In order of relevance
(ALS) Amyotrophic Lateral Sclerosis or (MND) Motor Neurone Disease are referred to as ALS/MND.
Of everything I have researched over the last dozen years, what comprises a "good diet" is the most contentious. Whilst researching dairy products I discovered two papers, one claiming that dairy products may slow or delay the onset of neurodegenerative illnesses and another that, equally cogently, claimed that dairy foods could be the root cause of many western diseases and even premature death.
Similarly, eating red meat is either essential for good health or the cause of dire metabolic dysfunction. For every paper recommending a particular diet I have been able to find another paper diametrically opposed to those recommendations.
Fad diets come and go but some common sense dietary approaches are presented here. I would not presume to claim that I could define the best diet for PALS or anybody else for that matter but below are some dietary guidelines that I attempt to follow. I hope they provide some insight into the complex and confusing task of choosing a "healthy diet". Good luck!
Sluggish digestion, excess or insufficiency of certain foods may stress, slow or otherwise impair your liver and the function of other essential metabolic processes. Here are some common sense dietary rules-of-thumb that should help maintain healthy liver and metabolic function, improve digestion and aid in the excretion of potentially harmful toxins.
1 On waking in the morning, drink two glasses of water. Drink eight to twelve glasses of filtered or bottled water per day (approximately 4 litres/9 pints) to assist in cleansing/flushing the kidneys and liver. Drink water throughout the day but do not drink a lot with meals.
2 Do not eat if you are not hungry - but do not put up with hunger pangs.
3 Do not eat large amounts of sugar - especially refined sugars. The liver turns these into fat. Artificial sweeteners (e.g. aspartame) used in "diet" foods and drinks impair liver function and may be toxic. If you need a sweet snack, eat fresh or dried fruit, honey or molasses. Fruit canned in its own juice (not sugar syrup) may be a viable alternative to fresh fruit.
4 Adopt good intestinal hygiene habits because the liver filters viruses and bacteria in food. Eat fresh food, preferably organically grown fruit, vegetables and free range foods (e.g. eggs and poultry) if available. These minimise your intake of pesticides, growth-hormones, antibiotics and saturated fats. Do not reheat food more than once. Avoid preserved meats of all types. Always wash your hands before eating.
5 Avoid foods you may be allergic to or you find difficult to digest (you may need to keep a record to establish which foods appear to cause problems). If your digestion is weak, poor or sluggish you may try digestive enzyme tablets before meals or include a yoghurt that contains bifidus and acidophilus in your daily diet. Try to start a meal with some raw fruit or vegetables.
6 Minimise your coffee, tea and alcohol consumption. Gradually cut down to one cup/glass a day or better still cut them out completely. If you drink tea, note that adding milk tends to reduce the antioxidant benefits of the tea.
7 Try not to eat when you are stressed or anxious. When you are stressed, blood is diverted away from the intestines and liver. This can lead to bloating and poor digestion.
8 Avoid foods with artificial flavourings, colouring, preservatives and sweeteners.
9 Eat red meat in moderation, say no more than 4 ounces per serve (as in an average hamburger patty). As well as proteins derived from meat, eggs and fish include more proteins derived from grains, nuts, seeds and legumes.
10 Try to minimise butter and margarine in your diet. Eat good quality, high fibre multi grain bread rather than "brown" bread, which is often simply white bread with added food colouring.
11 Do not eat excessive saturated or damaged fats. There are good and bad fats. Margarine, hydrogenated oils, shortening, fried foods, packaged cookies/biscuits, potato chips/crisps and the like should be avoided. Use unrefined, cold pressed oils for cooking (e.g. virgin olive oil) and keep them refrigerated and out of direct light.
12 Eat foods high in fibre such as raw fruits and vegetables; bran or breakfast cereals containing bran; high fibre breads and so on. Combined with adequate water intake this will help prevent constipation, aid digestion and consequent excessive "fermentation" of food in the gut.
13 Attempt to increase the quantity of raw food in your diet to around 40%. Eat a light breakfast that includes raw fruits, cereals with soy milk. Fresh vegetable juices are good to include at breakfast time. Try to include a salad as part of your main meals of the day (lunch and dinner). Snack on fruits, carrot, celery, raw cashews, almonds, seeds, dried fruit and the like.
14 Listen to your body. Drink (preferably water) as soon as you feel thirsty. Eat only when you feel hungry. Avoid stress and or use a relaxation/meditation technique to control stress levels.
15 When possible, start a meal with a "bitter" food such as those found in Mediterranean style "ante pasta" (olives and bitter salad greens particularly). "Bitter Principles" (not sour like lemons or vinegar) stimulate the bitter-sensitive taste buds that are connected neurally to the gut wall and promote the secretion of gastrin.
Gastrin is a hormone that aids the digestive process on many levels. If you do not like olives and similar foods, "bitters" and bitter tinctures can be obtained from health food shops, naturopaths and herbalists and taken with a small amount of water before meals.
16 It may be a good idea to get tested for food allergies.
RECOMMENDED DIETARY BOOK
After many years of studying diet and its possible affects on the progress of neurodegeneration only one book has stood out as sensible, scientifically sound, easy to read and has recommendations that are easy to follow.
The New Glucose Revolution
Subtitle: The Glycemic Index Solution for Optimum Health.
Authors Prof Jennie Brand- Miller, Kaye Foster-Powell, Assoc Prof Stephen Colagiuri.Publisher: Hodder. ISBN 0-7336-1500-7.
For information about the Gylcemic Index Diet
also see this information about type 2 diabetes
More useful dietary information
Link to excellent site for food and dietary information
"The Liver Cleansing Diet" by Dr Sandra Cabot explains the role of the liver and offers suggestions and even diet menus to assist in improving liver function. For more information
Although marketed as a diet book, it explains liver function clearly and simply and presents a compelling argument supporting the need to improve and maintain good liver function. I discovered too late that most of the fundamental information I struggled to assemble for this page is included in The Liver Cleansing Diet.
"Food from Friends is a feel-good book - like a warm hug. The recipes are inspirational, achievable, delicious and inventive.” (Kate Fraser) Everything in this book has been donated, from the recipes, the photography, book design and layout. This is a great gift idea and each purchase will support a worthy ALS/MND cause.
Apples, not caffeine, are more efficient at waking you up in the morning.
Some Further Notes on Diet
Diet is such an incredibly complex topic that I can present only a fraction of the more relevant information I have researched.
It is likely that highly processed carbohydrates, particularly refined sugar as added to coffee, tea, sodas, breakfast cereals, candies, cookies, cakes, chocolate and so on, could "short circuit" the process of complex-carbohydrate metabolisation.
The body grabs the easily-accessed refined sugar and interferes with or even blocks the metabolisation of more complete sugars derived from complex carbohydrates.
The poorly metabolised carbohydrates may then place and extra load on the liver, further disrupting the metabolic process. In the long term, this could cause free radical production, beneficial cell sugar depletion and a negative domino effect in the digestive and central nervous systems.
Dr Dharma Khalsa, President Alzheimer's Foundation, states that "Fat promotes brain deterioration much as it wreaks havoc with the heart and arteries. It clogs the vessels that carry oxygen and glucose - the brain's fuel - to millions of neurones and produce free radicals, the highly reactive and destructive chemicals that scar and kill brain cells.
Keep your fat intake below 20% of total calories". [This may be more complicated than it first appears after you have read further].
For 15 years experts advised that we should eat less fat and more carbohydrates. Data analysis during those 15 years shows while the dietary intake of saturated fats and cholesterol decreased, obesity in western countries has increased. Apparently the experts were not clear about how fats/lipids are metabolised.
Eating fat does not make you fat.
Your body's response to excess carbohydrates is to converts them into body fat. Low-calorie, high-carbohydrate diets generate biochemical signals in your body that make it difficult to access stored body fat.
The ratio of macronutrients (protein, carbohydrate and fat) in meals is the key to weight management and optimal health. When you eat these macronutrients, they generate complex hormonal responses that determine how much body fat you store. Knowing how to control these responses is important.
The body requires a continual intake of carbohydrates to feed the brain, which uses glucose (a sugar derived from carbohydrates) as its primary energy source. Any carbohydrates not immediately used by the body will be stored as glycogen (a string of linked glucose molecules). The body stores glycogen in the liver and the muscles.
Only the glycogen stored in the liver can be broken down and returned to the bloodstream to maintain blood sugar levels for adequate brain function.
Whether it's in the liver or the muscles, the body's carbohydrate storage capacity is limited. It is difficult to metabolise carbohydrates stored in muscles. In the liver, carbohydrates are accessible for glucose conversion but we can store only 60-90g, the equivalent to about two cups of cooked pasta. This represents your total reserve to keep the brain working properly. Once glycogen levels are filled in both the liver and the muscles, excess carbohydrates are converted into stored fat.
Volunteers on a diet low in calories (1000 calories) but high in fat (90 percent of total calories) metabolised significant amounts of stored body fat. The same volunteers on a high carbohydrate diet (90 per cent of the calories as carbohydrate) lost virtually no body fat (therefore failing to metabolise it).
Optimal health is based on an understanding of the complex hormonal responses generated when you eat. Food is a control system for hormones.
The hormonal composition of each meal will determine the energy source available for the next four to six hours. With the correct hormonal balance you can tap into energy stored as body fat. The wrong balance will utilise limited, poor quality, stored carbohydrates.
The correct hormonal trigger is in the insulin-glucagon axis. Insulin is a storage hormone that takes excess glucose from dietary carbohydrates and excess stores of amino acids from dietary protein and stores them in adipose tissues as fat and locks it up so it can't be released.
Glucagon is insulin's biological opposite - a mobilisation hormone. Its primary job is to release stored carbohydrates in the form of glucose from the liver. The release of insulin is stimulated by carbohydrates, especially high-glycemic carbohydrates such as bread and pasta. Glucagon production is stimulated by dietary protein.
The hormonal balance of insulin and glucagon depends on the size of the meal you eat and its ratio of protein to carbohydrate - excess calories stimulate secretion of insulin.
Eat small meals with a ratio of protein to carbohydrate of 1-3gm protein to every 4gm carbohydrate.
You should eat a little more carbohydrate than protein and always include some "healthy" fat (some listed below). Fats supply the building block for essential hormones and function as a control mechanism, like fibre, to slow the entry rate of carbohydrates into the bloodstream. Fats also make food taste good and activate the hormone cholecystokinin, which tells the brain you're satisfied, and to stop eating.
Fats are vital for hormone production, reducing unhealthy, excess body fat and promoting good health.
A particularly bad fat is arachidonic acid, found in egg yolks, offal, most delicatessen meats and fatty red meat. Restrict or eliminate these from your diet. Saturated fats, found in animal protein sources and in whole-fat dairy products should be kept to a minimum as they tend to raise insulin levels. Favour animal protein sources low in saturated fat, such as white meat, poultry and fish.
Most of the good fats are monounsaturated like those found in olive oil, canola oil, olives, macadamia nuts and avocados. They have no effect on insulin levels.
Magnesium is important for neuro-muscular function and the utilization of calcium in the body. Calcium cannot be absorbed properly without vitamin D but vitamin D is toxic in large amounts and should only be taken under medical supervision. Vitamin D is almost completely lacking in food, apart from fish-liver oils (although margarine is usually supplemented with vitamin D).
Our chief source of vitamin D comes from sunlight on our bare skin producing a substance that changes into vitamin D within the body. Some PALS find that Calcium/Magnesium supplementation worsens fasciculations and cramping. Supplements of all types should only be taken in conjunction with a healthy diet and/or other supplements to facilitate their metabolisation. See Possible Medications.
The loss of calcium is greater with high protein foods rich in phosphorus, such as meat and eggs. According to Dr Julian Whitaker, a contributor to Prevention magazine, excess nitrogen and sulphur in the blood from a high protein diet creates an acid condition that leaches calcium from bone.
The combined effect that the body loses more calcium than it takes in, so using calcium supplements may not help when you are eating excess protein. Osteoporosis, the gradual deterioration of the bones is rare in countries where the diet is low in protein - even when calcium intake is relatively low. People wishing to lose weight sometimes adopt a high protein, low carbohydrate diet. Dietary protein alone will not maintain the protein tissues of your body.
Without carbohydrates the body cannot use the proteins that are ingested. Carbohydrates spare protein and increase protein utilization. Attempt to eat only unrefined carbohydrates.
This two week diet may be suitable for newly diagnosed or slow onset PALS.
Most so-called "Detox" diets are far too extreme for people with chronic illnesses but this diet may help identify possible food intolerances
Cut out all dairy products, wheat, buckwheat and sugar, including honey and syrups, and any foods containing these.
Cut out all citrus fruits (lemon, orange, grapefruit, lime, tangerine, mandarin, clementine). Eat only vegetables and those fruits not belonging to the citrus and nightshade families