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BEST BET DIET

Ashton Embry

The formulation of an effective treatment for MS clearly depends on knowing the cause of the disease. The Best Bet Diet assumes that dietary factors are the main cause of MS onset and progression because such a cause best fits the extensive epidemiological data base and is theoretically plausible.

The basic elements of a dietary model for MS are the escape of intact food proteins through a leaky gut and subsequent activation of the immune system. The immune system is activated against tissue in the central nervous system due to molecular similarities between the food proteins and self-proteins in the CNS. Access to the CNS through the blood-brain barrier (BBB) may be aided by type 1 and type 3 hypersensitivity reactions also precipitated by foods.

The keys to combating MS are thus halting the activation of the immune system and healing and strengthening various systems including the gut, the BBB and the immune system.

HALTING AUTOIMMUNE REACTIONS
There are two main strategies for halting the immune reactions which result in an attack on CNS tissue. These are healing a leaky gut to slow down and ideally prevent intact food proteins from entering circulation and stop eating foods which contain proteins which can potentially mimic self-proteins in the CNS.

A leaky gut refers to increased permeability of the intestinal tract and such a condition allows food protein fragments to pass between intestinal cells into the circulatory system. Laboratories offer intestinal permeability tests although it may be easier to assume you have a leaky gut and to take steps to heal it.

Increased intestinal permeability has various causes such as ingestion of allergenic foods, candida overgrowth, alcohol consumption, infection, parasites, trauma and usage of non-steroidal anti-inflammatory drugs such as Aspirin. Notably lectins (a type of protein) found in grains and legumes also increase gut permeability. It is critical to eliminate the source of the problem (e.g. candida overgrowth). In some cases this is straight forward but for food allergies it can be more difficult. There are various methods used to test for food hypersensitivities and each has advantages and disadvantages. The three most reliable methods, which are scientifically based, are described and evaluated below.

For IgE-mediated, immediate hypersensitivity, the cheapest and most easily accessible method is skin testing. The main drawback to this method is that it only looks at one component of hypersensitivity (IgE) and thus, at best, it provides only very limited data for identifying one's offending foods. If only such a test is used many major food hypersensitivities may well be overlooked.

A second method for identifying immune-reactive foods is a blood test using either a RAST (Radioallergosorbent) or ELISA (enzyme-linked immunosorbent assay) methodology. Both of these methodologies measure the amounts of various antibodies produced when a blood sample is challenged with a given food protein. The ELISA methodology is somewhat more sensitive than the RAST and is cheaper to do. Usually both IgE and IgG4 (a subclass of IgG, the most common antibody type are measured. In some tests all four subclasses of IgG are measured. The advantages of this type of test is that it is non-invasive ("in vitro"), easy to administer, relatively cheap and can cover most common foods. Also, by measuring IgG4, foods which cause delayed hypersensitivity (e.g. Type III reactions), are also uncovered. The disadvantages of such blood tests is that they tend to be only about 80% accurate and false negatives can occur.

A third method is the use of an elemental diet followed by individual food challenges. Foods which cause a reaction and result in a symptom (e.g. headache, stomach ache, numbness, etc.) Are readily identified as being hypersensitive. This methodology, because it involves the body's reactions ("in vivo") to foods, is perhaps the most reliable methods for identifying foods which cause hypersensitivity reactions. Also foods which result in all three types of hypersensitivity reactions can be identified. The drawbacks are that it is very time consuming and potentially expensive. Also there is some question if MS symptoms consistently become apparent on food challenges.

Other blood tests which may help uncover foods which cause damaging immune reactions are the cytotoxic test and a test which measures the level of immune complexes in the blood. The relationship of the results of these tests to food hypersensitivities is somewhat debatable but such data are undoubtedly of some value.

There are a number of unconventional tests available such as muscle tests and pulse tests. It is difficult to evaluate the reliability of these tests because there is no theoretical basis for the relationship between food hypersensitivities and the measured effects and they have never been scientifically validated. I would suggest such tests not be used in place of the above scientific tests until more data on their reliability and scientific basis are obtained.

Once the source of the gut irritation has been removed (e.g. food allergens) then it is important to take supplements which help to heal the gut. Galland lists a number of supplements which are of value. Some of these include acidophilus, glutamine, glutathione, grape seed extract, evening primrose oil, fish oil, fiber and enzymes.

The second and perhaps most important strategy for halting autoimmune reactions is to stop eating foods which potentially contain proteins which can mimic self proteins. Unfortunately there is no test which can be administered to establish which foods may be problematic for a given individual. Thus it is essential to eliminate all foods which have the potential to mimic self.

These foods include all dairy products, all grains, all legumes (e.g. beans), eggs and yeast. For grains the most problematic ones are glutenous ones which include wheat, rye, barley and oats. These must be avoided without fail. Rice seems like the safest of the non-gluten grains but even it can be problematic for some. The ELISA test can help guide decisions on the safety of non-glutenous grains although such grains must always be regarded as potentially problematic. Also one should always be aware of how a given food affects them and eliminate foods which consistently result in discomfort and minor symptoms (fatigue, tingling etc.).

In general saturated fats and trans-fatty acids (altered unsaturated fatty acids) seem to promote inflammatory reactions whereas polyunsaturated fats modulate such reactions. Thus it is important to keep the daily intake of saturated fat to less than 15 grams a day. This essentially necessitates the avoidance of all red meat and dark meat from chicken and turkey. Monosaturated oils (extra virgin olive oil) and polyunsaturated oils (unrefined sunflower and safflower oil) can be used with a maximum consumption of about 60 g a day. All margarines should be avoided. Omega three essential fatty acids tend to be deficient in many and these are mainly derived from fish and flax oil. Notably fish oil has been found to be very beneficial in controlling another autoimmune disease, Crohn's disease.

STRENGTHENING THE BBB AND THE IMMUNE SYSTEM
The first disease process in the inflammation in the CNS is the breach of the blood-brain barrier (BBB). This is usually accomplished by an activated immune system which damages the BBB in passage.

Go to BBB for more info.

Experiments with animals have shown that there are three related chemicals, anthocyanosides, proanthocyanidins and procyanidolic oligomers, which strengthen the BBB. These chemicals are found in blueberries, cherries, blackberries, grapes and the bark and needles of certain pine trees. They are currently available as encapsulated supplements called bilberry, grape seed extract and pycnogenol. These supplements and/or substantial quantities of the above fruits should be ingested daily to help strengthen the BBB.

The anthocyanosides and proanthocyanidins act as very powerful anti-oxidants, block enzyme actions and bind with the BBB and it is these properties which likely result in their beneficial effect on the BBB. Other supplements which are anti-oxidants (much less powerful) include vitamin A (cod liver oil), vitamin C (with bioflavonoids) and vitamin E. These, along with vitamin B complex and vitamin D, should be taken daily.

Because MS is basically caused by a malfunctioning immune system, it is worthwhile to strength the immune system such that it operates in a more normal fashion Most important in this regard is the healthy functioning of the suppression side of the system which is programmed to shut down harmful autoimmune reactions as soon as possible.

Minerals such as zinc and selenium, help strengthen the immune system, and also may well have value in warding off viral infections. It has also been suggested that herbs such as goldenseal and echinacea have value in strengthening the immune system. One problem with these herbs is that they may cause hypersensitivities (goldenseal is closely related to ragweed) and questions still remain concerning the wisdom in taking these herbs over a long time period. I would suggest caution in their use for MS treatment with echinacea perhaps being the safest herb to use to strengthen the immune system.

The key elements of diet revision are:

Avoid all dairy, grains, legumes, eggs and yeast.
Avoid all allergenic foods which are identified by skin and ELISA tests.
Avoid all red meat and margarine
Eat fish and skinless breast of chicken and turkey, for protein fruits and vegetables for carbohydrates and micro-nutrients and extra virgin olive oil and unrefined sunflower oil for fats.
Take as many of the recommended supplements as your budget allows.

This diet is essentially a "Paleolithic Diet" (Eaton and Konner, 1985) and is the one which our genetic structure evolved in concert with over 2 million years. Thus it is very compatible with our genetic makeup and results in few if any biochemical failures.

Ashton Embry's Best Bet Diet (BBD) works on five fronts.

I - To stop, or at least restrict, the consumption of foods whose molecular structure is so similar to the myelin in our own bodies that they could ignite the autoimmunity process. This includes dairy, gluten(wheat, rye, barley and oats), legumes(beans and peas) and yeast. Refined sugar is also avoided because it can make the leaky gut worse and can also adversely affect the immune system. Eggs are allowed in limited quantities as long as the individual shows no specific allergic reaction to them. The diet is low in saturated fat and also aims to reduce the intake of Omega 6 fats and, at the same time, increase the intake of Omega 3 fats, in order to achieve a far healthier balance than is the normal in today's western society, where the condition is now rife. Both these approaches have been seen to be of benefit to PwMS.

2 - To take supplements which are known to dampen down the immune system in such a way that autoimmune reactions are far less likely. These include vitamin d3(calciferol), calcium, magnesium and omega 3 fish oil and vitamin E.

3 - To take supplements which are known to repair the leaky gut(these include acidophilus, glutamine, evening primrose oil, grape seed extract, fish oil and enzymes) and thereby eventually prevent the escape of intact food proteins into the circulatory system in the first place.

4 - To take supplements which are known to strengthen and heal the blood brain barrier to prevent any attacks on the myelin in the cells in the Central Nervous System. These supplements include gingko biloba, grape seed extract/pycnogenol and co-enzyme QIO..

5 - To have an ELISA blood test done to identify which, if any, specific foods may have escaped across the leaky gut in the past and caused the individual's immune system to create an lgG antibody as part of it's defence mechanism. The individual may be hypersensitive to these foods and they may be contributing to the pourous nature of the gut. It would be necessary to avoid, or at least rotate, these foods in the diet, at least for a time, to give the leaky gut a chance to heal.