Can food be bet­ter than medicine at fight­ing dis­ease?

From the mother who eased her MS with a daily dose of flax seeds, to choles­terol-beat­ing chick­peas ...

Irish Daily Mail - - Good Health - By AN­GELA EP­STEIN

WHEN you’re di­ag­nosed with a chronic con­di­tion, treat­ment is usu­ally med­i­cal — drugs or surgery, for in­stance. You’ll prob­a­bly be ad­vised to im­prove your diet, but of­ten with lit­tle, or no, ad­vice on how to do it.

But, in­creas­ingly, ev­i­dence sug­gests that diet should be more than just a part of the treat­ment pack­age, it should be seen as in­te­gral — some­times work­ing as well as, if not bet­ter than, med­i­ca­tion.

For in­stance, a land­mark seven-year study last year sug­gested a Mediter­ranean-style diet may be bet­ter at treat­ing heart dis­ease than statins.

The re­search, led by Pro­fes­sor Gio­vanni de Gae­tano of the Neu­romed In­sti­tute in Pozzilli, Italy, found that heart pa­tients whose diet was rich in veg­eta­bles, nuts, fish and olive oil, cut their risk of a pre­ma­ture death by 37per cent (com­pared with 18 per cent for statins, ac­cord­ing to pre­vi­ous re­search). ‘Of course, doc­tors

will con­tinue to pre­scribe drugs such as statins but we can’t look at drugs as the only way of [sav­ing lives],’ said Pro­fes­sor de Gae­tano.

An­other study, pub­lished in the Lancet in 2014, com­pared diet and ex­er­cise with the drug met­formin for di­a­betes and found life­style was more ef­fec­tive in pre­vent­ing de­vel­op­ment of di­a­betes in those at high risk.

Yet many doc­tors seem un­aware of diet’s pos­i­tive ef­fect.

‘There is lit­tle or no train­ing at med­i­cal school or post­grad­u­ate level on the im­pact of nutri­tion on health,’ says Dr Aseem Mal­ho­tra, a con­sul­tant car­di­ol­o­gist.

‘Doc­tors need to know about the im­pact ev­i­dence-based life­style in­ter­ven­tions such as diet can have on chronic con­di­tions,’ he says. ‘The heal­ing power of diet has been un­der­played and, un­like drugs, doesn’t have side-ef­fects. If it was a pill, any com­pany that man­u­fac­tured it would make bil­lions be­cause the ef­fect is so good.’

It’s not sim­ply that switch­ing to health­ier eat­ing and los­ing weight makes the dif­fer­ence — but it seems spe­cific foods may also have a par­tic­u­lar ‘heal­ing’ ef­fect in cer­tain con­di­tions.

Here, we speak to five pa­tients who say swap­ping to dis­ease-spe­cific di­ets has trans­formed their health. NOTE: Speak to your doc­tor be­fore chang­ing your diet and do not stop tak­ing your med­i­ca­tion without med­i­cal ad­vice.

MY FAM­ILY NO LONGER LIVE IN FEAR OF MY MS

THE DIET: The Over­com­ing MS (OMS) pro­gramme MUL­TI­PLE SCLE­RO­SIS (MS) is a se­ri­ous neu­ro­log­i­cal con­di­tion char­ac­terised by symp­toms such as prob­lems with vi­sion and mobility. Treat­ment usu­ally in­volves man­ag­ing symp­toms and try­ing to slow its pro­gres­sion.

This diet was de­vel­oped by Pro­fes­sor George Je­linek, an euro epi­demi­ol­o­gist at the Univer­sity of Mel­bourne, fol­low­ing his own MS di­ag­no­sis. He is symp­tom free, 18 years af­ter be­ing di­ag­nosed.

It in­volves giv­ing up meat, dairy and other foods high in sat­u­rated fats in favour of a plant-based whole­food diet with seafood and 20 to 30ml a day of omega-3s, ide­ally from flaxseed oil, plus vi­ta­min D (and up to 15 min­utes of sun­light five times a week).

Life­style changes in­clude ex­er­cise and med­i­ta­tion to re­duce stress. More than a dozen pa­pers, in­clud­ing one in the Jour­nal of Nu­tri­tional Neu­ro­science in 2015, have found the pro­gramme can im­prove phys­i­cal and men­tal health. But Dr Eli Sil­ber, a lead­ing con­sul­tant-says: ‘There haven’t been prop­erly con­trolled large-scale tri­als to sup­port it.’ THE PA­TIENT: Nicole Green, 45, a hospi­tal man­ager, lives with her hus­band, Dave, 50, a dock worker and their four chil­dren, aged 13 to 25. I’VE been on a roller-coaster with my health since be­ing di­ag­nosed nine years ago. I have re­laps­ing and re­mit­ting MS — new symp­toms ap­pear or old ones re­turn for any­thing from a few hours to days. The di­ag­no­sis was a ter­ri­ble shock, es­pe­cially as my chil­dren were young. As well as the un­pre­dictabil­ity, the worst thing was be­ing told there was no cure.

I’d have a re­lapse about once a year when my eye­sight would be re­ally poor and my mobility so bad I’d be con­fined to a wheel­chair. I could be off work for months.

Even when I went into re­mis­sion, the cu­mu­la­tive dam­age meant the vi­sion in my left eye has been per­ma­nently af­fected — it’s like look­ing out of an opaque win­dow. I’d read about diet and MS, but as a veg­e­tar­ian for ten years, how much health­ier could I be? But af­ter a mas­sive re­lapse two-and-ahalf years ago, where for a few months my vi­sion went al­most com­pletely in both eyes and I was so weak I couldn’t even lift a ket­tle, I was des­per­ate.

That’s when I heard about Pro­fes­sor Je­linek’s diet. I didn’t feel I needed to tell my own doc­tor: it wasn’t as if I was giv­ing up my med­i­ca­tion.

I be­gan eat­ing fish — a strug­gle as a veg­e­tar­ian. It was also re­ally hard giv­ing up cheese. But the dif­fer­ence has been mas­sive: within weeks I was able to do Pi­lates and Aqua Fit reg­u­larly. I now do five ex­er­cise classes a week be­cause I have the en­ergy and mobility.

I was thrilled when I had a brain scan last Septem­ber and it showed no new dis­ease com­pared to pre­vi­ous scans. My doc­tors sug­gest this could be the med­i­ca­tion, but there’s no doubt in my mind it’s this diet that’s changed my life: I haven’t had a re­lapse since.

My fam­ily no longer lives with the fear of the next re­lapse and won­der­ing what dam­age it’ll cause: we can have a nor­mal life again.

For more de­tails see over­com­ingms.org/re­cov­ery-pro­gram/

I DITCHED GAR­LIC AND MELON TO BEAT IBS

THE DIET: Low FODMAP

Ir­ri­ta­ble Bowel Syn­drome af­fects hun­dreds of thou­sands of peo­ple in Ire­land, with symp­toms such as bloat­ing, ab­dom­i­nal pain and di­ar­rhoea or con­sti­pa­tion. Pa­tients are typ­i­cally of­fered an­ti­spas­modic drugs and told to eat more fi­bre.

The low FODMAP diet was de­vised in 2012 by sci­en­tists at Monash Univer­sity in Mel­bourne, Aus­tralia, who found that IBS symp­toms could be trig­gered by sug­ars known as fer­mentable oligosac­cha­rides, dis­ac­cha­rides, monosac­cha­rides and poly­ols (or FODMAPs).

These are found in foods such as wheat prod­ucts, gar­lic, dairy, and fruit and veg­eta­bles in­clud­ing onions, leeks, cab­bage, cel­ery, ap­ples, pears, peaches and plums. These sug­ars are poorly ab­sorbed in some peo­ple’s small in­tes­tine and fer­ment, trig­ger­ing symp­toms. ‘Low FODMAP is be­com­ing a stan­dard diet for peo­ple with IBS, es­pe­cially those with bloat­ing as a pre­dom­i­nant symp­tom,’ ex­plains Dr Steven Mann, a con­sul­tant gas­troen­terol­o­gist.

‘It has an ef­fect on other symp­toms, but less so. It’s re­stric­tive, so the usual ad­vice is to do it for six to eight weeks and then grad­u­ally rein­tro­duce foods to see which have an ef­fect.

‘Most peo­ple with IBS have mul­ti­ple in­tol­er­ances: this finds spe­cific trig­gers. I rec­om­mend the diet to my pa­tients.’

THE PA­TIENT: Han­nah Cross­land-Scott, 29, an ad­min­is­tra­tor, lives with hus­band, Mitchell, 27, who works in telecom­mu­ni­ca­tions, and sons Jesse, three and Leo, 18 months. I’VE suf­fered with ter­ri­ble IBS since I was 14 — it would rule my life. A flare-up could hap­pen up to twice a week, caus­ing stom­ach ache and ter­ri­ble bloat­ing. I’d have to can­cel plans, and be near a toi­let. I was pre­scribed dif­fer­ent an­ti­spas­modic med­i­ca­tion which didn’t re­ally help. I was also told by one doc­tor to look at my life­style — but I al­ready had a healthy, bal­anced diet and ex­er­cised.

Then about two years ago an­other GP, who had IBS, told me about the low FODMAP diet.

The diet was ter­ri­bly re­stric­tive, but it was as­ton­ish­ing — within a week I’d no­ticed im­prove­ments and now I rarely get a flare-up if I avoid my trig­ger foods, such as dairy, onions, gar­lic and melon, or any­thing with gluten. If I do get a flare-up, say one a month, it’s usu­ally be­cause I’m stressed.

I now have the con­fi­dence to go out and make plans when I want. For more de­tails see emgdc.ie

CHICK­PEAS CUT MY CHOLES­TEROL

THE DIET: Eat Your Way to Lower Choles­terol

THIS was de­vel­oped by nutri­tion­ist Ian Mar­ber and Dr Laura Corr, a car­di­ol­o­gist.

The stan­dard ad­vice for high choles­terol is to re­duce sat­u­rated fat and red meat and fol­low a Mediter­ranean diet.

The Mar­ber and Corr ap­proach is based on healthy eat­ing but in­cludes daily con­sump­tion of six foods that have been shown to lower choles­terol: soya, healthy oil such as olive oil, fi­bre (bran or pulses), oats, nuts and foods for­ti­fied with plant sterols, com­pounds thought to lower choles­terol by mim­ick­ing it and com­pet­ing with it for ab­sorp­tion into the body from the gut.

The daily doses to be taken are spe­cific: two ta­ble­spoons of vir­gin olive oil, 20 al­monds and 30g of soya prod­ucts.

The au­thors say all these food groups are backed by sci­en­tific ev­i­dence.

‘We don’t have a huge amount of ev­i­dence that di­ets like this will make you live longer — un­like statins where there is hard ev­i­dence that they can re­duce heart at­tack or stroke,’ warns Dr Ju­lian Strange, a lead­ing in­ter­ven­tional con­sul­tant car­di­ol­o­gist.

‘But the diet may help you lower choles­terol.

‘How­ever, it should never be an ex­cuse not to take statins — rather it should be part of the process.’

THE PA­TIENT: Bill Rogers, 52, a re­tired civil ser­vant, lives with his wife, He­len, 52 and has two chil­dren. ABOUT two years ago I went to see my GP as I was hav­ing giddy spells. I’m a fit guy — us­ing a row­ing ma­chine at home for 20 min­utes ev­ery day and I did a lot of walk­ing — but blood tests showed my choles­terol was 7.1 (‘healthy’ is be­low 5). The doc­tor wanted to put me on statins, but I re­ally didn’t want to start tak­ing drugs. My wife found Dr Laura Carr and Ian Mar­ber’s diet and I de­cided there was no harm in try­ing it for a few months be­fore de­cid­ing what to do next. My GP said I was okay to try it for three months. It was a bit of an ed­u­ca­tion, eat­ing foods I’d never tried such as chick­peas, soya and sweet pota­toes. I also started do­ing things like putting olive oil in­stead of but­ter in my sand­wiches — which took some get­ting used to.

But af­ter three months my choles­terol was down to 4.2. My doc­tor said it must be a fluke, but I con­tin­ued and a few months later it was still only 4.4.

It did rise again last Oc­to­ber, to 5.7, but I’d been on hol­i­day and let my­self go a bit.

‘Last month it was 4.6. I’m thrilled. My doc­tor says I don’t need statins pro­vided my choles­terol stays this way.

MY SEIZURES ARE UN­DER CON­TROL

THE DIET: The Ke­to­genic diet

THIS diet, de­vised in the 1920s by a US doc­tor, is a high-fat, low-carb ap­proach based on the idea that swap­ping the body’s en­ergy source from carbs to fats can re­duce seizures.

The typ­i­cal ke­to­genic diet is about ra­tio, eat­ing 3 to 4g of fat for ev­ery 1g of car­bo­hy­drate and pro­tein.

It in­cludes high-fat foods such as but­ter, heavy whip­ping cream, may­on­naise, and oils.

It’s much more re­stric­tive than stan­dard low-carb di­ets, and much higher in fat and lower in pro­tein.

‘The ke­to­genic diet has been a proven form of treat­ment for chil­dren who don’t re­spond to epilepsy med­i­ca­tion,’ ex­plains Dr Manny Ba­gary, a con­sul­tant epilep­tol­o­gist and neu­ropsy­chi­a­trist.

‘It hasn’t tra­di­tion­ally been used by adults since there haven’t yet been large enough ran­domised clin­i­cal tri­als to prove its ef­fec­tive­ness for them, but there’s no rea­son why adults whose con­di­tion doesn’t re­spond to seizure med­i­ca­tion shouldn’t try this diet, un­der the su­per­vi­sion of their doc­tor.’ THE PA­TIENT: Kasam Parker, 49, a so­cial care fa­cil­i­ta­tor, lives with his wife, Na­jma, 47, and their daugh­ters aged 18 and 21. EPILEPSY can take over your life as seizures are so un­pre­dictable. Since my first at 23 I’ve had them at work, home and out with the fam­ily.

‘I can feel giddy for around 24 hours af­ter­wards. I’ve also bro­ken my shoul­der, frac­tured my nose, had cuts to my face and once hit my head so hard I briefly lost my mem­ory. There’s no pat­tern, ei­ther — I could have a seizure ev­ery week or month. It didn’t help that over the years I de­vel­oped a tol­er­ance to dif­fer­ent med­i­ca­tions.

It was an aw­ful way to live. Then two years ago, I read on­line about the ke­to­genic diet. I felt I had noth­ing to lose and my doc­tor said I could do it, pro­vided it was un­der a di­eti­cian’s su­per­vi­sion.

I di­vide my car­bo­hy­drate — around 30g a day — into 5g blocks, a spoon­ful of ce­real at break­fast and then a mouth­ful of bread or pota­toes at lunch or din­ner, and I eat lots of eggs and soya milk.

It’s been dif­fi­cult, but in two years I’ve had only two seizures — the last was eight months ago. I want other peo­ple to know you

can take con­trol with epilepsy.

For help and in­for­ma­tion visit epilepsy.ie

MY BLOOD SUGAR IS BACK TO NOR­MAL

THE DIET: The Low Carb Pro­gramme

THE of­fi­cial ad­vice to di­a­betes pa­tients is to en­sure starchy car­bo­hy­drates, such as rice and pota­toes, fea­ture heav­ily in ev­ery meal and keep fats to a min­i­mum.

The Low Carb Pro­gramme, launched in 2015 by the lead­img char­ity and web­site di­a­betes.co.

uk, is part of a grow­ing move­ment to tackle di­a­betes by cut­ting back on carbs to con­trol blood sugar lev­els.

‘This Low Carb Pro­gramme has been shown to be ef­fec­tive in the short term with weight re­duc­tion and blood glu­cose con­trol,’ says Dr Dushyant Sharma, a con­sul­tant di­a­betol­o­gist. ‘But we don’t have enough ev­i­dence for how well it could con­trol di­a­betes in the long term.’ THE PA­TIENT: Gra­ham Hog­ben, 66, a re­tired men­tal health nurse, lives with his wife Sue, 63. He has one child and four stepchil­dren. I NEVER for a mo­ment thought some­one like me would get type 2 di­a­betes: I was slim, ate healthily and ex­er­cised — and had no ob­vi­ous symp­toms. ‘But eight years ago, I was feel­ing tired and a blood test con­firmed it was di­a­betes. My GP said it could be down to fam­ily his­tory — my mum and grand­mother had type 2. Med­i­ca­tion didn’t seem to help and af­ter two years there was talk about putting me on in­sulin. My wife came across the Low Car­bo­hy­drate Pro­gramme 18 months ago. I de­cided to have a go. I used to eat a lot of bread, pota­toes and pasta, but swapped to lots of meat and fish. I’d snack on green olives or cheese, rather than crisps. Within a week my blood sugar dropped, from be­tween 14 to 18 mmol/L down to 6 to 8 (nor­mal is 4 to 7). My lat­est read­ing was 5.5 and I’ve also lost 3st. My med­i­ca­tion — Gli­clazide — has been halved and my di­a­betes nurse, who was scep­ti­cal, is as­ton­ished. I didn’t re­alise how slug­gish and un­well I felt: now I walk 40 to 50 miles a week and have a new spring in my step. ‘In fact, I’ve never felt bet­ter.’

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