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Thread: Multiple Sclerosis: Diets, Nutrition, and Alternative Treatments

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    Distinguished Community Member Sherman Peabody's Avatar
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    Default Multiple Sclerosis: Diets, Nutrition, and Alternative Treatments

    Multiple sclerosis (MS) is the most common autoimmune disease of the brain and previously thought of as incurable. However, the idea that MS can be hacked and put into remission has recently emerged.

    In this post, we review treatments for MS and how they work – both alternative and conventional.

    Wahls Protocol Review

    The Wahls Protocol developed by Dr. Terry Wahls involves a modified paleolithic diet with antioxidants, nutritional supplements, stretching, neuromuscular stimulation, and strengthening exercises. The purpose behind this regimen is to increase the quality of life and combat fatigue, a disabling symptom of multiple sclerosis.

    The purpose of the Wahls Protocol diet is to:

    - reduce inflammation
    - improve mitochondrial function
    - correct nutritional deficiencies that contribute to the disease
    - reduce oxidative stress and protect the nerve cells by providing dietary antioxidants

    Important nutrients in the Wahls Protocol include vitamin D, calcium, magnesium, omega-3 fatty acids, coenzyme Q, and dietary enzymes.

    The Wahls Protocol is categorized into 3 levels – Wahls Diet (allows gluten-free grains and legumes), Wahls Paleo, and Wahls Paleo Plus with varying levels of restrictions. The Wahls Paleo Plus recommends using fats liberally and reducing proteins to enter ketosis.

    The following are foods and recommendations related to the Wahls Protocol Diets:

    - Green leafy vegetables – recommended 3 servings
    - Sulfur-rich vegetables such as cruciferous vegetables, onion-family vegetables, and mushrooms – recommended 3 servings
    - Intensely colored fruits or vegetables – recommended 3 servings
    - Omega-3 oils – encouraged 2 tablespoons
    - Animal protein – encouraged 4 ounces or more
    - Organic meats – at least 1 serving per week
    - Plant protein – encouraged 4 ounces or more
    - Nutritional yeast – encouraged 1 tablespoon
    - Alternative types of milk (soy, almond, peanut, rice, and coconut) – encouraged, subjective to individual choice
    - Kelp – encouraged ¼ teaspoon
    - Green algae – encouraged ¼-1 teaspoon
    - Gluten-free starchy vegetables and fruits – allowed only 2 servings per week
    - Added fats, including coconut oil, avocados, olive oils, nuts, and seeds

    The protocol also recommends eating 2 meals a day and fasting 12 – 16 hours every day (including sleep time).

    Is the Wahls Protocol Effective?

    In the few studies that are available, this diet seems to have a disease-modifying effect. It not only reduces symptoms but also helps with the regeneration of the destroyed neuronal tissues beyond what conventional treatments could do.

    For Dr. Terry Wahls herself, the diet, in combination with exercise and neuromuscular electrical stimulation reversed most of her MS symptoms. In a short pilot study involving 12 MS patients, the diet, together with exercise, stretching, massage, and meditation, significantly reduced fatigue.

    Additional larger and controlled studies would be necessary to demonstrate the safety and effectiveness of this protocol.

    Why the Wahl’s Protocol Works: Potential Mechanism

    The Wahl’s Protocol is a mild ketogenic diet. Ketogenic diets have been used to successfully manage many neurological diseases including epilepsy, Alzheimer’s, and Parkinson’s diseases. A ketogenic diet may help with MS by:

    - Inhibiting mTOR, thus suppressing Th1 and Th17 dominance, while increasing Treg
    - Reducing glucose metabolism, which protects against glutamate-induced toxicity and oxidative stress in the brain
    - Activating autophagy, which allows for cellular clean up of damaged myelin and neurons
    - Supporting myelination [R]
    - Increasing Sirt1 (important for cognitive function, brain, and synaptic plasticity) and BDNF levels by ketone bodies

    This protocol also eliminates common inflammatory foods.

    The Wahls Protocol eliminates gluten, dairy, and legumes, which are some of the most inflammatory foods for people with autoimmunity.

    By eliminating gluten, the diet reduces leaky gut and leaky brain through the zonulin pathway.

    Dairy protein butyrophilin is similar to proteins on myelin, which could trigger MS.

    Legumes contain some of the most harmful lectins, but it is allowed on the Wahls protocol if prepared properly to reduce lectins and other harmful substances.

    Wahls Protocol is a micronutrient-dense diet that supports the mitochondria.

    The basis of the Wahls Protocol is that it supplies a lot of nutrients and antioxidants for the mitochondria.

    The mitochondrial enzyme that consumes oxygen (complex IV) can be blocked by nitric oxide, which is generated in high levels around active MS lesions. This can cause symptoms of low oxygen, increased oxidative stress, and subsequently brain degeneration.

    The mitochondria, therefore, is a potential therapeutic target for MS treatment. However, a challenge in devising such therapy is that it is difficult to ensure that these antioxidants enter the brain, the affected cells, and the mitochondria.

    Additional studies would be necessary to test whether this diet improves MS outcomes mainly through supporting mitochondrial function.

    By providing a lot of fats and other micronutrients, this diet also provides building blocks that support brain health and brain regeneration.

    This protocol also addresses other factors, not only diet.

    Management of autoimmune diseases typically involves much more than diet alone.

    The Wahls Protocol also addresses these other factors by recommending:

    - Exercise therapy, which helps stimulate neuronal regeneration by increasing BDNF and NGF
    - Neuromuscular stimulation, which helps reduces spasms and muscle wasting
    - Meditation and stress management, which reduces inflammation
    - Reducing toxic load, which is a risk factor and may cause MS

    The Swank Diet Review

    The Swank diet was developed in the 50s before multiple sclerosis was well understood as an autoimmune disease.

    Interestingly, the term “autoimmune” was not used in any of Dr. Swank’s published reports, including ones that were published as late as in the 90s.

    This diet is based on the (incorrect or incomplete) assumption that saturated fat consumption caused MS because the incidence of MS seemed to be higher in regions and during times of higher fat consumption. The author, however, was aware that saturated fats or fat consumption may not be the sole cause of MS.

    The Swank diet, developed by Dr. Roy Swank, consists of eating foods with very low saturated fat (less than 20 grams a day).

    Butter fats and hydrogenated oils are eliminated from this diet. The diet contains lean meats such as fish, seafood, skinless turkey, and the white meat of the chicken. These meats are supplemented with skimmed milk, vegetables, cereal, nuts, and one egg a day.

    The Swank diet diminished the frequency of attacks and severity of MS over the course of 50 years.

    However, so far only one cohort study has examined the relations between fat consumption and MS risks. This study reported that low consumption of omega-3 fatty acids, but not high consumption of saturated or animal fats, were associated with increased MS risks.

    A recent randomized controlled study demonstrated that a low-fat diet supplemented with fish oil decreased the number of MS relapses.

    While the Swank diet may have some effectiveness, it is likely that the diet affects the course of disease through other means than lowered saturated fats.

    Alternative/Adjunct Therapies for Multiple Sclerosis

    There are several treatments that can mitigate and manage symptoms of MS. In this section, we review the literature involving natural options to manage MS.

    1) Physiotherapy and Exercise

    Physical therapy, or rehabilitation exercises, are helpful with reducing fatigue in patients who are not bed-bound.

    A meta-analysis of many clinical studies demonstrated that exercise therapy is generally safe for MS with the exception of falls. The odds of relapse triggered by exercise is low. However, care should be taken to prevent exacerbation of symptoms from body heat generated by exercise.

    These exercise therapy for MS can be beneficial to patients not experiencing an exacerbation.

    2) Chiropractic Medicine for the Mitigation of Pain

    Pain medication carries the risk of addiction. Chiropractic medicine serves as a viable alternative for the mitigation of chronic pain caused by MS. However, the lack of knowledge and moderate uptake of chiropractic medicine has been the limiting factor for widespread use.

    Spinal manipulation in chiropractic medicine has been shown to mitigate acute and chronic lower back pain. This technique alleviates pressure and stiffness caused by other tissues in previous injuries or degenerative conditions.

    Although chiropractic medicine shows strong potential to be a physical treatment for MS, more studies are needed to validate the efficacy of these treatments.

    3) Massage Therapy

    Massage therapy helps with MS, with benefits including:

    - Pain reduction
    - Reduced spasms
    - Improved circulation
    - Increased joint and limb mobility
    - Decreased fatigue

    The conditions that cause fatigue in MS are not well defined. Damages to the (central) nervous system such as MS lesions and inflammation can contribute to fatigue. Massage therapy has been shown to diminish fatigue and pain in MS patients.

    Tight muscle tension can cause direct pain in the muscles by activating the pain receptors and restricting blood flow to that area (ischemia).

    Massage helps reduce the tension in the muscles leading to pain and spasm reduction. Massage also increases blood flow to affected areas. Other benefits of massage include relaxation and sleep improvement.

    Relaxation caused by massage therapy also reduces anxiety and stress levels by increasing parasympathetic nervous system activity and decreasing cortisol.

    Stress reduction not only increases the quality of life in MS patients but also helps manage physical symptoms.

    Massage is a safe, non-invasive supplementary treatment option that helps manage stress and the physical symptoms of MS.

    4) Reflexology

    Reflexology is one of the most common and low-cost treatments in complementary medicine.

    Reflexology is the study of how one part of the body is related to another. Application of the appropriate pressure and massage will stimulate other parts of the body, exerting its therapeutic effects.

    Reflexology applies pressure with the thumb and fingers to specific points of the feet that are related to internal organs or glands.

    Foot reflexology therapy effectively increases blood and lymph circulation, which helps stabilize the movement of muscles, joints, and tendons. This improvement in mobility also reinforces muscle strength and promotes relaxation.

    The following are benefits of reflexology in the context of MS:

    - Reducing pain
    - Stopping muscle spasms
    - Reducing bladder and bowel problems
    - Improving mobility
    - Decreasing fatigue

    In a randomized, sham-controlled clinical trial (53 participants) on reflexology, specific reflexology treatment has demonstrated alleviation in mobility, sensation, and urinary symptoms in MS patients.

    Supplements for MS

    Omega-3 Fatty Acids (FAs)

    High intake of saturated fatty acids increases the risk of MS. Omega-3 fatty acids are a great alternative to reduce the risk of MS.

    Omega-3 FAs are “essential fatty acids” that cannot be produced by the human body. As a result, this nutrient must come from the diet. Omega-3 FAs can be found in fish, fish oil, flaxseeds, flaxseed oil, soy products, soybean oil, and canola oil.

    Administration of Omega-3 FAs reduces inflammation (inflammatory cytokines), which contributes to MS lesions.

    Some of these fatty acids, such as DHA, can cross the blood brain barrier and act as a major component of neuronal cell membranes. These compounds can not only act as an anti-inflammatory agent but also an inhibitor to T cell transportation to the brain (inhibiting MMP-9).

    MS patients have elevated transportation for T cells (elevated MMP-9 proteins and mRNA) in the (central) nervous system.

    Omega-3 FA inhibits T-cell migration through the blood brain barrier.

    However, the mechanism of this process is unknown.

    In a study (DB-PCT), participants taking omega-3 FAs showed no significant difference compared to the controls. However, the results displayed a trend to improvement in the omega-3 treated subjects. The diet of the participants was a confounding effect in the study.

    Vitamin D3

    Vitamin D modulates the immune system. Low vitamin D3 has been associated with MS risks. Among MS patients, lower levels of vitamin D is associated with worse clinical outcomes.

    However, clinical trials have shown that vitamin D supplementation may be beneficial for MS.

    Since vitamin D supplementation is generally safe, it is generally recommended as part of the treatment plan for MS.

    Fullerene (C60)

    Fullerene or C60 derivatives, when combined with drugs that block NMDA receptors, can help with MS. It reduces axonal degeneration, disease progression, monocyte attraction, and penetration of inflammatory cells in mouse models of MS.

    Conventional Treatments for MS

    Although there is no universal cure for MS, several therapies have proven effective in preventing the progression and relapses of the disease. There are no known therapies that promote the regeneration of these deficits because MS damages neurons in the brain.

    Spontaneous recovery is rare if the damage to the neurons has progressed longer than 6 months.

    MS long-term disability progresses slowly over many years. As a result, many treatments mitigate the short-term symptoms of the disease.

    1. Glucocorticoids

    A patient with MS (relapsing-remitting MS or primary progressive MS) will commonly face relapses or attacks, which are flare-ups of new or recurring symptoms. Administration of high doses of glucocorticoids (methylprednisolone) or corticosteroids is the current routine therapy for acute relapses.

    The advantages of using glucocorticoids include the rapid functional recovery in patients with acute attacks.

    Limitations of Glucocorticoids

    Administration of intravenous glucocorticoid can lead to potential side effects such as reddening of the face, ankle swelling, and a metallic taste in the mouth. Oral administration of glucocorticoids has more side effects including disturbed sleep, mood changes, and stomach problems.

    Also, glucocorticoids only mitigate the short-term symptoms of MS without dealing with the long-term effects.

    High doses of glucocorticoids will not affect long-term disease improvement because of the treatment’s limited effects on MS lesions in the brain. The irreversible damages are not being regenerated.

    Glucocorticoids may also have detrimental effects on bone density, increasing the risk for bone fracture.

    2. Disease-Modifying Therapies

    Disease-modifying therapies (DMTs) were created and approved to manage the long-term effects of MS by slowing the natural course of the disease. Clinical studies have demonstrated that disease-modifying therapies (interferon beta, glatiramer acetate) have anti-inflammatory effects and slows the progression in relapsing-remitting multiple sclerosis (RRMS) patients.

    Some disease-modifying therapies (IFNb-1a) promote nerve growth factors (NGF) to support the repair of neurological damages, leading to decrease in lesion activities and disease relapse rates.

    Disease-modifying treatments (IFNb, glatiramer acetate) also reduce the attack rates or relapses in relapsing-remitting multiple sclerosis patients and is effective at mitigating those attacks in the earlier stages.

    Limitations of Disease-Modifying Therapies

    Some common adverse side effects of disease-modifying therapies (IFNb, glatiramer acetate) include bruising, redness of the skin, pain, irritation, skin lesions, swelling, and sometimes cell death (necrosis).

    Other rare potential side effects of disease-modifying therapies (IFNb) include immune system problems (psoriasis), insomnia, hearing loss, hair loss (alopecia), and in more severe and rare cases, liver damage.

    Primary progressive multiple sclerosis (PPMS) is characterized by the progressive worsening of neurologic functioning from the onset of the disease, usually targeting one part of the brain (usually the spinal cord). As the disease progresses, the symptoms increases. Progressive MS is a more advanced form of the disease and is more difficult not only to diagnose but also to treat.

    Most of the disease-modifying therapy drugs (IFNb, glatiramer acetate) were approved and effective for relapsing-remitting MS. Most of these drugs are not effective against primary progressive MS.

    3. Ocrelizumab

    Primary progressive MS is problematic and tricky because patients do not respond to currently available treatments. About 10% of the patients have primary progressive MS, which accumulates neurological deterioration without relapses.

    On March 28, 2017, the FDA approved ocrelizumab (produced by Hoffmann-La Roche) as the first treatment for primary progressive MS.

    Ocrelizumab is a biologic immunosuppressive drug (anti-CD20 monoclonal antibody) that binds to immune cells (B cells) and prevents those cells from exerting harmful effects on the body.

    During clinical trials, ocrelizumab has reduced relapse rates by 46%-47% and disability progression by 40%. Ocrelizumab also incredibly reduced inflammation and decreased the progression of lesions in the brain.

    Limitations and Contraindications of Ocrelizumab

    Ocrelizumab is contraindicated in patients with hepatitis B or allergic reactions to ocrelizumab. Ocrelizumab therapies can lead to increased risk for respiratory tract infections, viral infections of the brain (Progressive Multifocal Leukoencephalopathy), or breast cancer.

    Ocrelizumab is a relatively new, approved drug and the FDA required Hoffmann-La Roche to continue post-marketing surveillance (phase IV trials) and report any risks, side effects, or adverse effects associated with the drug.

    4. Neuromuscular Electrical Stimulation

    Neuromuscular electrical stimulation can be used to treat some of the physical symptoms of MS such as mobility problems, fatigue, and tremors.

    Secondary progressive MS exhibits excessive oxidative stress and excitotoxicity. A case report of a 52-year-old female with secondary progressive MS have shown that dietary manipulation and neuromuscular electrical stimulations are synergistic in reducing oxidative stress and excitotoxicity.

    Neuromuscular electrical stimulation has been effective at treating muscle spasms, muscle pain, and muscle degeneration (disuse atrophy).
    Last edited by Sherman Peabody; 11-06-2017 at 04:07 PM.

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    Distinguished Community Member agate's Avatar
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    We've had some discussions of the Wahls diet here--this one, for instance:

    Some people here have access to Facebook and can enter "Terry Wahls MD" in its search window, to see her Webpage. If you scroll on down on it you'll find a video she posted yesterday. It's about 40 minutes long but people might want to watch it and see what they think.

    It's a talk she gave as a chat session, and you can see the people's comments over on the right. She replies to some of them during the talk.
    Last edited by agate; 11-06-2017 at 06:55 PM.
    MS diagnosed 1980. Avonex 2002-2005. Copaxone 6/07 - 5/10.
    Member of this MS board since 2001.

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    Distinguished Community Member Sunshine's Avatar
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    Organ meat. Yucky.

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    Distinguished Community Member agate's Avatar
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    BBS, did you watch the video where she just talks? There's another video on there where she demonstrates some food. I haven't watched that one yet.

    In the one where she just talks, she gets up and walks around a bit once, but you can't tell whether she's using a walker or cane. Or at least I couldn't figure it out.
    MS diagnosed 1980. Avonex 2002-2005. Copaxone 6/07 - 5/10.
    Member of this MS board since 2001.

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    Yes, it’s very impressive! All that organ meat though.

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    Distinguished Community Member Sherman Peabody's Avatar
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    How to reverse MS symptoms with the Wahls Protocol

    Katie - Wellness Mama

    Are you or a loved one looking for a way to reverse MS or autoimmune symptoms? If you haven’t heard of Dr. Terry Wahls, this incredible M.D. and researcher was able to turn back the clock on her own progressive multiple sclerosis with lifestyle changes and a specifically tailored Paleo-type diet.

    (If you prefer to hear Dr. Wahls explain her story and her methods rather than read about it, you’re in luck! I had the privilege of interviewing Dr. Wahls in this Healthy Moms podcast where she explains how she designed her multi-faceted protocol to support and nourish the cell mitochondria with the power of real food.)

    Her journey started as it does for many of us … searching for answers to the puzzling health problems that affect us personally.

    Dr. Terry Wahls and How She Found a Way to Reverse MS

    Dr. Wahls started to experience the symptoms of MS while she was attending medical school. Her first official diagnosis of relapsing remitting multiple sclerosis came in 2000.

    In 2003, this former national tae-kwon-do competitor needed a tilt recline wheelchair. She now had secondary progressive MS, and the drugs weren’t working. Even with her own medical knowledge and the help of some of the best doctors in the world, she wasn’t getting any better. So, armed with piles of studies, she dug into the research herself to find answers.

    It soon became obvious to Dr. Wahls that it couldn’t hurt to try known brain-boosting nutritional supplements for help. This led her to consider … how could she get the same brain-nourishing benefits from real food? Her research led her to learn how a hunter-gatherer (Paleo) diet could help nourish her body and possibly heal her from her disease.

    Amazingly, by changing her lifestyle and diet, Dr. Wahls was able to start riding her bicycle to work … after four long years in a wheelchair.

    What Is Multiple Sclerosis?

    What is this dreaded disease that strikes seemingly out of nowhere?

    There’s still a long way to go in understanding MS, but in a nutshell, the immune system has an abnormal response and attacks the body’s central nervous system.

    The attack targets the fatty shield around nerve fibers, gradually impeding the body’s signals to the brain and vice versa. This results in all kinds of undesirable and increasingly debilitating symptoms.

    It is interesting to note that although the cause of MS is still unknown, unlike a true autoimmune disease, researchers suspect an outside environmental trigger (combined with a person’s genetic susceptibility to such a trigger). Dr. Wahls’ prescription for supporting the body’s natural detoxification abilities makes sense in this scenario.

    The Wahls Protocol: Hope for MS Sufferers

    Dr. Wahls now continues her work on a wider level. She conducts clinical trials to expand research on the role of diet in diseases like MS and developed her plan to reverse MS into a book, The Wahls Protocol. Since it’s been revised to address other autoimmune disorders and she’s also written a cookbook with recipes tailored to reverse MS. In addition, there is now a full seminar with workshops and certification in the Wahls Protocol methods.

    I met Dr. Wahls when I happened to sit next to her during a session at a health event we both attended. At that time she had literally just received a preview copy of her book. I was so glad I had learned to speed read … I spent the whole session finishing her book! We got to meet after, and I found her so energetic and inspirational.

    The Wahls Protocol is full of solid, practical advice and tips (and easy to follow at the same time). Much of the advice is appropriate for anyone struggling with an autoimmune condition of any kind. I love that Dr. Wahls focuses not so much on removing foods but on consuming nutrient-dense foods that support mitochondria function, which is so important for MS and autoimmune sufferers.

    So what’s in her plan to reverse MS? These are the highlights:

    Dr. Wahls’ Dietary Protocol to Reverse MS

    Mitochondria are the body’s power producers, so it makes sense that Dr. Wahls pinpoints their role in optimizing brain and immune system health. Here’s the broad strokes of the dietary advice the Wahls Protocol suggests for MS and autoimmune-specific conditions:

    - Remove the 3 most common foods that trigger abnormal immune system response: gluten, casein, and albumin (the protein in egg whites).
    - Take in 9 cups of vegetables and fruits daily (fresh, juiced, blended, or lightly steamed), specifically:
    - 3 cups leafy green vegetables (spinach, kale, lettuce, etc.)
    - 3 cups brightly colored fruits or vegetables (Ideally these would be 3 different colors, and colored all the way through … so no bananas, for example … I always knew bananas were no good!)
    - 3 cups sulfur-rich vegetables (broccoli, cauliflower, onions, garlic, etc.)
    - Consume bone broth and fermented foods daily.
    - Have high quality wild-caught or grass-fed protein for dinner.

    (Sounds really familiar, right?)

    Basically, this protocol can not only help reverse MS but can help anyone suffering from leaky gut, fibromyalgia, chronic fatigue, lupus, arthritis, psoriasis, chronic pain, diabetes, traumatic brain injury, depression, PTSD … and the list goes on.

    Be sure to check out the Wahls Protocol book for all the details on the diet plus how to craft a nutritional supplement regimen to help reverse MS. (Dr. Wahls recommends doing this along with the help and oversight of a functional medicine doctor).

    Research, help and hope on the Horizon

    The exciting part is Dr. Wahls’ research is receiving attention from even the mainstream medical world. In 2016 the National MS Society granted her a $1 million grant to conduct further research … a very exciting development for MS sufferers, and the real food movement in general!
    Last edited by Sherman Peabody; 11-07-2017 at 08:50 PM.

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    Distinguished Community Member Sherman Peabody's Avatar
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    Wahls Veggie Protocol: Q&A

    “It occurred to me, that I should get my long list of nutrients from food [rather than supplements]. That if I did that, I would probably get hundreds and maybe thousands of other compounds that science had yet to name, that would be helpful to my brain and my mitochondria.”

    ~ Dr. Terry Wahls

    Who is Dr. Terry Wahls?

    If you aren't familiar with Dr. Terry Wahls, check out our interview. She's a leader in the paleo movement, having reversed her multiple sclerosis through dietary intervention. A cornerstone of her protocol is feeding the mitochondria in our bodies, with 9 cups of vegetables/fruit daily.

    P.S. If you have people in your life who think paleo is a meat-only diet, feel free to direct them to this article, or any article about Dr. Wahls. Paleo people LOVE their vegetables and often eat more of them than vegans/vegetarians who get a bulk of their calories from grains.

    What are mitochondria?

    Mitochondria are the cell's power producers. They convert food molecules into the energy our cells need to do their jobs. They also coordinate communication between cells, and every function in our body depends on them. Every cell contains mitochondria, and some cells contain thousands of them. You can see why Dr. Wahls focused on feeding the mitochondria, to give our bodies optimal health.

    Tell me more about the 9 cups of vegetables and fruit daily.

    Through years of personal study, Dr. Wahls identified 31 microntutrients that the mitochondria need to function. She then learned what foods provide those nutrients and came up with her “9 Cups Daily” protocol:

    - 3 cups (about one heaping plateful) of leafy green vegetables, such as kale, collards, chard, spinach or lettuce, which provide vitamins A, B, C and K.
    - 3 cups of sulfur-rich vegetables, such as cabbage, broccoli, cauliflower, onions, garlic, mushrooms and asparagus, because they support the removal of toxins from the body.
    - 3 cups of colorful vegetables and fruits (ideally three different colors each day), because they're full of antioxidants.
    They have to be colored all the way through, so apples and bananas don't count as colored, but berries, peaches, citrus, beets and carrots do.

    Can you eat less than 9 cups, and still gain benefit?

    Any fresh vegetables you add to your diet will provide vital micronutrients. Dr. Wahls believes that 9 cups daily is the “sweet spot” for men and tall women, for optimal health. She said petite women can get by on 6 cups daily. If you can't manage the full amount right now, start with what you can, with a goal of increasing over time. Also, remember these measurements are raw. So, if you can't imagine eating a salad that includes 3 cups of greens, go ahead and cook your greens. They'll reduce in size by at least half, and for some people, cooked greens are easier to digest anyway. Lastly, there is one vegetable that has a special status: garlic! Because garlic is so potently healthy, Dr. Wahls says that 2 garlic cloves is the equivalent of 1 cup of sulfur-rich vegetables. If you still have trouble eating enough vegetables, try supplementing with Dr. Cowan's Garden Vegetable Powders. 1/2 teaspoon of their organic dehydrated vegetables equals 1/2 cup cooked or 1 cup raw fresh vegetables. They shouldn't replace all of your vegetable intake, but they can give it a boost both in quantity and diversity. Use the code PHOENIX for 15% off your first order.

    How should the vegetables be prepared?

    She prefers the vegetables be either raw, or cooked at a low temperature, for maximum nutrient retention. If you boil or steam your vegetables, she says you should drink the water, so as not to lose any micronutrients that have leached into the water. Soup is a lovely way to eat vegetables, because you automatically drink the liquid in which the vegetables are cooked. A quick sauté is another option. That said, Dr. Wahls loves kale chips and the occasional roasted vegetable, so you can cook them that way, too, but the nutrient density is greatest in her recommended methods.

    What if it's hard for me to chew raw vegetables? One symptom of some autoimmune conditions is chewing fatigue.

    In this case, she recommends juicing the vegetables in a high-powered blender. She doesn't recommend an extraction juicer, because she wants us to get the whole foods, including
    the fiber. That said, some autoimmune conditions include digestive symptoms that are irritated by fiber; in that case feel free to use an extraction juicer. Like every protocol, you need to personalize it for you. Another option for anyone with a fiber sensitivity is to heal it through the GAPS Introduction diet. Many people find they can eat fiber again after 1-4 weeks on that protocol.

    Do they need to be organic?

    Ideally, organic is best, but we all have budgets. Buy whatever is within your means. If you buy conventional produce, rinse them with some white vinegar and water before cooking, to remove any pesticide residue. If you have the option to buy some (but not all) of your produce organic, the Environmental Working Group has a shopping list called the Clean Fifteen and Dirty Dozen, outlining which crops have the highest and lowest pesticide use.

    What's the rule on starchy vegetables?

    I asked her about this, and she said starch tolerance varies from individual to individual. She herself does best with a lower starch diet. However, she knows both individuals and traditional cultures who have done well with high amounts of starch. She includes beets and carrots in her colored vegetable category, because they're on the lower end of starch content and the higher end of micronutrient content. Also, the other 6 cups of vegetables (in the leafy green and sulfur categories) are automatically non-starchy and provide a good balance.

    How important is variety?

    Dr. Wahls recommends rotating vegetables as much as possible, simply because they each contain a unique micronutrient profile. The more variety you eat, the richer your nutrition.

    Do I eat the vegetables plain or with other foods?

    Always eat them with some healthy fat for better nutrient absorption. Healthy fats include avocados, unrefined coconut oil, ghee, extra virgin olive-oil and animal fats such as tallow and lard. Also don't neglect your protein needs. The Wahls Protocol is a version of the paleo diet, which means no grains/legumes/processed foods, and she recommends some grass-fed meat or wild fish at each meal, as well as bone broth and fermented foods daily. And once/week, she recommends organ meat (for its nutrient density) and seaweed (for iodine and selenium).

    What are some examples of how to eat this many vegetables on a daily basis?

    - Looking for recipes? Check out this A-Z Vegetable Recipe Roundup and the Wahls Protocol Cooking for Life.
    - Juice or blend 3 cups of vegetables daily. Drink this alongside a meal, to keep blood sugar stable.
    - Make a huge pot of vegetable soup in bone broth for the week, and have a portion every day.
    - Have a large salad for lunch. Mark Sisson provides some great ideas for building his famous daily bigass salad.
    - At dinner, get used to a 4-6 oz. portion of quality fish or meat, with a huge side of vegetables cooked in a healthy fat.
    - Snack on berries, with coconut flakes or coconut milk.
    - It's really not that hard.

    The above answers I have gleaned from Dr. Wahls' writings, presentations, and our interview earlier this year. Check out her website for more information.
    Last edited by Sherman Peabody; 11-07-2017 at 09:00 PM.

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    Distinguished Community Member agate's Avatar
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    Well, since she's promoting a diet that she claims cured her MS, the proof is in the pudding, I can't help wondering how she's doing.

    That's what I wanted to know as I watched her video. She was seated during most of it but at one point she got up and took a few steps.

    I thought that now I would see how she's walking.

    I was denied that opportunity because it's not really shown whether she's hanging onto a walker or cane, and yet that seemed to me to be an important thing to know about her.

    The fact that the camera didn't allow the viewer to see that indicates to me that there might have been a bit of deception going on. The choice must have been made about how much to show, what to leave out.

    I'm not saying that her diet has no value. It doesn't sound harmful and it just might be helpful. But I wonder about the claims about a cure.
    Last edited by agate; 11-08-2017 at 08:34 AM.
    MS diagnosed 1980. Avonex 2002-2005. Copaxone 6/07 - 5/10.
    Member of this MS board since 2001.

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  17. #9
    Distinguished Community Member Sherman Peabody's Avatar
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    Sep 2017
    Frostbite Falls, MN
    Blog Entries


    What I eat in a day: Functional medicine doctor Terry Wahls tells all

    Dr. Terry Wahls

    As a functional medicine doctor who used diet and lifestyle changes to restore my health after I was wheelchair-bound with MS, I'm often asked what I eat in a typical day. It depends on the time of year. During the winter, I eat the Wahls Paleo Plus version of my diet. During the summer, I'm eating low glycemic index, following the Wahls Paleo version of my diet plans. I eat from my garden and will have more berries and vegetables.

    I eat one or two meals a day for the benefits that a 12- to 16-hour fast will do to boost mitochondrial efficiency. For the same reason, I will do a water fast for one to three days twice a year.

    Here's what I eat in a typical day for energy and vibrant health:

    Morning Meal

    My day starts with a vegetable-based smoothie. I use greens, coconut milk, water, and ice to make a smoothie. I might have this before going to work, or I may have this at noon, depending upon whether I am shooting for 12 or 16 hours between my evening meal and my morning meal. I'll typically make another vegetable smoothie to have later with my evening meal.

    One of these smoothies will be based upon greens. The other one may be based upon vegetables such as heirloom carrots or beets. I'm also very intentional about having a wide variety of greens for my smoothies, like wild edibles such as dandelions, plantain, or lamb's quarters, and greens from my garden such as kale, bok choi, lettuce, spinach, radish greens, and beet greens. I also use the herbs from my garden—borage, oregano, basil, savory, thyme, sage, lavender, lavage, parsley, lemon balm, mint, dill, and tarragon.

    During the winter, I'll also have a kettle of water with a chicken carcass and chicken feet to make bone broth. I'll blend the bone broth with coconut milk and vegetables to make a morning and evening beverage.

    Evening Meal

    My evening meals will include a smoothie in the summer or bone broth in the winter.

    During the winter, we often have soup. I'll start with a bone broth base, then I'll add chopped vegetables, chopped greens, and a can of coconut milk and let it simmer for five minutes. Most often these vegetables are frozen from our garden. I'll add chopped precooked meat and serve. This meal takes just 15 minutes to prepare.

    In addition to the soup, I'll often have another vegetable smoothie.

    I'll also enjoy a large salad with fresh garden herbs. Or we may have nitrate-free bacon and cooked greens from my garden. My son and daughter say that bacon will fix any vegetable! We will fry up some bacon to the desired level of crispness, turn off the heat, and add the chopped greens; cover and wait two minutes. I'll saute some meat and add vegetables (often onions, garlic, mushrooms, and peppers) for the last two to five minutes. I like to blend olive oil and fresh basil from the garden to make a pesto sauce to add to the vegetables or serve over grilled burgers. It's quite lovely.

    Sometimes, I'll put sautéed onions, peppers, and fish with hot sauce over a large salad to make a fajita-style salad. That is currently a favorite meal in our household and it takes only a few minutes to prepare.


    I don't do Paleo desserts. I don't think eating gluten-free pastries, cakes, and other desserts are health-promoting. Nor do I think substituting fructose-based sweeteners (for example, honey, maple syrup, or agave) or artificial sweeteners are health promoting. I avoid sweeteners of all types.

    Instead, I'll eat berries and chia pudding as a treat. Or I may have berries with a bit of coconut milk and chopped nuts. As summer progresses, I'll eat the fresh local fruits that are in season, probably one serving a day. Fruit is a treat enough for me.


    Along with the smoothies, I may have other beverages separate from my meals. My favorites are water with lime juice or lemon juice (without any sweetener), herbal teas, chamomile tea, green tea, and reverse osmosis water. I never developed a taste for coffee.

    I will occasionally have a glass of wine. Or I may have chamomile tea with coconut milk and a shot of rum for an evening nightcap.

    So, there's a glance at a typical day of eating for me. I believe that taking back your health means taking back your relationship to food and becoming comfortable cooking. I'm publishing a cookbook April 4 to inspire you to prepare your own home-cooked meals.

    Terry Wahls, M.D., is a functional medicine doctor, clinical professor, and a survivor of progressive multiple sclerosis who used her own protocol to heal. This week, we're sharing her expertise in a new series on adrenal fatigue and natural techniques to restore energy. To learn more, check out her new mindbodygreen class, How to Heal Adrenal Fatigue: The Food & Habits You Need for Optimal Health & Energy.
    Last edited by Sherman Peabody; 11-08-2017 at 03:40 PM.

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