The Best Bet Diet for Multiple Sclerosis

Can eating certain foods cause multiple sclerosis?

Moringa powder on spoon and wooden table and glass of moringa smoothie
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The “Best Bet Diet” is the work of Ashton Embry, PhD, who first wrote about the link between MS and nutrition in 1996. He is currently the president and research director of DIRECT-MS, a Canadian non-profit organization devoted to providing science-based information on the role of nutritional factors in MS and funding research around diet and MS.

The Theory Behind The Best Bet Diet

The hypothesis behind the Best Bet Diet starts with the fairly established idea that MS is an autoimmune disease. More specifically, that our immune cells are attacking our myelin, the fatty sheath surrounding nerve structures in the brain and spinal cord. According to the authors and supporters of the Best Bet Diet, the whole autoimmune process is initiated in the gastrointestinal system in people experiencing “leaky gut syndrome.” In these people, the gut has become porous (perhaps due to low amounts of stomach acid) and undigested food protein can escape into the bloodstream.

The immune system sees these protein particles as invaders and creates antibodies against them. The theory continues that these food proteins are similar to the proteins in myelin (called "molecular mimicry") and the antibodies formed in response to the food proteins begin to attack the myelin. Of course, for that to happen, they need to be able to cross the blood-brain barrier, which also must be compromised in some way in order for these immune cells to end up in the central nervous system. 

The Claims of The Best Bet Diet

I have searched pretty extensively and nowhere can I find the claim that the Best Bet Diet will “cure” MS. This doesn't surprise me, as I feel strongly that there is not a dietary cure for multiple sclerosis (nor is there yet a non-dietary cure for that matter). In several places I have seen that the Best Bet Diet will slow progression of disability and lower chances of premature death from MS. There is also the implication that relatives of people with MS could prevent getting MS themselves by following the Best Bet Diet, as there is a genetic component which increases risk for developing multiple sclerosis (although this is still pretty low). 

The Basics of The Best Bet Diet

There are two main components of the Best Bet Diet. First, avoid potential “problem” foods and second, take vitamin, mineral, and herbal supplements. The idea behind avoiding potential “problem” foods is to avoid any foods with proteins that resemble those in myelin that are attacked by the immune system. These include:

  • Dairy: Avoid all animal milk. Also avoid all butter, cheeses, yogurt and any products that contain them.
  • Gluten: Avoid all wheat, rye, and barley. Also avoid any products that contain them.
  • Legumes: Avoid all beans and peas. Also avoid peanuts. Soybeans and soy products are also no-nos.
  • Refined Sugar: This is also avoided because of general inflammatory properties, with the suggestion of using other sweeteners instead, such as honey, maple syrup, and stevia.
  • Eggs: The idea here is to limit, rather than strictly cut out, eggs (unless you have an allergic reaction to them).
  • Yeast: Same idea as eggs. Unless you are allergic, limited quantities are allowed.

Taking vitamin, mineral and herbal supplements:

  • Vitamin D3: The “headliner” in the Best Bet Diet is vitamin D3 (cholecalciferol), which is recommended in quantities of 2000 IU/day in the summer and 4000 IU/day in the winter - however, it is strongly recommended that you get tested for 25(OH)D to determine what the appropriate levels are in your case.
  • Calcium: This is recommended at between 800 to 1,200 mg/day, and even higher if you are concerned about osteoporosis (a common problem in people with MS).
  • Magnesium: Should be taken in a calcium:magnesium ration between 2:1 to 1:1. Therefore, if you take 1,000 mg of calcium, you should take between 500 and 1,000 mg of magnesium a day.
  • Other Vitamins, Oils, Minerals, and Antioxidants: Embry recommends omega-3 fish oil, vitamin A, vitamin B complex, and vitamin B12, vitamin C, vitamin E, zinc, copper, selenium, manganese, gingko biloba, grape seed extract, coenzyme Q10, acidophilus, lecithin and amino acids. 

The Evidence Supporting The Best Bet Diet

To date, there has been no formal research published on the Best Bet Diet, although a clinical trial was undertaken in early 2006 by Dr. Jonathan O’Riordan, a neurologist in Scotland. Results have not been published yet. 

Additional Information/Tips About The Best Bet Diet

T-Cells or B-Cells (or Both)?: There is currently a bit of an immunologic puzzle around what types of immune cells are attacking the myelin of people with MS. For a long time, it was thought that the “rogue cells” were T-cells, which do not produce antibodies (antibodies are made by B-cells) but attack on their own. This would “debunk” the leaky gut and MS connection behind the Best Bet Diet. However, now there are conflicting reports of the role played by anti-myelin oligodendrocyte glycoprotein antibodies and anti-myelin basic protein antibodies. Some studies have shown these to be implicated in MS, while others say that they play no role. Of course, there could be other antibodies at work that have not yet been discovered.

ELISA Test: Proponents of the diet recommend that people get an ELISA blood test done to identify which foods may have escaped across the “leaky gut,” the idea being that the immune system would have produced identifiable antibodies to these foods.

No Vitamin D By Itself and Monitor Blood Levels: The proponents of the Best Bet Diet are very adamant that the recommended vitamin D supplements only be taken in conjunction with the appropriate amounts of calcium and magnesium. In addition, serum calcium levels should be monitored on a regular basis (Best Bet Diet people recommend testing in October and April for the first two to three years) to check for hypercalcemia, a condition of too much calcium circulating in the blood. If vitamin D levels are too high and there is not enough supplemental calcium, this can cause calcium to be leached from bones (bone resorption) and causes symptoms such as constipation, confusion, fatigue, nausea, and ulcers. A more likely result of this would be an increased risk of osteoporosis. Most experts agree that levels under 10,000 IU/day are unlikely to cause problems, but it is imperative that your doc know what you are doing and determines how best to monitor your levels.

The Bottom Line

I am hesitant to recommend one diet over another for slowing, halting or preventing multiple sclerosis. I will say this, however - I have a feeling that many of us with multiple sclerosis (and other autoimmune diseases) probably have a tendency towards food “sensitivities,” meaning that certain food cause inflammation in our systems.

I happen to follow a gluten-free and legume-free diet. I figured out that these foods did not agree with me before I even heard of the Best Bet Diet. I don’t know if gluten or beans/peanuts contribute to my disease progression, but I do know that many of my MS symptoms feel much worse after I consume these foods (peanuts being the worst culprit). I would say that it never hurts to experiment with eliminating certain foods and reintroducing them to test your reaction to them.

I am a little more cautious around supplementation and do feel that this is a matter to discuss with your doctor, especially if you are thinking of trying doses out of the recommended daily allowance range. Many of us are on different types of medications that may be affected by some of these supplements. At the very least, make sure that you run anything you are considering through the Drug Interactions Checker to see if there are any warnings that pop up.

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Article Sources
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  • Vieth R. “Vitamin D and cancer mini-symposium: the risk of additional vitamin D.” Ann Epidemiol. 2009 Jul;19(7):441-5.