Vegetarians versus omnivores; which one is right? If you take a tour through this site it will become very apparent that I am a big proponent of the role diet can have in both the development but also the course of multiple sclerosis. Dietary strategies for MS have not been largely studied by the medical community as the current wisdom in Western Medicine is that MS is a neurological condition brought on by dysfunction in the immune system. This view of the disease is followed by the statements, “we do not know the cause” and, “there is no cure.” There can be no debating the last two statements at this current time, however every current conventional treatment is based on the assumption that the statement preceding them is correct. The prevailing wisdom amongst neurologists and many MS patients is there is no evidence to support the role of diet in the development and in recovery from MS and the management of symptoms. However, if evidence did exist that diet can have a profound impact on the disease, should people with MS consider a change in diet? If so, would a vegetarian or omnivorous based diet be best?
Before diving into whether a vegetarian or omnivorous diet is best, it is important to show that there is evidence to support the role of diet in multiple sclerosis. However, what constitutes ‘evidence’ can itself become a epistemological debate. Much of the evidence to be presented here will be discarded by some as ‘anecdotal’ or not valid proof because it only shows a correlation and not a clear cause and effect relationship. Herein lies both the issue and the debate since the medical community is largely unwilling to look at diet with regard to MS. As a result no large scientific studies on the specifics of what is to be presented here have been done. In order to meet the burden of proof, one or more of the bodies which will either discredit or discount the evidence would have to perform a study. It is circular reasoning at it’s worst- “Since by my standard no proper study has been done, which I would have to do in order for it to be considered proper but I refuse to do, your ideas and circumstantial evidence are not valid.” In reading the evidence presented here, you as the consumer of the evidence will need to decide if it meets your requirements.
A link between multiple sclerosis and vitamin D was established years ago. There exists a very real geographic distribution of the disease and it is more prevalent in populations further north and further inland. Since one of the primary sources of vitamin D is sun exposure and there is less sun exposure the further away people live from the equator, it is reasonable to make the connection between vitamin D and MS. From a dietary perspective, one of the primary non-solar sources of vitamin D is fish oil. A study was done in the 1990’s (which you can read here) which showed:
…the relatively high MS risk in Scandinavia except along the Atlantic coast of Norway. This anomaly is also unlikely to have a genetic basis, but it may have a dietary basis. Most foods have little vitamin D3 content, but fish oil is a rich source of vitamin D3. Norwegians living in coastal fishing districts consumed an amount of fish and margarine that provided about 1300 IU of vitamin D3 daily, about 3-fold higher than individuals living in the inland agricultural districts.
Critics will argue that this study merely shows a correlation between vitamin D, fish oil, latitude, and multiple sclerosis. It can’t be argued that the study demonstrates a definitive causal link. However, given the relatively low cost of vitamin D and fish oil supplements, would a person with multiple sclerosis find this evidence compelling? Would you?
Vitamin D is absorbed from the sun, but most of the essential vitamins and nutrients required for humans to live and thrive are received from dietary sources. A 2002 study, published in Nutritional Neuroscience which you can read here, found that:
….The findings of those studies as well as the present study may support the idea that there is in fact a strong relationship between antioxidant vitamins and oxidative stress although there are some other factors involved in the pathogenesis of MS.
Our study raises the interesting question of whether or not vitamin supplementation could be of any value in prevention or treatment of MS.
Again, critics will argue that this ‘evidence’ is indirect and does not demonstrate a clear link, only a correlation.
However, what if a multiple sclerosis patient existed who had successfully tried nutritional strategies to improve their condition? What if this patient was a practicing medical doctor who had tried and failed with conventional therapies? If such a person existed and was combined with the examples above, would it constitute ‘good evidence?’
The person described does exist. Hopefully you’ve heard the story of Dr. Terry Wahls. She had progressive multiple sclerosis and was confined to a wheelchair. She had tried, unsuccessfully, all of the current cutting edge therapies for MS and continued to get worse. She did her own research and came to the conclusion that proper nutrition, specifically for her mitochondria, could be the key to reversing the disease. She designed a diet and within months was walking and riding her bike! From a wheelchair to walking within months- is that good evidence? (you can watch Dr. Wahls’ Ted Talk on the diet page)
How does all the above relate to a vegetarian diet versus an omnivorous diet for those with multiple sclerosis? Dr. Wahls’ diet specifically looked at the following vitamins/nutrients and their relation to both mitochondrial and brain health and highlighted the importance of:
- Animal-based omega-3 fatty acids
- Coenzyme Q10
- Vitamin B1
- Vitamin B9
- Vitamin B12
When considering whether a vegetarian or omnivorous diet would be best for people with MS, we first have to agree on a starting point. If we agree to use Dr. Wahls’ diet as an optimal diet for people with MS, then we can evaluate the essential nutrients and vitamins she sees as crucial (listed above) to see if a pattern develops. It is reasonable to use Dr.Wahls’ diet as a starting point as her recovery from progressive MS combined with her also being a medical doctor make her story both compelling and a unique example. Omega-3 fatty acids are essential for human health and your body can’t produce them. Omega-3’s can be found in both animal and plant sources, however:
Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are found in cold water fish such as salmon, mackerel, halibut, sardines, tuna, and herring. ALA is found in flaxseeds, flaxseed oil, canola (rapeseed) oil, soybeans, soybean oil, pumpkin seeds, pumpkin seed oil, purslane, perilla seed oil, walnuts, and walnut oil. The health effects of omega-3 fatty acids come mostly from EPA and DHA.
Dr. Wahls specifically highlights animal based omega 3’s as most of the health benefits are found in this form. It should be noted that the body can convert the plant based sources into DHA and EPA, but this process isn’t ideal as most people don’t make this conversion efficiently. So for people with MS, it would be best to obtain omega 3 from animal sources.
The human body makes creatine from meat and fish. It supports skeletal muscles and plays a role in brain function and supporting the mitochondria. Creatine can’t be absorbed by eating fruits and vegetables, but vegetarian sources of creatine can be found in non-naturally occurring supplements. So naturally, humans would obtain creatine from eating meat, however, thanks to modern science, vegetarian sources of creatine are available.
Most B vitamins, like vitamin B1 and B9, can be acquired from plant sources. Iodine and coQ10 can also be absorbed from plant based foods. Green vegetables, seeds, nuts, and numerous other plant based foods can provide adequate levels of most B vitamins, iodine, and coQ10. However, vitamin B12 isn’t actually produced by either plants or animals but rather bacteria. Plant foods, “do not contain vitamin B12 except when they are contaminated by microorganisms or have vitamin B12 added to them.” Animals are contaminated with B12, so eating meat naturally provides B12. Vegetarians who use supplements or consume foods fortified with vitamin B12 can receive an adequate amount.
The dietary strategies espoused by Dr. Terry Wahls, and people like Ashton Embry before her, would on the surface seem to promote an omnivorous diet over a vegetarian one. However, to be fair, most of Dr. Wahls’ diet is plant based and then supplemented by wild and grass fed meat. An omnivorous diet would be best due to the natural absence of substances like omega 3 (DHA and EPA), creatine, and vitamin B12, in plant based foods. However, adequate levels of most of these vitamins/nutrients (the only debatable ones being DHA and EPA from omega 3 fatty acids) can be obtained through synthetic supplementation.
So what is the best diet for those with multiple sclerosis? The answer to that question really depends on personal preference. If Dr. Wahls’ story and the supporting evidence found on this site and others are compelling to you, then the choice is clear- the omnivorous diet is the ideal one. However, if you have a philosophical, religious, or political aversion to eating meat, it appears possible to supplement your diet with artificial compounds to ensure adequate levels of essential vitamins and nutrients.
For me, I feel the most natural diet is best. I’ve made a commitment to myself to eat as natural of a diet as possible. I source grass fed and wild meats from a local butcher and I also source wild seafood from a local supplier. In addition, I try to purchase only organic fruits and vegetables whenever possible. Using artificially created supplements would seem counter intuitive to eating naturally. In addition to that sentiment, in Dr. Wahls’ Ted Talk (which you can view on the diet page), she makes the comment:
…I should get my long list of nutrients from food; that if I did that I would probably get hundreds, maybe thousands of other compounds science has yet to identify but would be helpful to my brain and my mitochondria.”
This comment is another reason why I’m not certain of using supplements for substances like vitamin B12 and omega-3 fatty acids; there could be other substances contained in meat and fish that aid in slowing or reversing multiple sclerosis. As mentioned from the outset of this piece, there hasn’t been enough research done on diet to adequately answer this question and is the primary reason many in the medical community (and even patients) ignore and discount the growing body of circumstantial and anecdotal evidence on the role of diet. It is up to each person living with MS to ask their own questions and do their own research and come up with their own plan to fight the disease.
Until next time,