Multiple sclerosis (MS) is an autoimmune disease characterized by the demyelination of nerve cells in the central nervous system (CNS). This chronic inflammatory process leads to gradual but permanent neuronal damage. While there is currently no cure for MS, various dietary patterns have been proposed to mitigate the course of the disease, reduce the number of relapses, and alleviate symptoms. Among these, the Best Bet diet has gained attention, particularly due to the experience of individuals like Mathew Embry, who has lived symptom-free for over 26 years following this dietary approach. This article provides a comprehensive overview of the Best Bet diet, its principles, its potential benefits, and other dietary considerations for managing MS.
Understanding Multiple Sclerosis and the Role of Diet
Autoimmune diseases affect more than 3% of the world’s population, with MS typically beginning between the ages of 20 and 40. The disease affects women more often than men. While the exact mechanisms of MS are unknown, genetics, infections, and environmental factors are believed to play a role. A higher prevalence of MS in the US, Western Europe, and Scandinavia may be related to regional dietary habits. The Western lifestyle, characterized by low physical activity, poor eating habits, high intake of saturated fatty acids (SFAs) and simple sugars, and low levels of vitamin D, has been linked to an increase in autoimmune diseases, including MS.
Given the limited capacity of the brain to repair itself, nutritional prophylaxis and other measures to prevent disease progression are crucial. A proper and well-balanced diet can also counteract the occurrence of malnutrition in patients, which can progress as the patient’s mobility is reduced.
The Best Bet Diet: Principles and Rationale
The Best Bet Diet is based on the principle of avoiding foods containing ingredients that resemble myelin, the protective layer around nerves, including those in the brain and spinal cord. The diet aims to reduce the effects of leaky gut syndrome by avoiding proteins that trigger an immune response. It consolidates previous recommendations on saturated fats with research showing that certain proteins (gluten, casein) can interfere with immune and nervous system functions. It also builds on the research on leaky gut syndrome and therefore excludes legumes from the diet.
Key components of the Best Bet Diet:
- Avoidance of foods that resemble myelin: This includes certain proteins that may trigger an autoimmune reaction.
- Limiting saturated fats: The diet restricts saturated fat intake, aligning with observations that MS incidence is higher in areas with higher saturated fat consumption.
- Exclusion of gluten and casein: These proteins can interfere with immune and nervous system functions.
- Elimination of legumes: This addresses concerns about leaky gut syndrome, where the gut barrier becomes permeable, allowing substances to enter the bloodstream and trigger immune responses.
- Avoidance of artificial fats, high sugar content foods and processed foods: These components are generally considered detrimental to overall health and may exacerbate inflammation.
The Best Bet diet does not completely cut out gluten-free grains (e.g., buckwheat, millet) and other starch-rich food sources, making it easier to cover carbohydrate needs compared to stricter diets like the Autoimmune Protocol (AIP) or paleo diets.
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Mathew Embry's Story: A Testament to the Best Bet Diet
Mathew Embry's experience provides a real-world example of the potential benefits of the Best Bet diet. Diagnosed with MS after experiencing a sudden loss of feeling in his feet while playing soccer, Mathew began the diet created by his father, Dr. Ashton Embry, six weeks after his diagnosis. Within 18 months, his symptoms began to subside, eventually disappearing completely. For over 26 years, Mathew has remained symptom-free, attributing his success to the Best Bet diet and a commitment to daily exercise.
Daily Exercise: An Integral Part of the Best Bet Approach
Mathew Embry emphasizes the importance of daily exercise alongside the Best Bet diet. Regular exercise boosts the body’s oxygen and nutrient supplies, benefits the heart, strengthens muscles, improves blood circulation, and reduces stress. It is crucial to use and train muscles daily, even if it's just for 10-15 minutes. Activities like gymnastics, walking, swimming, strength training, or yoga can be incorporated, with a preference for cycling cardio and strength workouts. Mathew's initial choice was swimming, as the water's temperature protected him from overheating while providing ample oxygen.
Discipline and Commitment: Keys to Success
Discipline, commitment, and the power of action are central to Mathew's approach. Making healthy practices a part of life, step by step, is essential. This includes consistent adherence to the diet and exercise regimen.
GoodPhyte: A Potential Breakthrough Nutritional Aid
In early 2024, Mathew began incorporating GoodPhyte, a product developed by nutritionist and researcher Amy Puzey, into his regimen. GoodPhyte contains phytase, an enzyme that targets phytate, an anti-nutrient found in seeds, nuts, legumes, and grains. Phytate can hinder the absorption of essential nutrients like zinc, iron, calcium, magnesium, vitamin D, and amino acids. By taking phytase, individuals may experience enhanced absorption of these vital nutrients, potentially alleviating symptoms, boosting energy levels, and supporting overall well-being.
Alternative Dietary Approaches for MS
While the Best Bet diet has shown promise for some individuals with MS, other dietary approaches have also been investigated. These include:
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- Anti-inflammatory diet: Focuses on reducing inflammation in the body through the consumption of anti-inflammatory foods.
- Mediterranean diet (MD): Emphasizes fruits, vegetables, whole grains, legumes, nuts, and olive oil, while limiting red meat and processed foods.
- Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet: Combines aspects of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets, focusing on brain health.
- Intermittent fasting (IF): Involves cycling between periods of eating and fasting.
- Gluten-free diet: Eliminates gluten, a protein found in wheat, barley, and rye.
- Ketogenic diet: A high-fat, low-carbohydrate diet that forces the body to burn fat for energy.
- Paleo diet: Based on the presumed diet of early humans, emphasizing whole, unprocessed foods.
- Wahls diet: A modified paleo diet developed by Dr. Terry Wahls, specifically for MS.
- McDougall diet: A very low-fat, plant-based diet.
- Swank diet: Very low in saturated fat, fatty meat, and processed foods.
- Overcoming MS (OMS) diet: A plant-based diet that excludes meat, poultry, eggs, dairy, coconut oil, and palm oil, but recommends seafood.
Ketogenic Diet
The ketogenic diet has shown promise in various experimental models, including animal models showing marked inflammatory changes. Studies suggest that the ketogenic diet can reduce inflammatory mediators and the expression of enzymes involved in the biosynthesis of pro-inflammatory eicosanoids. A pilot study suggests that a modified ketogenic diet may benefit patients with MS by alleviating fatigue and depressive symptoms, reducing body fat and pro-inflammatory adipokines. A study involving patients with relapsing-remitting MS (RRMS) reported significant improvements in disability status, quality of life, fatigue, and body fat levels following a 6-month ketogenic diet intervention. Another study showed that MS patients who followed a ketogenic, isocaloric diet based on the principles of the Mediterranean diet, rich in medium-chain triglycerides (MCTs), for 4 months experienced an increase in lean body mass, an improvement in metabolic profile (reduced inflammation), and an increase in satiety. One theory supporting the use of the ketogenic diet in MS is its effect on the gut microbiota, increasing gut microbial diversity. Studies have shown that a ketogenic diet intervention in MS patients resulted in an increase in the concentrations of significant microbial groups after 6 months, to the extent that no differences were observed between MS patients and a healthy group.
Paleo Diet
A recently published study found that a paleo diet may be useful in the treatment of MS, reducing perceived fatigue, improving mental and physical quality of life, increasing exercise capacity, and improving arm and leg function. A study evaluated the safety of a modified paleo diet as part of a 12-month intervention among people with progressive MS. The average kilocalorie intake was 1820 ± 506 kilocalories/day and consisted of approximately 38% carbohydrate, 18% protein and 44% fat. Micronutrient intake from food exceeded individual recommendations for most vitamins and minerals. However, vitamin D, choline and calcium were not consumed in sufficient amounts, indicating nutrients of concern. Many people did not meet individual recommendations for vitamin E.
Swank and Wahls Diets
A recent study compared a modified paleo diet (Wahls) and the Swank diet in RRMS. The Wahls group experienced a greater reduction in fatigue compared to the Swank group. Adherence to both diets was associated with reduced fatigue and improved quality of life in patients with RRMS.
Intermittent Fasting
Studies on animal models have shown that intermittent fasting can affect the composition of the microbiota, enriching beneficial bacterial families. This has an immunomodulatory effect that is at least partially mediated by the gut microbiome. A clinical trial examined the effects of intermittent fasting and a kilocalorie-restricted diet in patients with MS. Both intermittent and daily calorie restriction were shown to be unlikely to be harmful methods of weight loss in this group, at least in the short term. Both calorie-restricted diets were associated with trends toward improved cardiometabolic outcomes and emotional well-being.
Antioxidants and MS
Oxidative stress is believed to contribute significantly to MS. Serum levels of antioxidant vitamins have been shown to be lower in MS patients compared to controls. Recent work has shown a decrease in levels of glutathione, the brain’s main antioxidant, in progressive MS. Patients with MS have reduced levels of total serum antioxidant capacity.
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Considerations and Cautions
It's important to note that while these dietary approaches show promise, more research is needed to fully understand their effects on MS. It is essential to consult with a healthcare professional or registered dietitian before making significant changes to your diet, especially if you have MS. Some diets, such as the ketogenic diet, may not be suitable for everyone and may require careful monitoring. Additionally, modified Paleolithic diets may carry the risk of nutritional deficiencies such as vitamin B, calcium and vitamin D.