healthy nutrition with multiple sclerosis · about a possible connection between vitamin d and...
TRANSCRIPT
Healthy nutrition with multiple sclerosisNutritional recommendations
4
2
Eating healthy with MSDear reader,
First things first: There is no “official” scientifically-approved diet for MS patients. Although you may frequently read about special MS diets, there is no evidence so far that they are effective.
On the other hand, we do know that certain aspects of a patient’s diet can have a positive effect on inflammatory and immune processes in the body. Anti-inflammatory diets therefore focus on certain fats, vitamins and trace elements.
In the following pages, you’ll learn more about which components of your diet have an impact on inflammatory processes in the body, and how they can influence osteoporosis, bladder and intestinal problems, or obesity. And you’ll learn some easy ways to optimise your daily meal plan.
Superfoods, veganism, paleo or Mediterranean diets — there’s always some new food trend to try out. But not all of them are really good for you. That’s why we’ve collected all the most important information in one place.
This brochure is designed to help you to develop a healthy diet that will have a positive influence on your physical comfort. But while discipline is important, don’t forget that a “good diet” also means one that brings you pleasure and improves your quality of life. In other words: Go ahead and treat yourself once in a while. Exceptions are allowed.
For more information, simply visit the Web links provided in the text.
We wish you the best of luck.
Your MS und Ich team
To learn more:
www.msundich.de/fuer-patienten/leben-mit-ms/
i
3
Contents Nutritional recommendations
Why fats are important ................................... 4
Vitamins and trace elements protect your cells ............................................... 6
Vitamin D to protect against MS? ............... 8
Preventing osteoporosis .................................. 9
The importance of a balanced diet............10
Tips for good digestion ..................................12
Exceptions are definitely allowed! .............13
Superfoods, veganism, and more ...............14
Key recommendations at a glance ......16
Additional information
Additional information .................................18
Help and advice ...............................................19
4
Why fats are importantAlongside proteins and carbohydrates, fats are one of the three basic building blocks of our diet.
Omega-6 and omega-3 fatty acids affect inflammatory processes in the body. Arachidonic acid, a pro-inflammatory omega-6 fatty acid, is especially prevalent in animal-based foods.
Fatty fishes like salmon, herring and mackerel are particularly rich in eicosapentaenoic acid, an anti-inflammatory omega-3 fatty acid.
Reducing pro-inflammatory fats and favouring anti-inflammatory fats is the key to an “anti-inflammatory diet”.
4
5
Nutritional recommendations: FATS
Fats and oils
Recommended daily amounts
10–15 g oil (e.g. rapeseed, soybean or walnut oil)
15–30 g butter or margarine
Rapeseed, soybean, safflower, walnut, pumpkin seed, olive, sunflower and wheat germ oils, diet margarine
Animal fats like butter and lard
Meat, sausage, fish, eggs
Recommended weekly amounts
300–600 g lean meat and sausage
80–150 g low-fat sea fish plus 70 g fatty sea fish
3 eggs, incl. processed eggs
Chicken, turkey, beef, lamb and pork fillets, lean ham, roast beef, fresh or frozen fish or seafood
Fatty meats, chicken with skin, organ meats, fatty sausage, liver sausage, bacon, etc.
Milk and dairy products
Recommended daily amounts
200–250 g milk/yoghurt plus 2 slices of low-fat cheese (50–60 g)
Buttermilk, low-fat milk and dairy products, low-fat yoghurt, kefir, cheese up to 45% fat in dry matter.
Whole milk, fatty cheese over 45% fat in dry matter, cream, mayonnaise, crème fraîche
5
6
Normally, an efficient system of vitamins, trace elements and enzymes, known as antioxidants, protects our body and its cells.
Vitamins and trace elements protect your cells
People with multiple sclerosis may have a greater need for antioxidants due to the inflammatory processes caused by the disease.
Important antioxidants include vitamin A, vitamin C, vitamin E and beta carotene, as well as trace elements like copper, selenium and zinc. An adequate supply of these nutrients is an important part of an anti-inflammatory diet for multiple sclerosis patients.
A balanced diet — with a variety of foods, neither too little nor too much — ensures you get all the most important nutrients you need each day.
Dietary supplements are only recommended in a few specific cases. You should only take these supplements after consulting with your doctor, since too much of certain nutrients can actually be harmful.
7
Nutritional recommendations: FRUITS AND VEGETABLES
Vegetables, salads and legumes
Recommended daily amounts
At least 3 servings of vegetables:300 g vegetables (cooked)
plus 100 g raw vegetables / salad or 200 g cooked vegetables plus 200 g raw vegetables / salad
Fresh seasonal vegetables like peppers, broccoli, spinach, carrots, legumes; fresh herbs e.g. parsley; salads; frozen vegetables as a supplement
Vegetables in jars and tins or in fatty prepared meals
Fruit and nuts
Recommended daily amounts
2–3 servings of fruit (250 g or more)
One portion of fruit can be replaced by 25 g of nuts
Fresh seasonal fruits like apples, pears, blackcurrants, apricots, honeydew melon, strawberries, plums, cherries, peaches, walnuts, cashews, peanuts and almonds, sunflower seeds, pumpkin seeds, dried fruits, etc.
Fruit in jars and tins
7
8
Recent years have seen increasing discussion about a possible connection between vitamin D and multiple sclerosis.
The original basis for this was the realisation that MS occurs more frequently in places that are farther from the equator. Researchers therefore suspected that the amount of sunshine exposure might influence the risk of developing MS.
It was also observed that MS patients had lower vitamin D levels than healthy people. An association was established between vitamin D deficiency and an increased relapse rate and disease activity in MRI scans. A number of studies are currently investigating how much of a connection there may be between vitamin D deficiency and disease activity.
The body can produce vitamin D on its own through exposure to UV light. Even just 10 minutes a day in the sun are enough to produce sufficient vitamin D for the day. You can consult with your doctor about whether an additional dose of vitamin D would make sense for you.
Vitamin D to protect against MS?
9
Preventing osteoporosisPeople with multiple sclerosis are at increased risk of developing osteoporosis. To prevent osteoporosis, do physical activity outdoors every day if possible, and be sure to get enough calcium and vitamin D.
The biggest sources of calcium in our diet are milk and dairy products. However, certain vegetables including kale, soybeans and grains (preferably whole grains) also have a high calcium content, as do fish and legumes.
Tips to prevent osteoporosis
Keep an eye on your diet and be sure to get enough calcium.
Exercise outdoors every day. If you have limited mobility, talk to your physiotherapist about an exercise programme.
Don’t smoke.
Watch your weight.
If you don’t get much sun, you should talk to your doctor about an additional dose of vitamin D.
10
A balanced diet provides the body with all the nutrients it needs. That means eating a variety of foods in appropriate quantities — not too much and not too little — and consuming a suitable combination of nutrient-rich and low-calorie foods, with an emphasis on plant-based foods.
It’s important to always chew your food thoroughly. So take your time, eat slowly and enjoy your meals. To keep your intestines
The importance of a balanced diet
operating smoothly, make sure to eat enough fibre every day.
You should always drink enough fluids with your meals and throughout the day. Consuming sufficient amounts of liquids is not only an important part of a balanced diet, it also reduces the risk of urinary tract infection, stimulates digestion and helps with concentration problems and fatigue. It’s a simple way to keep both body and mind in good shape.
11
Nutritional recommendations: GRAINS, SIDE DISHES AND BEVERAGES
Bread, grains, side dishes
Recommended daily amounts
200–300 g or 4–6 slices of bread or 150–250 g or 3–5 slices of bread plus 50–60 g breakfast cereal
200–250 g potatoes (cooked) or 200–250 g pasta (noodles) or 150–180 g rice (cooked)
Whole-grain bread, whole-grain noodles, raw muesli, oat flakes, potatoes
White flour and all products made from it: Noodles, bread, rolls, cakes
Beverages
Recommended daily amounts
At least 1.5 litres
Mineral water, fresh-squeezed fruit juices, spritzers, fruit tea, herbal tea, decaffeinated coffee
Soft drinks, coffee, cola, instant beverages, wine, beer, spirits
11
12
Stress and a hectic lifestyle often have a negative effect on digestion. Regular exercise or simply taking a walk stimulates the metabolism and supports intestinal activity. For relatively mild digestive problems, certain natural methods can help to stimulate intestinal activity.
If you have frequent or severe digestion problems, consult a doctor. He or she can prescribe medication and give you additional advice.
Tips for good digestionNatural ways to stimulate intestinal activity
Drink a glass of uncarbonated, room-temperature water when you first get up
Soaked dried fruit (drink the water and eat the fruit)
Linseed, wheat bran or lactose in muesli, fruit salad or yoghurt
Sauerkraut or sauerkraut juice
Intestinal massages (circular movements from right to left)
Take a walk after eating
12
13
Exceptions are definitely allowed!
The nutritional recommendations of the “Deutsche Gesellschaft für Ernährung” provide an important basis for a healthy and balanced everyday diet. But while discipline is important, don’t forget that a “good diet” also means one that brings you pleasure and improves your quality of life. So it’s also important that eating be a fun and enjoyable experience. Find foods that are healthy and taste good to you personally, as well as recipes that you can enjoy.
And don't forget: It’s all right to make exceptions too! Nutritional recommendations are mainly about our day-to-day eating habits. But you can certainly treat yourself to something special now and then, whether it’s cake, pizza or wine. There’s no reason you can’t cut loose a little over dinner with friends or when celebrating a special occasion. Regular or excessive consumption of alcoholic beverages should be avoided, however.
14
Superfoods, veganism, and moreThere are plenty of new nutrition trends out there, from veganism and superfoods to the “stone age” Paleo diet and “clean eating”. Everyone wants to stay healthy and be conscious of what they’re eating, and of course to get in better shape and maybe lose some weight along the way.
There’s a focus on fresh and minimally-processed foods, prepared gently to preserve nutrients. The superfoods approach emphasises specific foods with high levels of key nutrients.
As tempting as these new trends may seem, not every trend is good for you. Certain diets are too one-sided and may result in nutrient deficiencies, while others are too meat-heavy. Before trying out any new nutritional programme, be sure to research it as thoroughly as possible.
Clean eatingThe foods you eat are fresh and left largely in their natural state. Foods that contain more than five ingredients are generally not considered “clean”. Avoid flavour enhancers, preservatives, fried foods, sugar, white flour products and excessive amounts of salt.
SuperfoodsFoods included in this diet are especially rich in secondary phytochemicals, vitamins, minerals, fats and other nutrients that have a particularly positive effect on our health.
They may have detoxifying, antioxidant or anti-inflammatory effects. Well-known examples include acai and goji berries, but plants from closer to home like basil, spinach and dandelion have equally impressive properties.
15
Mediterranean diet The Mediterranean diet emphasises high-quality vegetable oils and fish, raw or gently-cooked vegetables, and walnuts, pistachios or pine nuts. This diet includes only limited
amounts of meat.
Raw foodAll foods are eaten raw: fruit, vegetables, juices, nuts, sprouts and seeds, cold-pressed oil or honey, cheese from raw milk, dried meat or raw fish. This diet offers plenty of options. But not everyone can easily tolerate raw food.
The “paleo” diet: Stone Age eatingAcceptable foods include anything you can hunt, fish, gather or pick: vegetables, fish, eggs, nuts, seeds, fruits and meat. The downside is that this diet tends to include large amounts of meat. Dietary fibre from whole grain is lacking, and dairy products are not allowed, which can lead to calcium deficiency.
Vegetarian dietA vegetarian diet focuses mainly on vegetable-based foods and excludes all forms of meat, and sometimes fish as well. Products from live animals, such as milk and eggs, are generally allowed on this diet. Avoiding meat and sausages can have clear health benefits. If you choose not to eat fish, consume rapeseed, walnut or linseed oil instead.
Vegan dietA purely vegan diet excludes all forms of animal-based foods and food products. Since certain important nutrients are found only in animal products, a healthy vegan diet requires very good knowledge of the nutrients contained in different foods.
16
Key recommendations at a glance
1 Emphasise plant-based foods, low-fat milk and dairy products.
2 Try not to eat meat-based meals more than twice a week.
Enjoy low-fat meat and game whenever possible. Avoid fatty
meat, sausages and organ meats.
3 Eat a fish-based meal at least twice a week — preferably fatty
fishes like salmon and herring.
4 Avoid animal fats like butter and lard as much as possible.
Instead, try to use vegetable fats like diet margarine and
cold-pressed oils, e.g. rapeseed, soybean and linseed oil.
5 Use egg substitutes. Try to avoid eating more than two yolks a week.
17
Key recommendations at a glance
6 Incorporate plenty of fruits and vegetables into your daily menu.
7 Eat whole-grain products every day, including nuts.
8 Drink about 1.5 litres of water or other low-calorie drinks each day.
9 Get exercise every day, preferably outdoors.
10 Keep an eye on your weight.
11 Alcohol, smoking and stress can contribute to inflammatory processes.
Take steps every day to establish healthier habits.
Key recommendations at a glance
18
Additional information
Detailed answers and additional information on multiple sclerosis and diet can be found at our web portal at www.msundich.de.
There you’ll find topics like:
Healthy nutrition with multiple sclerosis
Foods to enjoy and foods to avoid
Tables with nutritional information, including omega-3 fatty acids and antioxidants
Secondary phytochemicals
Alongside easy-to-understand information about all aspects of multiple sclerosis, the site also keeps you up to date on a changing set of highlighted topics. With regularly updated new information, plus plenty of tips and suggestions, we help people like you to deal with MS in their everyday lives.
We look forward to your visit at www.msundich.de
19
Help and advicePeople with multiple sclerosis usually have many questions about the disease and treatments for it. There are often as many different answers as there are different faces of MS. So a personal service with people who listen and look at each situation individually is especially important here.
With our MS und Ich Service Centre, you’ll get a personal consultation over the telephone. Trained employees can help you with your concerns or find the right contact person for your questions.
The medical and scientific information service of Novartis Pharma GmbH, or Novartis Info Service for short, offers personalised expert advice on your medications and the underlying treatment context, along with other reliable information.
Patients and their families can contact the service team by phone, fax or e-mail with their medical/pharmaceutical questions about drugs from Novartis Pharma. They usually receive the answers as part of a personal
conversation, and of course in written form as well whenever possible.
Still have questions?
Contact the MS und Ich Service Centre:
Telephone: 0 800 – 987 00 08*E-mail: [email protected]: www.msundich.de
* toll-free Mon–Fri from 10:00 to 17:00
To reach the Novartis Info Service:
Telephone: 0911 – 273 12 100* Fax: 0911 – 273 12 160*E-mail: [email protected]
* Mon–Fri from 8:00 to 18:00
11/2
017
10
7181
3Novartis Pharma GmbH | Roonstraße 25 | 90429 Nuremberg
* toll-free from Monday to Friday from 10:00 to 17:00
Contact us
0 800 – 987 00 08 *
www.msundich.de
App: MS und Ich
www.msundich.de/Apps