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Nutritional knowledge: a medical blind spot?

I am often asked why, if changing your diet can bring health benefits for people with MS, doctors do not suggest this as an option.

The answer is, of course, that nurses and medical students in the UK are taught very little about nutrition, or the way that what we eat affects the way our bodies work. This means that neither your GP, your neurologist nor your MS nurse are likely to suggest that altering what you eat could have a positive effect on your MS symptoms. Another reason is that it is difficult to test the effects of diet on patients using the same sort of double-blind clinical trials that pharmaceutical companies use to test drugs, and at present these are the only kind of trials that most doctors regard as reliable proof that a treatment works.

A recent edition of Radio4’s The Food Programme, discussed the woeful lack of training given to doctors in the UK on nutrition. This is strange, when it is estimated that between 60 and 70 percent of patients visiting GP surgeries are suffering from conditions that have their roots in how they live, and in particular, how and what they eat. In my opinion MS, like Type 2 diabetes or obesity, often has its roots in faulty diet. Changing what I ate certainly made a huge and positive difference to the progression of my MS.

Now, at last, things are beginning to change. Medical students are starting to request guidance on nutrition, and the Royal College of General Practitioners has approved a Culinary Medicine programme, which will help doctors to discuss food knowledgably with their patients. US medical schools are already running a similar programme. In the beginning, it appears this is going to be solely about healthy eating, rather than specific eating plans for specific illnesses. However, a healthy diet, rich in whole foods and vegetables, is definitely a good place to start for anyone with MS

NHS doctor, Rupy Aujla, is heading up the Culinary Medicine programme here in the UK. Like Professor Jelinek, who pioneered the Overcoming MS diet, he advocates other lifestyle changes, as well as a healthy diet, in order to maximise physical and mental wellbeing. These include regular exercise, adequate sleep, and either mindfulness or meditation.

One of the most effective ways to start to eat more healthily is to cut down radically on the amount of sugar you eat. Research at the University of Alabama has shown that white sugar has a rapid and adverse effect on the ability of white blood cells to fight infection. If, like many people with MS, you get a lot of bladder infections, this could be a good reason to reduce your sugar intake. But you don’t have to give up sweet treats altogether. I’ve been making sugar-free cakes for years, and I now much prefer them to  traditional sugar-laden recipes. This month’s recipe is an example of a cake that uses fruit and maple syrup instead of sugar to provide sweetness. Bear in mind, though, that although maple syrup is a healthier alternative than refined white sugar, it still contains a lot of natural sugar, so don’t eat too much of it.

Further reading:

The Doctor’s Kitchen by Dr. Rupy Aujla (Harper Collins, £14.99). - Copyright 2020 - No images or text may be reproduced without express written permission of Tessa Buckley

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Banana and Walnut Tea Cake

I used gluten-free flour in this recipe, as I eat a gluten-free diet, but you could try replacing this with wholemeal wheat flour.  In the same way, you can replace the margarine with butter, if dairy produce is part of your diet, and use skimmed cow’s milk instead of plant milk. Make sure any margarine, you use is unhydrogenated, as the hydrogenation process is now widely considered to be harmful to health.

Unlike a traditional cake recipe made of white flour, white sugar, butter and eggs, this one includes ingredients which are full of vital nutrients: walnuts (B vitamins, calcium and magnesium); banana (potassium); maple syrup (zinc, potassium, manganese, iron, magnesium); and cinnamon (antioxidants).

200g gluten-free flour

2 ½ tsp gluten-free baking powder

1 tsp ground cinnamon

½ tsp ground ginger

½ tsp nutmeg

60g unhydrogenated margarine such as PURE sunflower margerine

3 tablespoons liquid honey or maple syrup

200g mashed banana

50g chopped walnuts

50g raisins

150ml rice or soya milk

Heat oven to 180c (Gas 6) and grease and flour a 500g loaf tin.

Mix dry ingredients in a bowl and rub in margarine to form a crumb-like mixture. Add in everything else except the milk, and stir well. Then add milk gradually to form a soft dropping consistency. If the mixture is too stiff, add a little more milk.

Bake for 1 – 1 ¼ hours, or until a knife stuck into the centre comes out clean. Leave for half an hour before removing from tin. Slices can be eaten as they come, or spread with butter or margarine.

To store: Wrap in tinfoil and keep in the fridge, or freeze individual slices for future use.

June, 2019