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Fuel for Brain Power
By Dr Joanna McMillan
If you’re living with MS you have probably become somewhat of an expert on the brain. It is after all central to so many of the symptoms you experience. So trying to keep your brain healthy and able to function as well as it can is clearly key. This is the goal of many medications and therapy, but what about diet?
Although many physicians remain sceptical about the role of diet in MS, there are many more coming on board to accept its importance. A unifying consensus on the best diet is however currently lacking. Any internet search is liable to leave you further confused. I previously wrote about the low fat, vegetarian diet approach of Dr Roy Swank and this certainly seems to have the most solid evidence base behind it. But there are now anecdotal reports of those with MS trialling Paleo diets – the idea being to imitate as closely as possible the diets of our hunter-gatherer ancestors – and claiming impressive results.
It can be hard to know which way to turn and it’s easy to be swayed by one person’s powerfully told own story. Try not to let this happen and instead step back and look more broadly at the evidence.
For all of us a healthy diet is important for our brains and we know much about the nutrients the brain needs. This does not change when you have MS and in fact while the two dietary approaches above may seem diametrically opposed, there are in fact similarities of factors that are good for the brain.
So let’s take a look at what we know to be important for brain health.
1. Cut back on saturated & trans fats
This is the key component of Dr Swank’s dietary approach and he favours a very low saturated fat diet. The Paleo diet, contrary to what some people seem to think, is in fact also low in saturated fats if you follow it properly. Although it has more meat, it encourages grass-fed and wild meats while shunning modern feedlot produced grain-fed meat. The former are far lower in total and saturated fats and higher in omega-3s – more on those to come.
Several studies have found that those who eat a high intake of saturated fat have a higher risk of cognitive decline and dementia as they age. This may or may not be due to saturated fat itself, or a high saturated fat intake may be a marker for a poorer overall diet and less of the nutrients the brain needs. Other studies have associated saturated and trans fats with a worse memory and poorer brain function.
What it certainly means is that a diet of fatty meats and meat products, pies, pastries, cakes, biscuits and deep fried foods – all high in saturated fat – are not good for brain health, whether you have MS or not.
2. Eat more omega-3s
These long chain fats are found in concentrated amounts in the brain and so we know they must be important for optimal brain function. They have been shown to reduce inflammation in the brain and promote the growth of new brain cells.
We know from research that those who eat a lot of fish – high in long chain omega-3s - have a lower risk of dementia. When it comes to MS the research is starting to build. A 2015 study published in the Multiple Sclerosis Journal found a decreased risk of a first clinical diagnosis of CNS demyelination in those that ate a higher amount of omega-3s, particularly from fish. More recently a pilot study published in Experimental Biology and Medicine concluded that giving omega-3 supplements as part of a semi-vegetarian diet may ameliorate some of the physical symptoms and reduce inflammation.
You will find shorter chain omega-3s in some plant foods, including chia, flaxseed and almonds, but we have only a limited capacity to use these to make the long chain ones (called EPA and DHA) that are ultimately important for the brain.
To boost your intake of these directly tuck into oily fish such as salmon, trout or sardines two or three times a week (yes the canned ones count). You could also consider taking a good quality supplement.
3. Make extra virgin olive oil your pantry staple
People who eat more monounsaturated fats score better on cognitive tests, while those that eat a Mediterranean style of diet have been shown to have a lower risk of cognitive decline and Alzheimer’s disease. It may also play a protective role in MS too.
Extra virgin olive oil (EVOO) contains a wealth of phytochemicals including a group of phenolic compounds known to be anti-inflammatory but also neuroprotective. Scientists are therefore keenly investigating the use of EVOO in preventing and treating diseases that affect the nervous system including MS. A phenol of particular interest is oleocanthal as this has been shown to stop the enzymes involved in the demyelination process.
Extra virgin olive oil is made up of predominantly monounsaturated fat and this is very stable in cooking and in the body. By avoiding too many omega-6 fats found in seed oils, having EVOO actually helps you to absorb and utilise more of those fabulous omega-3s.
It’s a myth that you can’t cook with extra virgin olive oil. Being a mono fat makes it very stable and less prone to oxidation than polyunsaturated fats, plus the antioxidants help to protect the oil. Make it your pantry staple for cooking and dressings. It even helps you to absorb more of the antioxidants in your vegies – it’s a win-win!
4. Go for smart carbs
The brain is a glucose greedy organ. Compared to other animals we have very big brains and they use a lot of glucose to fuel the hard working brain cells. The brain will therefore work best if there is a nice consistent, steady supply of glucose via the blood.
If you’re eating poor quality foods full of added sugars and refined starch – think rice crackers, highly processed low fibre cereals, white bread, banana bread, muffins, cakes, lollies, soft drinks, energy drinks, low fat snack bars, white rice etc. - and eating them regularly throughout the day, your blood glucose levels will be all over the shop!
Immediately after eating your blood glucose will be sky high, but quickly followed by a rapid trough an hour and half or so later. Your brain picks up this drop in blood glucose and sends you signals to eat again – the brain doesn’t like low blood glucose. So you enter that cycle of eating every couple of hours, relying on sugary or starchy foods to pick up your energy levels and concentration. That’s bad news for brain health, not to mention weight control and overall vitality.
Instead go for what I call smart carbs. These are nutrient and fibre rich, but also low GI. This means they are digested and absorbed slowly, trickling glucose into your blood and providing a steady stream to the brain. Smart carbs include wholegrain low GI breads (sourdough a great option), muesli or oats, some high fibre cereals, legumes (chickpeas, beans, lentils), barley, quinoa, amaranth, buckwheat (including soba noodles), wholegrain pasta, brown basmati rice and most fruits.
5. A plus for caffeine!
While we usually think negatively about caffeine and coffee, it seems that they just might be good for the brain. Coffee has previously been associated with a lower risk of Alzheimer’s disease, while just this year two studies have been published from the US and Sweden showing a decreased risk of MS with a high consumption of coffee.
While we need to understand more about the impact of coffee on disease progression, at least one study published in 2012 found that the more coffee consumed, the slower the progression of disability in relapsing onset MS (although not in progressive onset MS).