressing.

Brandy: Yes.

Melanie: That's a way to drizzle it on there. So, you know, they provide these essential nutrients for our brain.

Choline is supportive

Brandy: Another nutrient that I'd like to mention is choline. So choline is required to make cell membranes of the myelin. So I think the superstar food for choline is egg yolks. Fantastic source of choline. So don't be afraid of those yolks. Eat the yolks.

Melanie: Yes. And the deeper the color and the more free range, the better.

Brandy: So several eggs a day, great source of choline, and that would be perfectly fine and safe to have a few eggs every single day. We also get a little bit of choline in beef, liver, poultry, fish. There are smaller amounts in plants like cruciferous vegetables. So as long as you're sticking to that real food diet and incorporating eggs regularly, you should be getting a good amount of choline. But those eggs; again, eat the yolks.

There's essential nutrients in them, not just choline, but if they're pasture raised, there could be some omega-3 in there as well. And not to mention just a great source of protein.

Include adequate animal protein

So I think we do need to talk a little bit more about protein, the importance of animal-based protein.

Melanie: I agree. Always the protein.

Brandy: Always with the protein. Well, protein is providing us the amino acids that are literally building every tissue in our body, and that includes our nerves, our muscles, and our immune cells. So we need amino acids from protein for proper nerve signaling, and we need protein to repair damaged tissue. And support our immune system.

And remember, MS is an immune mediated disease, which means our immune system is a little confused. It's dysfunctioning, it's attacking itself, and it's causing this inflammation throughout our body. So we need to do all that we can do support our immune system. And protein is just one way that we can do that.

Melanie: And who doesn't want a strong immune system year round?

Brandy: Of course.

Melanie: So here's something interesting. When it comes to protein and neurological diseases, muscle loss or sarcopenia can actually accelerate disability progression in neurological diseases like MS, Parkinson's, ALS, stroke, because muscle and the nervous system function as a connected system, you know, they're all buddies.

They all work together to support each other. And when muscle mass declines, it worsens the impact of neurological damage. And the body really can't compensate for that damage without adequate muscle mass. For example, a person with strong muscles may be able to tolerate partial nerve dysfunction, but someone with sarcopenia or low muscle mass may lose the ability to walk or climb stairs more quickly.

So just, it is really one more reason why we're always pushing to get your protein in. I saw a meme on Facebook where it showed a woman, sadly eating cottage cheese, and it said, I feel more pressure to eat protein now in my thirties than I did peer pressure for drugs in my teens.

And I thought that was hilarious because if you feel the protein pressure, you, you are not alone. It really feels like a part-time job if that's not something you've been doing.

Brandy: Yeah.

Melanie: But it really is so important for conditions that affect mobility.

Brandy: Yeah, and just thinking back to the, its role in supporting muscle mass, you know, they've been calling muscle our organ of longevity. And I think you just explained part of why that is the case.

Melanie: Yeah.

Brandy: So in the case of protein, if you're feeling pressured to eat it, my answer would I would say just say yes.

Melanie: I would say just say yes because the body is magic. It will, if you are not eating enough protein, it's going to source protein from bone and muscle.

Brandy: That's right.

Melanie: So the very thing that we don't want to lose. If we're not eating enough protein, we're going to accelerate that loss. And when you want mobility with MS, you need that muscle integrity to keep your mobility.

Brandy: A hundred percent.

Melanie: So we're ready for our first break and we will be right back to tell you more about multiple sclerosis.

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Brandy: Welcome back to Dishing Up Nutrition. My name is Brandy Buro and I'm here with Melanie Beasley. And we are talking about MS. And the best foods to eat for MS. So before break, we were talking about the important role protein plays in supporting a healthy immune system and supporting muscle mass and mobility in MS.

A couple other things that I want to point out when it comes to protein is we are getting some crucial nutrients that support our immune system, B vitamins and zinc.

Melanie: Mm-hmm.

Another important role of protein: blood sugar balance

Brandy: But something that I really want to call attention to is its role in blood sugar balance.

Melanie: Yes.

Brandy: Balancing blood sugar is going to be a, a top priority when it comes to diet and MS. Fatigue is one of the top symptoms with MS. And balancing your blood sugar is one thing that you have control over that can help regulate your energy levels.

Melanie: And that protein is so key. And don't you hear it from clients that when they start optimizing the amount of protein they're eating, their energy is so much better.

Brandy: Absolutely. 

Melanie: It’s a win.

Brandy: Yes. When you're eating enough protein, we are not experiencing as many blood sugar spikes, therefore, we're not experiencing as many blood sugar crashes, and that's when people's energy really starts to tank.

Melanie: And you just awful need that nap in the afternoon.

Brandy: Yeah. Totally. So to balance blood sugar, of course we need enough protein. We also need enough fat. But it's really important that you're choosing your carbohydrates responsibly.

Melanie: Responsible “carbing”.

Brandy: That's right. So we are, we're aiming for, again, those colorful fruits and vegetables; non-starchy vegetables, low sugar fruits, those are going to be the best for your blood sugar control.

Melanie: Skip the gluten-free crackers. Skip the gluten-free pasta.

Brandy: Yep.

Melanie: Because what color are they? They're bland, tan, and bland tan never serves the body well.

Brandy: That's right.

Melanie: Color, color, color. That's what we're going for.

Brandy: Eat the rainbow.

Melanie: Eat the rainbow.

Brandy: And remember those colors, every time you see a colorful fruit or vegetable, you're getting a good amount of antioxidants that are going to fight the inflammation and support your immune system. So colorful fruits and vegetables packed with antioxidants. They're preventing the oxidation, and reducing stress on the body.

Melanie: So listeners think about if you opened your refrigerator, if Brandy and I came over and we looked in your refrigerator, would you feel like, look, I have all the colors of the rainbow. Look, I've got bright, beautiful colors of lots of antioxidant ladened fruits and vegetables. Or would you think I've got bland, tan?

Brandy: Mm-hmm.

Melanie: So think about that and just do better.

Brandy: Yeah. Go shopping, pick three colors.

Melanie: And then actually eat them.

Brandy: Or one little hack, you know, simple. Get a bag of frozen mixed vegetables; stir fry mix. There you go.

Melanie: Love that.

Brandy: You've got probably three different colors in there, right there. And you don't have to wash or cut anything.

Melanie: Yeah. There's this mix that I found, I found in one of the big box stores, I think Costco, and it is the only oil used is olive oil. And it's this wonderful mix of vegetables that you could roast.

Brandy: Nice.

Melanie: I'm obsessed with it. It's so good.

Brandy: That sounds awesome.

Melanie: And then I just feel so righteous, you know? I've had a really good meal. I just pair it with a protein and all I had to do was put it in the oven at 400 for like 15, 20 minutes and I've got this great meal. I didn't have to chop.

Brandy: Mm-hmm.

Melanie: So there, you know, there are places to source something if you're feeling like you can't food prep…

Brandy: Yeah.

Consider removing/limiting grains to reduce inflammation

Melanie: …with this diagnosis. You have options and you know, I really want to talk about foods that may increase inflammation a little bit more. We already talked about eliminating gluten. That is huge. It affects everything. It can increase pain, it can increase digestive issues. The list goes on and on. Some people with an autoimmune disease may really have to avoid grains in general because they're just too inflammatory for them.

Brandy: Yeah.

Melanie: And so I, I personally, I, I'm not someone who eats rice. I don't eat corn. I don't eat gluten or wheat. I've eliminated grains for the most part. I'm not perfect, but I feel better. And I know that a lot of my clients feel better. Well, when you have MS, they can be very inflammatory, so it's something to work on…

Brandy: Mm-hmm.

Melanie: …with maybe a dietitian to figure out how to swap this for that. So you're just not in deprivation brain.

Brandy: Right.

Melanie: But regardless, even if you can tolerate a little whole grain, we really want to watch carbohydrate intake because you get that spike in your blood sugar. And with that comes inflammation,

Brandy: Right.

Melanie: So, you know, all carbs turn into sugar. So I'm not saying all carbs are bad, but we want to look at the source and are we risking it for the biscuit, right? Is it something that's going to do my body well? A carbohydrate source such as a, a big, colorful blackberry, blueberry, or purple cabbage, you know, these come with carbs.

But they're helping our body with inflammation. But sugar directly competes with vitamin C at the cellular level, essentially pushing vitamin C out, also other minerals out. We need enough magnesium; competes with magnesium and calcium, so sugar just doesn't serve us well.

Brandy: No. Especially when you think of its impact on your blood sugar. And now you bring up good points about the immune system. So it's just not really worth the risk.

Melanie: And you know, the crackers and the pasta, the cookies. I mean, they all convert rapidly to sugar.

Brandy: That's right.

Melanie: So if it comes from a factory, it's a Franken food.

Brandy: That's right.

Melanie: So we want to eliminate those Franken foods. And if you know you're having that gluten-free cereal or toast, just eliminate those. Just get to real food.

Brandy: Yeah. Even though it's gluten-free, still a highly processed food.

Melanie: Yeah. So when you have toast, I have a client and she will bake a sweet potato, and she slices it and toasts it and uses a slice of that as her toast.

Brandy: Perfect.

Melanie: Beautiful.

Brandy: I love that.

Melanie: I love a brilliant idea from a client that I can borrow.

Sample day of food for MS support

Brandy: Same. Well, maybe we should just think through what a day may look like.

Melanie: Yeah,

Brandy: We're kind of throwing all these ideas, what you should, what you shouldn't eat, but how does this actually boil down into what am I actually eating?

Melanie: So let's start with breakfast.

Brandy: Yeah, breakfast. So I think my breakfast is actually a great example.

Melanie: Let’s toot Brandy's horn. Okay.

Brandy: Yes. You know, I am, I am hooked on this specific formula for my breakfast. In my pan, put either a little olive oil or some grass fed butter.

Melanie: Mm-hmm.

Brandy: And then I throw in some mushrooms, a little bit of kale and some chopped bell pepper.

Melanie: Yummy.

Brandy: And then I crack in two or three eggs. That's my like little breakfast frittata. I often will put, maybe like a little ham or something just to kind of round out my protein needs.

Melanie: Oh, that sounds delicious.

Brandy: Yeah. If I have berries, I'll do a handful of raspberries or blueberries or today it was a clementine orange.

Melanie: Wow. I love that.

Brandy: Yeah. So that way I'm getting my color, I'm getting my vegetables, and I'm getting my protein and a little choline from those eggs.

Melanie: So I want to brag on breakfast. I know you took breakfast, but I have to brag on this breakfast I made on Saturday for my husband and I. So I had some chorizo that I had made, and then I also had Mexican stir fried rice. So I decided to make a Mexican bowl, with the stir fried cauli rice.

Brandy: Yeah.

Melanie: And the chorizo. And so I poached a couple eggs, put that in there. We chopped, I chopped up some lettuce that was going to go south quick, that was in there.

Brandy: Mm-hmm.

Melanie: I pickled, quick pickling with onions and sweet onions and purple cabbage.

Brandy: Ooh.

Melanie: And that was in there. And then we used a little salsa verde on top. He did, I can't do avocado, but he did avocado slices.

Brandy: I love that.

Melanie: So good. I was using up leftovers, and it was full of protein with the chorizo and the eggs, and it was something different.

Brandy: Something different.

Melanie: Using up leftovers.

Brandy: I love that. You feel ultra righteous.

Melanie: I did. I felt like a dietitian. So lunch.

Brandy: We're rocking it for breakfast. What's going on for lunch?

Melanie: Lunch, one of my favorite things that I do, and I will even do it at work, in our air fryer we have in the back, is I do salmon.

Brandy: Mm-hmm.

Melanie: So lunch today, salmon, I air fry it. I actually put it in frozen and air fry it on the French fry mode and it cooks it up great. But I also did carrot fries and cauliflower roasted, sprayed with avocado oil, little seasoning salt, roasted them till they were crispy and tender and had carrot fries and some roasted cauliflower and salmon.

Brandy: Love that. So you're getting your omega threes in.

Melanie: It didn't take a long time.

Brandy: Yeah.

Melanie: I was cooking, I was chopping, I chopped up the carrots into fries.

Brandy: Perfect. Delicious.

Melanie: Makes you feel like you're eating French fries.

Brandy: That is my weakness. And I do love an air fryer carrot fry, for sure.

Melanie: Yes.

Brandy: Well, let's think through a snack, a good snack or two. We still want to maintain that balance. Protein, natural fats, and some vegetable carbs.

Melanie: Yeah. Good.

Brandy: So lately I've been making a vegetable dip with some avocado oil mayonnaise.

Melanie: Hmm.

Brandy: And I've got like an herb seasoning. It's just got like some tarragon, dill, basil, and I'll do just fresh cut peppers, cucumbers. Protein, I may even do a hard-boiled egg again.

Melanie: Yeah.

Brandy: Or if I've meal prepped some turkey meatballs or our wild rice meatballs from our website, I'll do one or two of those to get my protein in. Great side dish. You can batch cook it; it reheats really well.

Melanie: But I love to food prep meatballs and use meatballs as my snack because apple and peanut butter, peanut butter's not really a good source of protein…

Brandy: Good point.

Melanie: …Like people think. It's, it really is…

Brandy: More of a fat.

Melanie: More of a fat, and it's a little more inflammatory versus a sunflower butter.

Brandy: Sure.

Melanie: Or an almond butter. So if you would love that half an apple and some nut butter…

Brandy: Mm-hmm.

Melanie: …you need to pair it with some sort of protein, a beef stick, a meatball, a chicken leg. Or hard-boiled egg.

Brandy: Yep. Perfect. Then we grab that balance in there.

Melanie: Yep.

Brandy: All right. And then to complete our day, a nice balanced dinner.

Melanie: I love always dinner to be a green salad. So it is going to have lots of greens. I always put the purple cabbage in there. I always chop up, I love curly kale. So if you don't love curly kale, you can do some other type of green that you love in there. Maybe you could do spinach or you could throw in some romaine in there.

Brandy: Yeah.

Melanie: And then once you've got that big green salad base, you could put anything in there. So I love to add some pistachios. I love to add some blueberry. Sometimes I will chop up a green apple, half of a green apple in our salad. I love the crunch in there. And then, you, all you have to do is pair it with protein.

Brandy: Yep.

Melanie: Sometimes I'll roast some sweet potatoes. I might use those in there, or beets.

Brandy: Mm-hmm.

Melanie: Not too much. If I'm doing it with apple, it might be like a fourth cup of each.

Brandy: Mm-hmm.

Melanie: So my total's a half a cup and then I pair it with a protein. Last night it was chicken thighs.

Brandy: Yeah. I did something very similar. Last night we did steak salads, so we had some sirloin steak on a bed of greens with roasted beets and like a balsamic vinegarette. Very good; some pecans on there.

Melanie: Oh, yummy. You know, we went out to dinner last weekend with my daughter and her husband and they had pomegranate seeds.

Brandy: Mm, yes. Fun.

Melanie: Which is a huge antioxidant in there. And I thought, I forget about these things. So I need to add those.

Brandy: It's a labor of love to cut into one of those, but it’s worth it.

Melanie: I have a device off Amazon that you literally, you just put half of the pomegranate in there and you put it over this thing and you smack the snickers at the top of your pomegranate. And all the seeds go in with none of the pit.

Brandy: I'll have to look into that.

Melanie: Somebody has gone before us because I used to pick them out and that's, that is a labor of love.

Brandy: Yeah for sure. Well, this is, I think, an example of a very colorful day and we are getting a good amount of protein, some healthy fats, lots of antioxidants from those vegetables. So really this is, I would consider this kind of, you know, a base camp if you have a MS or if you are trying to prevent the development of an autoimmune disease, like go back to this way of eating.

Supportive supplement considerations for MS

Melanie: it is your base camp. I love that because real food is, is foundational to healing, and you cannot out supplement or out-medicate a poor diet. For those of you who are concerned about MS or autoimmune disease, you want to make sure you're supplementing with vitamin D. I like vitamin D paired with K.

Brandy: Me too.

Melanie: Vitamin K. And it's one of the simple things that you can do to lower your risk of autoimmune disease. Certainly if you've already been diagnosed with MS, you want to prevent relapses or further damage. Vitamin D is foundational. So you might reach out to a nutritionist if you want to know dosing based upon your levels. But it's good to get tested.

Brandy: Right.

Melanie: And then our next favorite is a mineral, magnesium.

Brandy: Yes.

Melanie: Which is like protein, I feel like it's, she's trending.

Brandy: For good reason.

Melanie: So she is really a costar in every nervous system conversation that we have. Magnesium can help with muscle spasms, nerve signaling, and improving sleep. These are all very important components of healing and dealing with MS.

Brandy: Right.

Melanie: Most people are going to need 200 minimum.

Brandy: Yeah.

Melanie: 400 optimal. And I've done more if someone is really having some neurological and some muscle issue. There's a form called Magnesium Threonate that crosses the blood brain barrier. It's particularly helpful for brain focus and migraines. You could take the threonate during the day, and then the glycinate form, which is really the most readily available form for muscles and also helps with your sleep, relaxation, and anxiety.

Brandy: True.

Melanie: So all of these things that come hand in hand with the autoimmune disease, multiple sclerosis, you know, there are ways to optimize. If you're feeling overwhelmed, oh my gosh, Brandy and Melanie, you're just talking about too much, we are here at Nutritional Weight & Wellness to help you sort through what should your stack look like for supplements.

Brandy: Yep.

Melanie: How should your meals be? We are here to sort that for you. That's what we do and that's what we love to do.

Brandy: That is our life. We've come up with a system, we'll send you home with a very organized plan.

Melanie: That's tailored for you.

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Brandy: Absolutely. If I were to add one other supplement to this protocol, often with MS, I'm talking about vitamin B12. So a deficiency of vitamin B12 can actually mimic some of the neurological symptoms that happen in MS. So it, it just makes a lot of sense to make sure you're getting enough, supplementing with a multivitamin that has vitamin B12 in it. It's kind of a no brainer.

Melanie: And the vitamin B12 form that you should have, it should say methyl.

Brandy: That's right.

Melanie: Methylated in the form. And then, you know, I think I read a study that 60% of us have methylation issues.

Brandy: Mm-hmm.

Melanie: So I don't want to get, go down that rabbit hole, but we need methylated B12.

Brandy: Yep.

Melanie: And it, it's helpful for cardiovascular health. It's helpful for so many things.

Brandy: That's right.

Melanie: And when we're under stress, we burn through B vitamins faster. And that's especially relevant for MS. So maybe you think, well, I got tested and they said my B12 was fine. Are you taking a B vitamin prior to being tested? Because the test is going to pick up what's, what's floating around in your bloodstream? So you want to be off B vitamins?

Brandy: Yeah.

Melanie: At least two to three days prior to being tested. Or you'll get a false high.

Brandy: Right.

Melanie: B vitamins are water soluble. Nothing's scary there.

Brandy: Mm-hmm.

Melanie: But if your B vitamins are very low, it can be very exhausting. So not to mention the neurological problems that you can experience, like the numbness and tingling. So for someone with nerve function, you know that being the focus, I like to make sure they're using a good quality multi complex with methylated B vitamins for better absorption.

Brandy: Yes. All good points, especially when getting your levels tested, so important to know what your true levels are, so you know how much you need to supplement with. And when it comes to energy, you mentioned energy, Mel, another thing I think of is CoQ10.

Melanie: Yeah.

Brandy: CoQ10 helps with mitochondrial function. It can help prevent fatigue. It can be very energizing. So take that in the morning so you're not up all night. But that, that's also often in my protocol for MS, just to boost energy.

Melanie: Yeah. And I like 200 to 300 milligrams.

Brandy: Mm-hmm.

Melanie: Which, you know, seems like a lot, but that's a really good dosing.

Brandy: Yeah.

Lifestyle factors to support the brain repair process

Melanie: And finally, let's talk about lifestyle factors that support the brain's repair processes. So for clients with MS, I like to encourage them to move their bodies every single day. Motion is lotion.

Brandy: That's right.

Melanie: Keep moving. You want to use it, so you don't lose it. And daily movement is really necessary for protecting those neurons and even moderate exercise like a stationary bike, walking, something that you feel comfortable doing with whatever your limitations are.

Sometimes like a client today, I just had her do, we live in Minnesota. Everything is iced over right now, so I have her, my clients do functional exercise and it might be something as simple as you, every time you go to the bathroom, you pull up your pants and you do touchdowns. Right? You act like you're going to sit back down, but stand back up, sit back down, stand back up. Do 10 of those. The next time you go to the bathroom, maybe you're doing counter or wall pushups.

Brandy: Mm-hmm.

Melanie: But after you've done that, every time you go to the bathroom, hopefully you're hydrating. So you're going to the bathroom almost every hour. You've got a workout in.

Brandy: That's right.

Melanie: And it felt like you didn't have to change your clothes, you didn't have to go to the gym, you didn't have to sweat.

Brandy: Mm-hmm.

Melanie: But it's functional exercise. But if you can do above and beyond that, such as a Zumba class, or a workout class or walking.

Brandy: Mm-hmm.

Melanie: All good. All good. Motion is lotion.

Brandy: It all counts. It all contributes to this goal. And I do want to talk about sleep. We know sleep is critical for brain repair for everybody, but especially if you have a condition that impacts brain function like MS. Myelin producing cells are actually more active while you sleep, and that's just one reason why prioritizing that, that magic number seven and a half to nine hours of sleep every night is so important.

Melanie: So important.

Melanie: This is when we restore and repair is during sleep. So if you're struggling with sleep, we are here for you at Nutritional Weight & Wellness.

Brandy: Right. We, there are so many, sleep solutions and again, they're often very personalized, depending on the person. But one thing that I encourage my clients to do that can be helpful in just kind of establishing a healthy circadian rhythm is get outside first thing in the morning. Expose your eyes, your face to that day, that sunlight early because that's going to help regulate your circadian rhythm.

Melanie: And even if it is overcast, the lumens are still high enough. You're getting benefit.

Brandy: That's right. So it doesn't matter if it's cloudy, you're still getting benefit from the sun. On the flip side, getting some exposure to the sun setting can also help regulate and prepare your brain for sleep.

Melanie: Love that. Who doesn't love to watch a sunset?

Brandy: Right?

Melanie: And a sunrise.

Brandy: So two simple tips to help get your sleep on track. But being consistent with a normal bedtime and a normal wake time can also help with that situation too.

Melanie: And we at Nutritional Weight & Wellness, we have seen in clinic many great stories with MS, and we have several long-term clients that have successfully put their MS into remission through diet and lifestyle changes. They're feeling good, so it is possible. One of our clients, she doesn't even have to go back to the doctor anymore because of her good results.

Her success story is on our website, so even if you end up taking a medication for MS, we still encourage you to follow that real food diet and move your body because it's going to help your body heal no matter what. You know it's a team effort. It's a team effort. So the nutrition, the lifestyle, the medication, your doctor visits all work together.

Brandy: That's right. The next step for you might be meet with that dietitian who understands MS and let them know, these are my meds, these are my labs, these are the symptoms I'm dealing with. What makes sense for me? Do I need magnesium? Should I be supplementing with vitamin D?

That individualized support is where we see people thrive, and as dietitians, we recognize that MS is a very complicated and chronic disease. Most clients do need that ongoing support. I mean, we're here for you whenever you reach for that help, but we can be in your corner throughout this whole process.

Melanie: You know, changing the way your lifestyle is, your diet, you need someone who's supporting you because you're turning a cruise ship, you're not turning a sports car. So it takes some time to really regulate and maintain habits that are going to support this whole process.

Brandy: Exactly.

Melanie: And we hope today's show gave you some concrete ideas to start with. If this show resonated with you or you know someone navigating MS, please share it with them. It's your way of saying, I was thinking of you. I care about you, and if you'd like help personalizing all of this, our dietitians and nutritionists are available for one-on-one counseling.

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All of us can help you. It's often covered by many insurance plans, and you can visit our website, weightandwellness.com, or give us a call at (651) 699-3438 and find out more about our counseling and our insurance coverage so that we can support you in the journey.

Thanks for joining us today on Dishing Up Nutrition. Our goal at Nutritional Weight & Wellness is to help each and every person experience better health through eating real food. Thank you for listening today and enjoy your day.