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 ...

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.’