Fuelling Your Brain Right: A Neurologist’s Dialogue on lifestyle and Multiple sclerosis

Today, we embark on a transformative journey to uncover the powerful impact of nutrition on managing multiple sclerosis (MS). Think of your body as a high-performance vehicle that needs the finest fuel to operate at its best. Through a conversation inspired by real-life scenarios, featuring a fictional patient for illustrative purposes, we will explore the critical role diet plays in not only maintaining but also enhancing our health, particularly for those living with MS. By making mindful choices about our diet, we can significantly improve our well-being, energy levels, and overall quality of life. Together, let's discover how small, consistent changes in our eating habits can lead to profound health benefits, offering hope and empowerment to take control of our health destinies.

Dr. Agne Straukiene: Good morning! I’m glad we could sit down today to discuss something crucial to managing your MS—your diet. Just like a car, your body needs the right fuel to function optimally. What kinds of foods are you currently fueling up on?

Patient: Hello, Dr. Straukiene. Well, my diet isn’t great. It’s mostly ready meals and fast food, especially on busy days, which is most days!

?Dr. Agne Straukiene: It's very common to rely on convenience foods, but they can be like pouring sand into your car's gas tank. They might keep you running for a bit, but over time, they can really wear down your system. Could you share more about what you typically buy during your grocery shopping?

?Patient: Sure, I usually get ready to go meals: frozen pizzas, some ready-made burgers, potato chips, diet sodas, and maybe some canned soups. Here is my shopping list:

Dr. Agne Straukiene: Thanks for sharing that. These are quite common choices but let's think about optimizing your diet to help manage your MS.

Cost Estimation for 4 Weeks of Shopping

Healthy Groceries: Approximately €100 per week for fresh, whole foods, totalling €400 for four weeks.

Processed Groceries: Approximately €80 per week due to the lower cost of bulk and packaged foods, totalling €320 for four weeks.

Observations:

Calories: Processed foods tend to have higher calorie contents with lower nutritional quality, often leading to excessive calorie intake without substantial health benefits.

Cost: While processed groceries might seem cheaper at first glance, the potential long-term health costs due to lifestyle diseases can make them more expensive overall.

These examples highlight the differences in dietary choices and their implications for health and budget, providing a clear comparison for consumers looking to make informed decisions.

Opting for healthy foods over processed options not only benefits your immediate health but can also lead to significant long-term financial savings. Here are some compelling reasons why investing in a healthier diet can be cost-effective in the long run:

?1. Reduced Medical Expenses

Healthy eating reduces the risk of chronic diseases such as heart disease, diabetes, obesity, and certain types of cancer. By preventing these conditions, you're likely to save on medical costs including doctor visits, prescription medications, and hospital stays. Chronic diseases often require ongoing treatment and management, which can be costly.

?2. Increased Productivity

Eating a diet rich in whole foods provides the nutrients necessary for maintaining energy levels and cognitive function. This can lead to increased productivity at work, potentially resulting in higher earnings and fewer sick days. Healthier individuals are generally more capable of performing well in their professional and personal lives.

?3. Lower Insurance Premiums

Individuals who maintain a healthy lifestyle, including a balanced diet, often benefit from lower health insurance premiums. Insurance companies sometimes offer discounts or incentives for healthy habits because they are statistically less likely to make large medical claims.

?4. Decreased Dependence on Medications

A diet high in fruits, vegetables, whole grains, and lean proteins can help manage or even reverse certain medical conditions, such as high cholesterol, high blood pressure, and type 2 diabetes. This can reduce or eliminate the need for certain medications, which often come with their own side effects and costs.

?5. Longevity and Quality of Life

Investing in a healthy diet contributes to a longer life and improves the quality of life as you age. This means more years of active, productive living and less money spent on caregiving and senior health care services.

?6. Food Budget Management

While healthy foods can sometimes be more expensive upfront, smart shopping strategies like buying seasonal produce, choosing bulk grains and legumes, and reducing meat consumption can actually lower overall food bills. Additionally, cooking at home can be more economical than relying on processed or ready-made meals.

?7. Environmental Savings

Choosing a diet that includes more plant-based foods and less meat and processed foods can also lead to environmental savings. Reduced environmental impact translates to a healthier planet, which can indirectly reduce health costs by minimizing the effects of pollution-related health problems.

?8. Emotional and Mental Health Benefits

Healthy eating has been linked to better mental and emotional health. Diets that support gut health, such as those high in fibre and low in processed foods, can improve mood and decrease the risk of depression, further reducing expenditures on mental health treatments.

? While the upfront cost of healthy eating might appear higher, the long-term savings and benefits significantly outweigh the initial investment. This holistic approach not only preserves your health and increases your life expectancy but also minimizes your financial burden related to healthcare over time.

Patient: How to identifying processed foods in shopping centres?

Dr Agne Straukiene: Identifying processed foods in shopping centres can be simplified by paying attention to a few key indicators. Here are some practical tips to help you recognize and understand food labels, ingredients, and packaging characteristics:

1. Read the Ingredient List

• Length: Generally, the longer the ingredient list, the more processed the food. Look for products with fewer ingredients, which often indicate less processing.
• Unfamiliar Ingredients: Be cautious of foods containing ingredients that are hard to pronounce or sound like chemical names. These are often additives, preservatives, or artificial flavours.
• Whole Foods First: The first few ingredients listed make up the largest portion of what you’re eating. If the first ingredients include whole foods (e.g., whole grains, nuts, fruits), it’s a better choice.

2. Check the Nutrition Labels

• Added Sugars: Watch out for added sugars under various names like corn syrup, dextrose, fructose, or anything ending in “-ose.”
• Trans Fats: Avoid trans fats, which are a clear indicator of heavy processing. These may be listed as "partially hydrogenated oils."
• Sodium Content: High sodium levels can be a sign of processing. Look for lower-sodium options if available.

3. Packaging Cues

• Colour and Design: Brightly coloured packages and cartoon characters often appeal to children and may generally indicate more processed, less healthy food options.
• Marketing Terms: Be sceptical of terms like “natural,” “artisan,” or “traditional,” which are not regulated and do not necessarily equate to being minimally processed.

4. Location in the Store

• Shop the Perimeter: Most grocery stores are designed with the freshest, least processed foods around the perimeter of the store (fruits, vegetables, meats, and dairy). The inner aisles usually contain more processed foods.

5. Organic and Non-GMO Labels

• While these labels don’t necessarily mean the food is less processed, they do indicate the absence of certain artificial chemicals and genetically modified organisms, which can be a part of a cleaner eating approach.

6. Use of Technology

• Consider using apps that can scan barcodes and give you an instant readout of the healthfulness and processing level of food products. This can simplify decision-making while shopping.

7. Familiarize Yourself with Common Processed Foods

• Understanding which products are typically highly processed can help you make better choices. Examples include: Pre-packaged meals or mixes Snack foods like chips and cookies Frozen dinners, Sugary breakfast cereals and bars.

By integrating these strategies into your shopping routine, you can better navigate the array of products available and choose those that support a healthier, less processed diet.

?

Patient: That sounds healthier but is it realistic with my schedule?

?Dr. Agne Straukiene: Absolutely, and it doesn’t have to be time-consuming. Prepping meals ahead or choosing simple recipes can help. Let’s also talk about a growing concern globally—obesity and its impact on health, particularly with MS.

?Patient: I’ve heard about that. How exactly does it affect MS?

Dr. Agne Straukiene: Let's discuss global prevalence of obesity. Here is the data of global prevalence of obesity by country 2020-2022:

The proportionate contribution of each country to the global prevalence of obesity:

American Samoa has the highest prevalence of obesity in the world due to a combination of dietary changes, genetic predispositions, lifestyle shifts, economic factors, and cultural influences.

• ?Dietary Transition: Traditionally, the diet in American Samoa consisted of fresh fish, fruits, and vegetables. Over time, this diet has shifted towards high-calorie, high-fat imported foods, including processed foods and sugary beverages. This increase in caloric intake combined with lower nutritional value has contributed significantly to rising obesity rates.

• Genetic Factors: Samoans may have genetic predispositions that make them more susceptible to obesity when exposed to high-calorie diets. Historical periods of food scarcity might have led to genetic adaptations favouring energy storage, which becomes detrimental in an environment with abundant food.

• Sedentary Lifestyle: Modernization has led to a decrease in physical activity. Traditional activities like fishing and farming have been replaced by more sedentary lifestyles and jobs. This reduction in physical activity, paired with increased calorie consumption, has contributed to the obesity epidemic.

• Economic and Environmental Factors: There is limited availability of fresh, healthy food options, and unhealthy food choices are often cheaper and more accessible. This situation creates a significant barrier to maintaining a healthy diet.

• Cultural Influences: In many Pacific cultures, including American Samoa, a larger body size can be culturally associated with health and prosperity. This cultural perspective may contribute to higher acceptance and prevalence of obesity.

?

?Dr. Agne Straukiene: Obesity can increase inflammation and exacerbate MS symptoms. It’s crucial for MS patients to maintain a healthy weight. (1, 2)

Childhood obesity increases risk by ~ 30% and adult obesity ~ 40% of developing MS as per graph below. (3)

Childhood Obesity: The total effect of childhood obesity (without adjustment) shows a significant increase in MS risk. However, when adjusted for adult obesity, the direct effect of childhood obesity on MS risk is not significant. This suggests that the increased risk associated with childhood obesity is likely mediated through the persistence of obesity into adulthood rather than a direct effect.

Adult Obesity: Both the total and direct effects of adult obesity on MS risk are significant, indicating that higher BMI in adulthood is a direct and independent risk factor for developing MS.

Overall, the data supports that while childhood obesity is initially associated with an increased risk of MS, this risk is largely explained by continued obesity into adulthood. Adult obesity independently increases the risk of developing MS.

Dr Agne ?Straukiene: Do you mind me asking, do you smoke?

Patient: I have to admit I do smoke around 15cigarets a day regretfully…

Here's a graph showing the impact of smoking on MS, and similar principles apply to poor dietary habits.

Dr Agne Straukiene: I don’t want to scare you, but If you are a smoker, your chances of developing Multiple Sclerosis (MS) are significantly higher than if you don't smoke. Specifically, smoking increases your risk of getting MS by 54%.

?Additionally, you already have MS, smoking further increases the risk that your condition will worsen to a more severe form called Secondary Progressive MS (SPMS). In fact, smokers with MS are 80% more likely to see their condition progress to SPMS compared to non-smokers.

?Quitting smoking can reduce these risks and improve your overall health. If you smoke, consider reaching out to healthcare professionals for support and resources to help you quit.

?Let's calculate the yearly cost of smoking 15 cigarettes a day, we can follow the same steps as before but extend the calculation to a full year.

Calculation Steps for the Cost of Smoking vs. Gym Membership

Smoking Costs:

1. Cost of a pack of cigarettes: 7 euros
2. Number of cigarettes smoked per day: 15
3. Number of cigarettes per pack: 20

Calculating Daily and Yearly Costs:

• Packs smoked per day:You smoke 15 cigarettes a day, and there are 20 cigarettes in a pack. So you smoke 0.75 packs per day (15/20 = 0.75).
• Daily cost of smoking:0.75 packs x 7 euros per pack = 5.25 euros per day.
• Yearly cost of smoking:5.25 euros per day x 365 days = 1916.25 euros per year.

If you smoke 15 cigarettes a day, it costs approximately 1916.25 euros per year.

Costs for Different Smoking Habits:

• 5 cigarettes per day:5/20 packs x 7 euros x 365 days = 319.13 euros per year.
• 10 cigarettes per day:10/20 packs x 7 euros x 365 days = 638.25 euros per year.
• 15 cigarettes per day:15/20 packs x 7 euros x 365 days = 957.38 euros per year.
• 20 cigarettes per day:20/20 packs x 7 euros x 365 days = 1277.50 euros per year.
• 30 cigarettes per day:30/20 packs x 7 euros x 365 days = 1916.25 euros per year.

Gym Membership Costs:

1. Monthly cost: 23 euros
2. Number of months in a year: 12

Calculating Yearly Cost:

• Yearly cost of gym membership:23 euros per month x 12 months = 276 euros per year.

So, a yearly gym membership costs 276 euros.

Patient: That makes it clear. I never realized how my diet and smoking could impact my MS this much.

?Dr. Agne Straukiene: It’s a common oversight, but changing dietary habits and giving up smoking can have profound effects on your symptoms and overall health. Maintaining a balanced diet rich in nutrients supports your nervous system and can potentially slow the progression of MS.

?

Patient: I’m ready to make a change. Do you have any tips on sticking to a healthier diet?

Dr Agne Straukiene: Imagine switching to foods that are not just filling, but also nourishing. Here’s what a nourishing shopping list could look like:

These recipes use simple cooking techniques and ingredients from the shopping list to create wholesome, delicious meals suitable for any family dinner table in Europe. Adjust seasonings according to taste and dietary preferences.

Dr Agne Straukiene: Do you see the difference between your grocery shopping and provided shopping list by me?

Patient: Thank you, Dr. Straukiene. I feel more hopeful and informed. I’ll start with the shopping list you suggested.

Dr. Agne Straukiene: You’re welcome! Remember, the right food and healthy lifestyle behaviour can be your medicine, especially with MS. Let’s review your progress in our next appointment. I’m here to support you through this journey.

Conclusion:

The journey to better health through improved dietary habits and quitting smoking is not just a path to managing multiple sclerosis but a gateway to a more vibrant, fulfilling life. The evidence is clear: by choosing nutritious foods and committing to a healthy lifestyle, we can reduce inflammation, manage weight, and potentially slow the progression of MS. These changes may seem daunting at first, but with dedication and support, they are entirely achievable. Let’s fuel our bodies with what they truly need to thrive. Embrace this opportunity to transform your health, knowing that each positive choice you make today paves the way for a brighter, healthier tomorrow. Remember, every small step you take is a significant stride toward a better, stronger you. #BeewellwithMS, for more infomation on health living with neurological condition such as MS find here: www.beewellwithms.com

References:

?1.??????????? Jakimovski D, Guan Y, Ramanathan M, Weinstock-Guttman B, Zivadinov R. Lifestyle-based modifiable risk factors in multiple sclerosis: review of experimental and clinical findings. Neurodegener Dis Manag. 2019;9(3):149-72.

2.??????????? Ponsonby AL, Lucas RM, Dear K, van der Mei I, Taylor B, Chapman C, et al. The physical anthropometry, lifestyle habits and blood pressure of people presenting with a first clinical demyelinating event compared to controls: the Ausimmune study. Mult Scler. 2013;19(13):1717-25.

3.??????????? Harroud A, Mitchell RE, Richardson TG, Morris JA, Forgetta V, Davey Smith G, et al. Childhood obesity and multiple sclerosis: A Mendelian randomization study. Mult Scler. 2021;27(14):2150-8.

4.??????????? Degelman ML, Herman KM. Smoking and multiple sclerosis: A systematic review and meta-analysis using the Bradford Hill criteria for causation. Mult Scler Relat Disord. 2017;17:207-16.

Note: The infographics and descriptions are fictional suggestions to give you an idea of what visuals might accompany the article. Created by AI under my commands.

Disclaimer

The information and data presented in this document are for educational and informational purposes only. The calculations and representations have been performed using Python software and widely accessible data resources. While every effort has been made to ensure the accuracy and reliability of the information provided, no warranty, express or implied, is given regarding its accuracy, completeness, or usefulness. The author assumes no responsibility for any errors or omissions, or for any outcomes related to the use of this information. Users are advised to independently verify the information and seek professional advice if necessary.

If this article resonated with you or if you believe it can inspire someone else on their MS journey, I encourage you to like, comment, and share it with your community.

#Multiplesclerosis #Lifestyle #autoimune #chronic

? dr Agne Straukiene

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