Lukewarm – lifestyle & wellness

L

Barts-MS rose-tinted-odometer: ★★

How brain-healthy is your lifestyle?

Someone asked yesterday why did I give George Jelinek’s book ‘Overcoming MS’ a positive review and yet we don’t promote it openly on the blog? Very simple our policy is not to advertise commercial products on this blog and if we promoted OMS then what about the other MS-related lifestyle and wellness programmes? I am still pissed off with myself for not making it clear that I don’t support the OMS diet. Yes, I support the principles of OMS in terms of lifestyle interventions, but I simply can’t support the OMS diet. The diet is simply not evidence-based. In fact, there is no ‘MS diet’ that is evidence-based so anyone who claims their diet needs to be followed to treat MS can’t be doing this from any position of authority. 

So why did I give OMS a positive review?

The principles that underpin OMS are scientifically sound, but a lot of them are not evidence-based, i.e. they are not supported by randomised controlled trials. Some of the lifestyle recommendations in OMS are also quite extreme and hence are very difficult to follow. I view George Jelinek as the lifestyle-wellness equivalent of the ‘ultra-distance marathon runner’. You don’t need to run ultra-distance marathons to derive the benefits from running, some people do just fine on subscribing to and running regular 5km park runs. It is horses for courses. I think the important messages in OMS and other lifestyle-wellness programmes are:

  1. Lifestyle-wellness interventions are not alternative medicine, but complementary; i.e. you need to do them in addition to taking for example DMTs.
  2. Lifestyle-wellness interventions need to be personalised. In particular, they need to be affordable, compatible with your culture, your worldview and your belief systems.
  3. Lifestyle-wellness interventions fall on a continuum they are not all or nothing phenomenon. You can engage with some aspects of a programme and not others. In other words, doing something is better than doing nothing.
  4. You need to be self-motivated to stick to a healthy lifestyle and wellness programme. I think herein lies the secret of the success of the programmes. Setting goals and sticking to them is self-rewarding. The rewards centres in the brain make you feel good about yourself and motivate you further. The downside is that when you slip you have a sense of self-loathing and guilt. These emotions are part of the package; they are the regulatory or negative emotional feedback loop. My personal opinion is that slipping occasionally is fine, but you need to earn the off-days.
  5. Lifestyle wellness programmes take a holistic view of the management of the disease. Saying this is easy, but it is very difficult to set up a lifestyle-wellness service in the NHS. What is the evidence and how do we show that the programme will be cost-saving to justify the investment? In addition, adherence rates to lifestyle-wellness interventions are very poor. This is a conundrum that challenges HCPs and behavioural psychologists but is not an insurmountable obstacle. There are examples that when politicians, HCPs and the general public get behind a national lifestyle and wellness programme it can work. A good example of this is what Finland has done at a population level over the last 20 years. 
  6. Lifestyle-wellness interventions should be adopted by everyone regardless of whether, or not, you have MS. This is why we set up the Barts-MS Brain Health challenge and why I started the Think Brain Health initiative. Getting HCPs to personally engage with their own Brain Health would make them think about their patients’ health. In addition, patients are more likely to take the advice seriously from a Brain Healthy HCP than from an HCP who is unhealthy. If you smoke, are unfit, overweight and eat badly how can you tell your patients to stop smoking, to start exercising, change their diet and lose weight? Unless you walk the talk you are not credible. 
  7. Most lifestyle-wellness interventions are common sense with an evidence base from outside the field of MS. However, like any other field, the lifestyle-wellness space is full of quacks and charlatans so be careful to accept anything at face value. Do your research and ask questions. For example, what is the evidence that you need to follow a gluten-free diet? Plant-based diet? Etc? Unless you have documented gluten sensitivity there is no evidence. Similarly, the war on fats, and saturated fats, is built on a very poor evidence base. It is clear that fats, and saturated fats, are not bad for you if eaten in moderation. I am sure more evidence will emerge around this issue in the next few years. It is clear that at present processed and ultra-processed foods are in the dog house and justifiably so. I am adamant that what you eat needs to be compatible with your culture which is why I wrote a piece on Medium about Diet as a Philosophy.
  8. Please let common sense rule the day and if you find you like, and enjoy, walking or running 1 km or 5 km, who knows you may gradually extend your walks and runs to 10 km, half-marathons, marathons and possibly ultra-marathons. The intensity and distance are not that important it is getting started and staying committed that is important.

So I yes I have gone lukewarm on OMS because it is not the be-all and end-all of MS management. I have also heard from many independent sources that George Jelinek promotes it openly as an alternative option for the management of MS. I have seen many tragic examples of patients under my care who are now very disabled as a result of using lifestyle and wellness programmes as an alternative option to DMTs to manage their MS. OMS should only ever be used as a complementary MS management tool. 

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Disclaimer: Please note that the opinions expressed here are those of Professor Giovannoni and do not necessarily reflect the position of the Barts and The London School of Medicine and Dentistry nor Barts Health NHS Trust.

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

56 comments

  • Well written and balanced. One question does this advice not apply to everyone not just those with MS ?(though we be less able to get away with not following).

    • Absolutely. Brain Health is something we should all be focusing on whether or not we have a diagnosed medical condition. And please avoid listening to the diet quacks, evangelists, zealots, charlatans, or whatever you want to call them. What, how and when you eat is a very complex issue and what is culturally right and healthy for one group of people will not necessarily be culturally right nor healthy for another group of people.

  • This is a great piece. And I say this as someone who follows some aspects of OMS myself. I attended a conference a few years back and found it almost messianic at times. Anyway you even managed to write this without banging the low carb drum too much 🙂

    • Low carbohydrate diets are only suitable for some people. Some people simply can’t tolerate them and the biological effects of ketosis could be achieved with medication, e.g. fumarates, metformin and other Nrf2 activators. The latter will allow us to test the ketosis/Nrf2 hypothesis of neuroprotection in clinical trials.

      • Dear Prof G,

        Do you beileve that other areas of the OMS plan can help reduce disability and symptoms? Do you believe that exercise and meditation can change the outcome of MS?

        • There is evolving evidence base about the positive effects of exercise in MS; so yes. In terms of meditation, there is a small evidence base in MS, but a larger one in the psychiatric field covering mental health. So yes, I would say both of these components are important.

  • Fantastic piece. I have also learned to steer-clear of any so-called MS cures/permanent remission which rely heavily on personal anecdote like the Coimbra Protocol (advocating up to 200,000IU of Vit D a day).

  • The message that has trumped the others for me is the connection between developing co-morbidities and worsening MS. My feeling is that staving off preventable co-morbidities is the only significant thing within my control. I don’t expend emotional energy worrying about my medical care because I trust the people looking after me – fortunately. Support and care are solid . The clinical progression of the illness is not in my gift. The only thing that I can really influence is how I live. It’s a carrot and stick scenario, virtuosity sitting alongside fear of the consequences of letting things slip. Overall, virtuosity wins the day – my physio’s mantra is: ‘You have to live a happy, healthy life’. And knowing that this does impact the MS is what keeps me going.

    • I largely agree.

      There are two things that keep bothering me in that view though:
      1) Am I on the right DMT (ocrelizumab) and is there anything I should add to that? I don’t think anyone has a good answer to that or is there some decision criteria there that I missed?
      1) Which diet is right? I follow loosely Mediterranean (probably on average more meat) which seems like a safeish bet, but keep wondering if keto would be an option…

      Truth to be told, I find these posts a bit dispiriting – ‘I do all that anyway, yet feel like I am slowly declining’…

  • Brilliantly written …I shall certainly be copying and pasting this when I get sent ‘advice’ of how to manage (or fix) my MS!

  • Oh dear you’ve missed a few key points of OMS, including messing up key messaging of George Jelinek’s view on DMTs. He, and OMS say do “whatever it takes”, and if that means DMTs, then the advice is do DMTs! This article is poorly researched. Please do your homework first.

    • It is important to make sure this message is clear hence this post. Thanks, for reinforcing the message.

      Hopefully, an official OMS spokesperson or George Jelinek will post a comment in relation to this post stating this as well.

    • Joe,
      George Jelinek repeatedly says do “whatever it takes” but if you look close he has a very ambivalent relationship to DMT’s.
      For example, in his book he writes: “You may prefer not to use medicine unless it’s really needed. As MS varies widely, this approach seems sensible.” (https://overcomingms.org/recovery-program/medication/exploring-your-ms-medication-options).
      This flies in the face of a number of clinical studies which show that people with MS on DMT’s live longer and better lives – and are able to stay in work longer.
      Also, he continually refers to side effects of highly effective DMT’s… and prefers Copaxone – which is pretty ineffective as an MS drug.

  • “I have many tragic examples of patients under my care who are now very disabled as a result of using lifestyle and wellness programmes as an alternative option to DMTs….”

    No doubt this is true….OMS all think that relapses have stopped for 3-5 years that a diet cured their ms…laughable if it wasn’t so tragic and naive…but this is no different from neuros and pharma that allow people to believe that DMT therapy that only stops relapses and mri lesions stops their ms and removes all chances of disability progression.

    For this patient DMT didn’t help and this is a very..typical 15-30 year progression..continued lesions show he would have done far..far better with hsct.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5221476/

    • Why did this man only have a brain MRI and not a spinal one at first
      Symptom? Why did nothing show for two years?

      • “Why did this man only have a brain MRI and not a spinal one at first
        Symptom? ”
        That is standard procedure..wouldn’t have made any difference if he had spinal mri…all his spinal lesions came later with sp ms.

        “Why did nothing show for two years?”…That is how ms works..it comes and goes i.e. relapses…but the brain loss is relentless.

        • But the diagnostic tools for MS relies on Lesions being present and I thought when lesions come and cause symptoms they remain but are not always active?

          I understand there are around 5% who have clear MRI but my understanding is that it’s is probably even less than this with current MRI machines?

          How can they be so sure it’s not MS if someone has a clear MRI?

          And if someone has symptoms how soon after should they have a repeat MRI?

  • I use parts of the OMS program, but not slavishly, mainly because I was already running and my diet was almost identical to OMS, as I don’t much like dairy and definitely not meat. Yuk. I find the meditation a bit a of a bore but I try to meditate sometimes. I’m suspicious of westerners adopting eastern practices like yoga. We are occidentals and think differently. Quite enjoyed meeting Prof Jelinek and colleagues at a conference, but it’s important to think ‘moderation in all things’. I avoid the messianic approach. It can lead to a feeling of failure. So while I don’t think OMS is quackery and George Jelinek promotes DMTs as well as all the other stuff I put my faith in conventional medicine. Overall I have noticed no improvement after 2 1/2 years and I worry for the poor patients who cling to alternative medicine and approaches. It can be a dangerous path to tread if they then fail to follow standard advice from their neurologist. Their health may take up somewhat, maybe as a sense of ownership of their condition prevails but there’s a chance they may well deteriorate after that initial 2-3 years of going down this particular rabbit hole.

  • Thank you for this. It’s fair, honest and helpful to those of us who can feel a little bombarded by the diets advertised for MS through social media channels when we are just trying our best to keep our MS in check with a healthy, balanced diet, exercise when we can and starting DMTs early.

  • In only read the OMS book and there they emphazise you take your DMT’s. I thought that was one of the strong points of the book: do everything you can to slow this monster. Not familiair with the community. I did the OMS diet for first 7 months and did good on it. After that i tried Wahls paleo for a few months and switch to a very strict KETO diet for 3 months. Ketosis actually made me a lot more tired, a real bummer cause i liked the diet and the sience behind it.

    I find the diet game a very stressfull deal for a person with progressive MS, as i am desperate for every little small benefit i can get out of diet/lifestyle. I got my complete gut microbiome and all kind of markers checked out by a good lab and no shocker: the diversity is lacking. It also said i was probably on a high fat, high protein diet which is almost completely the opposite from what i have been on the last months. It is really impossible to find skilled people (in Holland)who can help me to see if based on this information there some benefits to get through diet.

    • Re: “In only read the OMS book and there they emphazise you take your DMT’s.”

      Yes, that is the point. The book states this, but the messaging from many of the proponents of OMS is that it is an alternative to DMTs. I just want to make the point that this is not the case.

    • People come and go here so it’s new to them…in general you are far too diplomatic/non confronting…w/ people here and other ms neuros.

      it seems…people hear what they want to hear..unless you sledgehammer the idea it does not get through.

  • Very good article, as someone with PPMS and do not have DMT option, all I have is lifestyle-wellness interventions (clean diet, exercise and nutrition supplementation) to provide some sense of hope and proactive control. Programmes like OMS in this situation can provide some hope/chance to slow down progression where there is nothing else on the table other than to be a spectator to the progression, what do I have to loose… (BTW not cool for OMS to miss quote you!)

      • Just want to say thank you for all your hard work, commitment, research and information, I’m not the best with words but big thank you for putting yourself out there and helping and informing those of us living with MS.

  • Earlier today, I recklessly defended Prof G’s honour on an FB group, when someone accused him of being an OMS fan. Being familiar with Prof G’s excellent diet philosophy set out in his ‘Medium’ piece, the accusation of Jelenik fandom sounded to me so unlikely that I charged into the lists without having taken the basic precaution of doing some research. Then this piece arrived. Live and learn, eh? 🙂

  • Excellent post and particularly like the emphasis on ‘different strokes for different folks’ as culture, religion etc plays a big role in how we relate to diet.

  • Great, balanced post. There is a lot of good sense in the OMS book and it’s a good reminder that a healthy lifestyle is important – if it’s something you’ve forgotten or never adhered to in the first place. But I think it is probably okay to eat an egg now and again :o)

  • Ultra runner and OMS follower here.

    I agree with most of what you have said though. I chose OMS because it was very close to how I already ate which is what I saw as a healthy pescetarian diet. The amount of dairy and coconut oil I consumed rose before my diagnosis though so in the context of an already healthy diet, these were the easiest things to change to make it healthier.

    The other parts of the programme appealed too – obviously exercise was easy. I ran my first ultra marathon a few months after my diagnosis but I was already running marathons and leading running groups. Vitamin D – a test when I was diagnosed revealed I was deficient so I started to supplement. Meditation was harder and I’m still working on that, but I feel the benefit when I practice more consistently. Taking medication is an important part of the programme and I adhere to this. I was adopted along with a genetic half brother so getting family members to follow the programme is less important but after staying with me, my mum decided she liked the food and felt great so that’s how she was going to eat from then on (no chance with my meat-loving and very unhealthy brother!).

    One thing I have noticed is a lot of people who follow OMS seem to make up extra, and more extreme rules for themselves like cutting out gluten, sugar, and all oils. I agree this is overkill. I have backed right away from a certain Facebook group where people seem to have made up their own interpretations of what the programme means.

    George Jelinek to me comes across as quite relaxed and advocating a common sense approach. For example, avocados contain saturated fat but he says it’s still good to eat them. I think one of the huge dangers of the programme is stressing too much about the food aspect of it, which in my mind really defeats the point. I certainly don’t follow the programme to the letter myself, but it’s a useful guide to return to especially at times when I’m not feeling 100% – I might double down on my healthy efforts and am usually rewarded with feeling a lot better. But as you say it’s important not to descend into self loathing. I love cooking and eating so it’s actually a really fun way for me to practice self-care – no self loathing allowed!

    I should also mention comorbidities – I have EDS and my diet prior to OMS could be seen as an “anti-inflammatory diet”. It seemed to help – I have gone from someone who thought I shouldn’t run because of my dodgy joints, to running (sub 4 hour) marathons and ultras (something like 15 to date, though I didn’t finish two of the longer ultras I still ran 65 and 75km in them!)

  • Dear Prof G,

    Do you beileve that other areas of the OMS plan can help reduce disability and symptoms? Do you believe that exercise and meditation can change the outcome of MS?

    • “Do you believe that exercise and meditation can change the outcome of MS?”

      He has posted many times…Most articles here have to do with EBV and b cells/tcells…your diet doesn’t influence those things…diet and exercise is good for your heart but does absolutely nothing for your ms. Why is this so hard for people to understand..? Why do people cling to this diet/exercise Voodoo..it is so very sad.

      • Exercise absolutely good for MS.

        The more obvious reasons:
        – Muscle can to some degree compensate unsteadiness
        – It helps with spasticity

        It very obviously is no silver bullet.

      • I don’t believe it is sad at all. There are a lot of people doing very well through exercise and whereas people were told in the past that exercise would increase their symptoms – lots find it very beneficial.

        What’s voodoo about that?

      • I don’t believe it is sad at all. There are a lot of people doing very well through exercise and whereas people were told in the past that exercise would increase their symptoms – lots find it very beneficial.

        What’s voodoo about that?

  • Excellent post

    George Jelinek & OMS are very appealing for anyone new to MS: at that stage you want something that says “Do this and you will be fine”. Which is something no neurologist will say

    You soon realise that the diet is unproven, unscientific. And so extreme that if someone does not do well, it can always be blamed on not following the diet. But the OMS people 100% believe in it and advocate the diet unthinkingly

    What is good about OMS is the idea that lifestyle interventions can make a difference.
    However, I really suspect that how much you can do is a function of your disease severity. If your disease is active, you’re not in mental and physical state to do much

  • Similar to many other pwms, shortly after being diagnosed I spent days researching everything MS related, which included diet as a cure, dare I say CCSVI, and many other rabbit holes. While I do believe in a balanced healthy diet, meditation, yoga, breathing techniques, exercise, vitamin supplements, and sleep……I do not believe they cure or treat MS. They are complements to a highly effective DMT. Pretty sure I saw in that one netflix movie, Dr. Wahls ultimately met the same disability end point we all face.

    I think pwms have zero “reserve” so we tend to “feel” the benefits of a healthy lifestyle more than the normal individual. However, one must balance living a healthy lifestyle with enjoying life. Most individuals live a healthy life to avoid getting diseases like MS, but I already have MS, so I am not very motivated to cut out the things in life that make me happy. All things in moderation.

    P.S. If one more co-worker, neighbor, or friend tells me a story of someone they know who “cured” their MS with diet X or vitamin Y…..I might just snap! With Peace and Love. Peace and Love.

  • Dear Prof G,
    Thank you for highlighting to your readers the messages that Overcoming MS champions, such as lifestyle interventions having a key role to play in MS prevention and progression.

    OMS wishes to re-affirm that taking a disease-modifying drug is one of the key steps of the OMS Program. With respect to the OMS-recommended diet, this recommendation for a high-quality plant-based wholefood diet plus seafood is based on the best available evidence. As noted in the blog, there are not yet any randomised controlled trials of diet in MS; the difficulties in conducting a trial where people are randomly allocated to adopting a new dietary pattern are self-evident. The evidence on which the dietary recommendations are based is quite large and congruent, and has continued to grow since the publication of the OMS book. Recent large observational studies in North America and the Netherlands note that those people with MS adopting higher quality diets have the best health; the Dutch study, shows that those people with MS following the OMS-recommended diet have the highest diet quality.

    The OMS Program offers a range of choices, based on the best available evidence; people with MS can assess the evidence base on which all the recommendations are made in the Overcoming Multiple Sclerosis book and on the website (www.overcomingms.org). We support and encourage people with MS to make informed choices about how much (if any) of the Program they adopt, and how rigorously. Many of us diagnosed with MS have chosen to adopt most or all of the recommendations to give ourselves the best possible chance of a good outcome and a long and healthy life. OMS hopes, as the evidence base continues to grow, that this broad-based program for people with MS, designed to prevent deterioration in their health, will become a mainstream medical approach recommended by healthcare providers.

    Overcoming MS exists to help inform, support and empower people with MS. We focus upon championing the role of self-management and addressing specific lifestyle factors that can help to reduce the risk of developing MS, and from progression of the condition itself. Our advice (articulated in the OMS program) includes diet as above, vitamin D supplementation, stress management, disease-modifying therapy and exercise.

    We also signed up to the Brain Health Matters which campaigns for early DMT treatment, and our view hasn’t changed.

    For any of your readers who are interested in learning more – please visit our website http://www.overcomingms.org

    Grazina Berry
    Chief Executive

    • Thanks, Grazina.

      I totally aligned with your statement “misguided beliefs that lifestyle interventions should replace conventional treatment, or that it should be all or nothing”. OMS is as good a guide as any to help pwMS manage their MS holistically. As I have said before I just don’t agree with the chapter on diet.

  • Thanks for this article. Your general points about lifestyle programmes are all spot on, especially that they are complementary not alternative.

    I started following advice from George Jelinek’s first MS book (Taking Control of Multiple Sclerosis) after I was diagnosed back in 2008, stuck on a waiting list for months as my condition rapidly deteriorated, so I was hoping to find anything I could do myself that might improve my chances. Honestly, I think if the book had been called “Overcoming Multiple Sclerosis” back then it would have put me off – it sounds too bombastic, too overconfident. I feel that MS is an illness we can work to live with, but not overcome.

    However, what made this book feel different to all of the other self-help guides was;

    1. all of the advice was also available for free on the website.

    2. Jelinek cited his evidence sources (hundreds of scientific and medical articles- I was studying for my PhD at the time so used my university access to read some of these, along with other literature on MS).

    3. the book wasn’t opposed to conventional medicine. It advocated using steroids and DMTs as needed.

    I started out with using bits and pieces from OMS. Over time I’ve built in more, but it’s not a religion, I don’t slavishly adhere to everything. It’s helped me, alongside treatment with steroids back in 2008 and with Tysabri. Over 12 years now with no relapses, working full time, living an active life.

    There wasn’t a randomised controlled trial to support the dietary guidance but that’s very difficult to do with diet unless you’re looking at a specific supplement as a tablet or similar. I believe that Jelinek is continuing to run studies on various aspects of dietary advice and will be interested to read the results.

  • There are a number of issues with this somewhat self-contradictory rant. Most concerning is the scare mongering created for many people who are actively engaged in the healthy lifestyle management that OMS advocates (nb. most of whom will also be taking a DMT). Using your platform to post such comments demonstrates the power imbalance that often exists between patients with MS and their Neurologists.

    My experience of OMS is that it is largely made up of people who simply want to do whatever they can to have a good quality of life; physically and psychologically. It is not a decision between drugs or lifestyle. They do not criticise drug treatments, but are grateful for the advances made in recent years. In fact, OMS events I have attended have given really valuable, clear advice on medication choices – much more detailed than that provided by neurologists who are understandably pushed for time during consultations. However, in my experience many people with MS DO feel let down that their decisions to make healthy lifestyle changes are so often challenged and, at times ridiculed. As a health professional myself I see no other medical speciality in which this happens.

    Personally I am very grateful for the information and support that OMS has provided for me over the last ten years – none of which I was able to access in mainstream services (a really very important point to note). At the time of my diagnosis DMT’s were not indicated so my options were go home and call the MS service if/when I relapsed, OR do my own research. Having lived and breathed OMS for many years I can say for certain that no guarantees have ever been given about outcomes at any point (in the same way no pharma treatment comes with guarantees). I do however take huge comfort from the fact I am doing all I am able to do, based on the best possible evidence, to live well with MS.

    Finally I would say that as a health professional, you cannot decide for someone else the side-effects and risk that another person should/can tolerate. Furthermore, the level of evidence required to make radical lifestyle changes will be different for everyone. A person with MS may feel that if making lifestyle changes contributes to just a 2% difference in their symptoms, then that is still absolutely worth it. That 2% is precious. No-one can decide for you because each person will see the balance of benefits V effort, differently. The point is, people with MS need to be supported to make their own, educated decisions and not patronised.

    • Not seeing any scare mongering against lifestyle changes in that article in the context of MS treatment (just not as sole treatment). If anything, ProfG is consistently very much in favor of those.

      I can only speak for my own experience, but neuros consistently encouraged me to focus on lifestyle with the caveat that none of them were big on diet recommendations (aside of the obvious stay away from sugar and processed foods) because the data just is not there for the more extreme diets. So by default it’s Mediterranean’ish diet because that’s unlikely to be actively negative.

    • Yes, I do with the caveat about the OMS diet. The book is well-written and makes sense. I would recommend all HCPs read it as well. A brain-healthy NHS workforce would help not only our patients but everyone.

      • “Most concerning is the scare mongering created for many people who are actively engaged in the healthy lifestyle management …”

        Sorry…not enough scare mongering when people are asking if
        diet and meditation can control ms.

  • I feel that you are missing a big factor about the OMS diet. Yes, the focus most people seem to pick up on is about drastically reducing saturated fat intake in the diet. However, the OMS diet is also about cutting out the highly refined vegetable oils from the diet also, which quite a few prominent people in the world of medicine and research (e.g. Tim Spector, Dr Andrew Jenkinson) are encouraging everyone to do…we have a huge propensity of these oils in our diet now – the availability of soy oil has increased by 320% in 50 years – and to give you a comparison the availability of sugar and sweetness has increased by 20% over the same 50 year period.

    I think it is unwise to completely disregard the OMS diet. I would say that the OMS diet gives patients a framework to begin to understand what foods and methods of cooking are beneficial to human health, and that if they can follow the diet for 4 to 5 days a week, then they will be eliminating much of the highly refined vegetable oils from their diet, eating far more fruit and vegetables and far less processed food, and will also be having their oily fish intake for the week too.

    Dairy and meat is a contentious issue, as it is difficult to get good quality products for both of these food groups. Most of the dairy and meat being consumed in the UK today is from industrially reared animals, who are not being fed a natural diet (it’s grain and vegetable oils much of the time), and also are quite highly medicated as well. To have a diet where these products take centre stage is not healthy for anyone – with or without MS. Dairy and meat can have their place, just it’s expensive and difficult for many to ensure that they are getting good quality grass reared produce.

    • Nobody is dismissing the OMS diet. It is just one type of diet of many. The problem is that it is antisocial. Most of my patients who stick to it religiously often have to eat separate meals to their families. Therein lies the problem.

      • Whether something is antisocial or not is entirely subjective. Some might say it’s pretty antisocial to eat an animal!
        And eating a largely plant based diet is actually very affordable and easy these days, as well as recommended by research relating to a range of health presentations.

        • Eating a diet very different from your social circle makes socializing (which quite often revolves at least partially around food) substantially harder.

          That’s what antisocial means here, not some sort of moral or value judgement on the components of said diets.

  • Apologies to GJ and the publisher of the OMS book. Just being reminded that I vetted the quote that did not include my thoughts on the diet. I have updated the blog post accordingly.

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