Terry Wahls, MD: Updates on Dietary Research: February 2023

foreign good afternoon everybody welcome to this conference hosted by Ms Focus the Multiple Sclerosis Foundation I'm your host Favia Suri Health educator at Ms focus and I'm joined by Dr Terry walls who's here to talk with us about updates on dietary research after her presentation we'll open it up to your questions and comments now I'm delighted to introduce our speaker Dr Terry walls she's a clinical professor at the University of Iowa where she conducts clinical trials that test the efficacy of therapeutic lifestyle to treat multiple sclerosis related symptoms additionally she's the author of The Walls protocol a radical new way to treat all chronic autoimmune conditions using paleo principles and the cookbook the walls protocol Cooking For Life the Revolutionary modern paleo plan to treat all chronic autoimmune conditions quite the Publications we're pleased to have her join us to present this important topic Dr walls thank you for being with us today great thank you for having me so we're going to do this in an interview style I'm going to be acting asking Dr walls questions and she'll be answering them and then at the end we'll open it up for a q a for everybody so are we ready absolutely let's go all right so can you tell us a little bit about yourself and your background please uh so I'm a farmer's daughter grew up in Northeast Iowa uh went to medical school and it was actually during medical school they started having symptoms of electrical pain that would later be diagnosed as trigeminal neuralgia and 20 years later when I was 45 I developed weakness in my left leg I saw my neurologist said this could be really bad or or really really bad uh and so I was thinking about my electrical face pains as I went through my work up for the next three weeks I was diagnosed with Ms I saw I did my research found the best MS Center in the United States saw them saw their best physician took the newest drugs including Ty zabri um but I went relentlessly downhill three years later I met a tilt recline wheelchair uh and my face pains are getting uh continually worse my 10 year old daughter hugs me as tears streamed down my face and that's when I start reading the basic science and I decide that mitochondria are the driver of disability and I create a supplement cocktail to support my mitochondria the speed of my decline slows I'm I'm very grateful I discovered a study using electrical stimulation of muscles I asked my physical therapist if I can try that he gives me a test session it hurts bad I mean really quite bad but when it's over I feel great he tells me it's because of the endorphins I and so we add e-stem to my physical therapy then I discovered the institute for functional medicine I take their course on neuroprotection I have a longer list of supplements and then I have an aha moment and actually I'm sort of embarrassed as to how long it took to have the Saha moment is that I've been fine the paleo diet already for about five years but now I think what if I redesign my paleo diet based on this long list of supplements that I'm taking so that's more research but I redesigned this new paleo diet and I start this new way of eating December 26 2007. for context at that time I can walk I can take a few steps using two walking sticks otherwise I'm in the topic line wheelchair I cannot sit up in a regular chair anymore if I sit more than 10 minutes I am uh so exhausted I can't function and I'm on bed rest for 24 hours I am still Staffing clinics for the residents uh from my zero gravity chair whether my knees are higher than my nose and I know I'm about to have to take a medical disability because I'm getting to have brain fog I start this new way of eating December 26th at the end of January my fatigue is markedly reduced my mental Clarity is markedly improved and my physical therapist says Terry you are getting stronger I'm advancing your exercises so now I can do and I had been limited to 10 minutes of exercise once a day now I'm going to do it twice a day then 15 minutes twice a day then 20 minutes twice a day then 30 minutes twice a day I'm doing more estim uh and I began walking with my two walking sticks at the hospital people are stunned then um IBN walking without my walking sticks they're stunned again then I tell my family I want to try riding my bike and and Jackie says you know that's my wife um maybe in the fall if things keep going well well two weeks later I really want to try riding my bike it's not Mother's Day so we have an emergency family meeting uh and Jackie tells my son who's a big boy six foot five Zach you jog alongside on the left my 13 year old daughter who's five six you jog alongside on the right and Jackie will follow so um we all get in position Jack gives you all clear and I get on my bike and I bike around the block wow and that big 16 year old boy he's cried my 13 year old daughter she's crying Jackie's cried I might cry right now so I and I cry when I talk about it because you know at that moment that's when I began to understand that the current understanding of progressive multiple sclerosis is incomplete and who knows how much recovery might be possible so I began biking a little more every day and in October Jackie says I'm signing you up for the courage ride it's 18.5 miles however far you go it's gonna be great at that point the furthest I had biked was eight miles so I bike 18.5 miles that day wow my kids are crying Jackie's crying I'm crying once again and of course this really changes how I think about disease and health it will change the way I practice medicine and it will change the focus of my research and it's my mission to teach people like everyone who's listening that there's so much you can do that will change your disease course and it's my mission to change the standard of care which is why I am so passionate about the research that I do because if we're going to change the standard of care we have to have published peer-reviewed clinical trials that show you know in randomized controlled trials that the intervention is helpful and it's better than usual care so I anyway I'm thrilled to be able to chat with everyone here and to give hope to all of you who are listening because if I can come back from horrific levels of pain beginning to have brain fog unable to set up struggling to walk even just a few feet with my walking sticks to the point where uh this morning I jogged 20 minutes on my treadmill 20 minutes folks it's pretty exciting I think I speak for everyone when I say that is that's beautiful I think that's the best way to put that thank you for sharing that that was quite the journey yeah I have to wipe my nose here you know I can't I pushed my tears backwards but thank you for sharing that I I can't tell that story without crying and I doubt that I ever will be able to and that it's your journey that's completely understandable thank you I think that definitely gives hope and motivation to a lot um are we ready for the next question absolutely okay prior to the new clinical trial that you're conducting you have been the author of two other studies review of two popular eating plans within the multiple sclerosis community that discuss the low saturated fat and modified Paleolithic diet and also the dietary approaches to treating multiple sclerosis related symptoms can you discuss the findings briefly that you had in each of those yeah so when I analyzed the the menus for the low set of slow saturated fat diet basically the Swank diet and the menus that we had in the walls protocol were able to show that both of those diets are nutrient dense uh vastly better than the average American diet uh and so that certainly addresses a lot of the concerns and pushbacks that we have from many registered dietitians and people within the neurology community that we're creating harm when in fact we're improving the nutrition for those folks so that was the first question could you remind me what the second half the question was uh so it was just both of your studies one was the review of two popular eating plans and the other was the dietary approaches to treating Ms related symptoms okay so the dietary approaches um so the the that paper was about our our study protocol where we're going to have and let me explain people come in we do all of their assessments and then we ask them don't change your diet don't add anything new and we will bring you back in 12 weeks and we'll repeat all of the assessments so that's to see if the measures are stable uh if they spontaneously improve or not and the measures of walking hand function Vision function uh uh working memory they were all stable measures of fatigue and quality of life they were stable then we randomized them to either get the Swank diet or the wall side uh and they got five calls from The dietitian then they came in at 12 weeks and we repeated all the measures then we send them on their way and we brought them back in another 12 weeks and here the question is could they keep up the good diet and we repeat all of the measures I and so we're able to look at how how much did things improve in the first 12 weeks and how much did they improve in the second 12 weeks so we got a look at what six months of the Swank diet and six months of the walls diet will do for people and uh do you want me to tell you that now or is that coming in a follow-up question that was part of it uh what did you find and okay I like I am so excited so you know really the the best thing that we could have possibly have found is that both diets are helpful uh and that is what we found uh is that the Swank diet uh reduces fatigue improves quality of life Mental Health Quality of Life uh and physical health quality of life now in some of the measures uh uh the walls diet was more effective than the Swank diet in terms of the more sensitive fatigue measure called the modified fatigue impact scale of the walls diet was significantly uh more effective than Swank edit p-value of 0.05 and then the mental health and physical health uh quality of life at 12 weeks uh the Wallace diet was significantly improved uh the Swank diet was not although it was improved by 24 weeks um the wall side again at a p-value of about 0.05 was different from Swank so it was more improved however I want to be very clear that if the Swank diet speaks to you and you're worried about saturated fat you would rather do the swag diet the swag diet was helpful so I I don't want to bash the Swank diet it's a good diet we did improve it by telling people more explicitly to eat more vegetables and more explicitly to reduce processed foods in added sugars so if you'll do that and and follow a low saturated fat diet I think Swank diet is a great diet if you do the modified paleo diet and let me sort of give people the overview for that um I took the standard paleo diet getting rid of grain getting rid of legumes yeah eating meat and I said you don't need quite as much meat but you need to eat a lot more vegetables I want you to have three platefuls of vegetables measured raw and that's what I want you to consume in the day now in my clinics at the VA were mostly men so these were guys nine cups of vegetables measured raw is not a burden for them right T women nine cups of vegetables measured raw might be too much for you so for women we might need you know six cups so if you're tall like maybe six foot tall nine cups is still pretty easy to do but if you're very petite you know four foot eleven five foot two six cups is probably better and we're talking about three cups of green leafy vegetables three cups of what I call the sulfur Rich vegetables cabbage onion mushroom family vegetables uh in three cups of deeply colored beets carrots berries the reason I'm so keen on greens carotenoids vitally that those are the pigments in those green leafies um they're called zeaxanthin mesoziaxanthin they're super important for protecting your eyes from ultraviolet light and they turn out to be super important for protecting your brain cells as well and then uh they have a lot of vitamin K in them that are bacterial metabolize further into the more active forms that our brain and our bones and teeth need and we know that these compounds the vitamin K appears to be at least in animal models very helpful in repairing myelin uh greens are also a great source of calcium and magnesium two important nutrients for the brain now for the sulfur Rich the blood vessel Health greatly improved with the cabbage and onion family vegetables and it will boost intracellular glutathione these are important antioxidant compounds really protective for our cells and our brain cells mushrooms we know the more mushrooms you eat the lower the rate of anxiety depression and dementia everybody should have mushrooms like I really want you to have mushrooms several times a week fabulously good for you and then color the more color you eat the lower the rinse the rate of diabetes the lower rate of cancer the lower the rate of obesity again really important to comorbid problems we need to have sufficient protein we want people to eat meat fish poultry and ideally you want to have 0.8 grams of protein per kilogram so six to 12 ounces of meat per day will generally take care of that we also wanted people to have sufficient vitamin D to get their vitamin D into the top half of the reference range and we gave them a multivite some fish oil and we I think that was all of the supplements that we were giving oh we and we gave them methyl B12 and methylfolate in addition because because we know High homocysteine is is more prevalent in people with MS and if you have high homocysteine more likely to have cognitive decline now the the other observation that I want to go back to is that we told people to not add additional exercise unless their physician had specifically sent them to physical therapy or gave them very specific instructions to exercise more so at 12 weeks neither groups walking endurance that is how far they could walk in six minutes changed but at 24 weeks yeah again the uh Swank group they're walking distance did not change The Walls Group did change and it met clinically significant differences although the p-value between the difference between that and Swank was only 0.08 so not statistically different but certainly very interesting that walking uh uh changed and we're still writing papers we still have more data to analyze so there'll be more papers that I can discuss the next time I come back about that paper about that study thank you for sharing all of that um in your opinion why don't all neurologists discuss diet and the role that it can or may play in multiple sclerosis well you know I tell my medical students and I tell my postdocs it takes about 30 years to change the standard of care you need to have a lot of peer-reviewed published research we present it and we've been doing that we've been presenting it at the MS research meetings that happen we presented at the Consortium Ms centers which is the big clinical meeting that happens every year and as a matter of fact we'll be giving six oral presentations at that meeting and we have four research abstracts that we've submitted and I have another research abstract that will submit uh I'm presuming that they'll have a late breaking abstract because we have some new really interesting results to submit it's it takes a lot of work to keep up so the old farts don't keep up because they're busy with kids and every and everything else it's hard for them but I I do want to tell you about a really interesting study that that was just published January 24th uh there are now 12 dietary intervention studies that are happening uh the state that we did in in 2010 was one of the first uh by the way uh but we now have 12 that have been randomized and controlled and um there's some a process called a network meta-analysis where you are able to standardize the main differences between the you know between the two diets whether it's controlled diet in the intervention diet or two or two intervention diets uh and then we they looked at the effect of the diet on fatigue on uh quality of life Mental Health Quality of Life physical health and when you do a network meta-analysis you're able to sort of rank order the diets so that you know which diets are the most effective and which are the least effective and we've been doing this for a long time to figure out which disease modifying drug treatments are the most effective and the least effective and which has the most serious side effects which have the least side effects so we've been knowing how to do this for quite some time there were eight diets that got looked at the low sat diet low saturated fat diet which was look at the Swank diet and the um a McDougall diet the modified the Paleolithic diet which and these were all studies that we had done so the modified paleo diet basically the walls Dot the anti-inflammation diet that was done in Iran the ketogenic diet now we've done some ketogenic diet studies and a group in Germany has done ketogenic diet studies and then Mediterranean diet studies that uh a lot of icat sand does and a fasting study and a calorie restriction study that Kate Fitzgerald stud and there were 608 people in all of those studies so there's still fairly small studies but it's very exciting we had 608 folks and there were three diets that that reduce fatigue the paleo diet Mediterranean diet and the low-fat diet there were two diets that improved quality of life mental health and physical health that's the paleo diet and the Mediterranean diet and there's a a particular figure called a forest plot that makes it visually easy to understand you have the the dot where the mean difference so the mean Improvement that the 95 percent air confidence interval which tells you the the truth of the matter lies somewhere between these error bars and the center line is everything to the right favors the intervention everything to the left favors the control and so if your mean benefit in the error bars are all on the side favoring control then you can say that diet definitely helps reduce fatigue or improves quality of life and it also lets you know which one is the best which one is the least effective so no surprise um well actually it's probably not surprising in some ways the cow restriction was the least effective people were more fatigued uh and that's pretty tough to sustain fasting was also tough to sustain uh the anti-inflammation diet was sort of uh this was not that hopeful ketogenic diet was helpful but the air error bars crossed over so you couldn't say it was definitely helpful the low-fat Mediterranean and paleo definitely helpful it was quite striking the Paleo was uh uh about twice as effective as Mediterranean or low fat on reducing fatigue and then on quality of life again what was helpful was paleo and Mediterranean the Paleo was about twice as effective as Mediterranean that came out in neurology the highest impact Journal that nearly every neurologist who sees Ms patients gets and hopefully red right and then hopefully they also read the editorial by three highly respected dietary interventions that researchers whose studies were not part of what we reported on or or what Dr snetzer reported on rather uh and they said there is good very good evidence that diet matters that diet can reduce anxiety and can improve quality of life and that every patient who's newly diagnosed or has been diagnosed should go see a nutrition professional and be told that diet matters they should be encouraged to follow the Mediterranean diet the paleo diet or at the very least dietary guidelines for Americans in that we should work with patients so they Implement a diet that they in their family are can do together as a family so I I I'm like so excited I am so excited we're halfway there folks right and I'm sure doing all these studies is definitely helping how can someone with I know you just mentioned it that nutrition is important in talking to dietitians so with that said how can someone with Ms go about getting a referral from their health care team so that they can discuss so there's a couple ways you can do this so you could ask your primary care person would you please give me a referral to a dietitian and you could if you have high blood pressure obesity diabetes pre-diabetes that's a Medicare approved indication for a visit with a dietitian and for it depends on your health insurance plan will that be covered but for many that will be a covered service yeah and there are other nutrition professionals out there that like I'd say licensed clinical nutritionist that could also provide some nutrition information as well but it certainly the registered dietitians and what I want you to do is talk to your dietitian say I I really I'm intrigued with the paleo diet I helped me do that I want to do a Mediterranean diet help me do that I'm really intrigued with the ketogenic diet because I'm really overweight and I I hear it's good for weight loss I'd like to do that I'm intrigued with intermittent fasting I want to do that so it's fine to come with what interests you have and hopefully hopefully we can send you the link and I'll show you the the link uh in PubMed to this article so you can at least see the abstract so the abstract should give you confidence to go in to talk to your neurologist and say hey this was a neurology it says that that really matters whether they pay their diet the Mediterranean diet and the low-fat diet are all good and I want to try one of them and you're a neurologist can no longer say diet doesn't matter because it was in neurology the journal that your neurologist will agree is a journal with really great science thank you I was actually going to ask if you could share the article or if a research or results are public so that so I yep um so I don't get to share the PDF but I can share the link to the PubMed abstract uh and so if you share that with everyone who attended uh they can read that abstract and then they could print out the abstract take it with them to their neurology visit and to their Primary Care visit for that matter and say I want to see a dietitian to talk about these three diets and I gotta pick one of them right that would be great thank you can you tell us about the new clinical trial that you are conducting oh I am so excited about this so again because I feel so passionate about doing diet and lifestyle research and changing the standard of care one of my grateful patients funded this study it will let us follow people for two years I and we will you have to be willing to come to Iowa uh at month zero month three month 24. you must have relapsing remitting Multiple Sclerosis uh and be between the ages of 18 and 70. at Baseline we'll collect some blood and saliva we will have you walk uh check your hand function Vision function and a a very easy measure of thinking function we will also ask questions about fatigue quality of life anxiety and depression we will get a research MRI so there's no contrast it's just a little bigger magnet and we'll measure your brain volume and we'll do that at the beginning and we'll do that again at the end the questions that I'm asking are number one can fixing your diet lead to reduced fatigue improved quality of life and better function and then I think the most interesting question of all is can fixing your diet lead to well I should back up for a moment all of us who have MS as a group our brains are shrinking three times as fast as occurs in someone who has healthy aging about one percent per year which is why people with Ms have higher rates of becoming frail higher rates of anxiety depression higher rates of dementia and early nursing home care in my clinical experience because people have such great Improvement on mental clarity and because I also have the chance to look at my brain volumes which are continuing to be very very good I'm very optimistic that brain volume will get back to healthy aging which is why you know we have to follow people for two years and you know and get these brain volumes at the beginning and at the end now the diets that we're studying are the modified paleo diet basically the same diet in the study that I just described and a Time restricted Olive oil-based ketogenic diet a lot of the ketogenic diets really lean into Dairy eggs and full fat Dairy which is very high in saturated fat I want to have something that's more heart friendly because I'm an internal medicine doc I care about hearts so so we reduce the saturated fat and we stress olive oil and then if people have a an elevated cholesterol we we don't let them have all that dairy uh and we just lean into uh olive oil and because we're using olive oil as a as opposed to coconut milk we time restrict the eating so there's an eating in a six to eight hour window which makes it easier to get into ketosis the control diet is the usual diet so for all of you who are listening to me hopefully you've been inspired that you got to fix your diet and we know that people who are who do diet studies agree to do diets because they want to fix their diet so the control arms always fix their diets in the control arm never has a a diet that's as bad as the standard American diet and I expect that will be the case in our study so again if you are listening to me and you you screen you want to be in my study and you fix your diet you're doing whether it's uh the the low saturated fat Swank diet walls diet or um a keto diet well yeah and you can what you have to be willing to agree is when we randomize you to one of the arms if we randomize you to the keto arm you're going to do the keto diet if we randomize you to the paleo diet you're going to do the paleo diet and if we randomize you to the usual diet you get to do your usual diet and if you already fixed your diet that's okay we aren't going to ask you to make your diet bad which is why I think the my question is can I get people to healthy rates of brain aging is the most important question we're asking in the study [Music] and if all three groups get to healthy aging that'll be extraordinary because if you take drugs drugs do a great the dmts do a very good job particularly the high potency ones of stopping relapses of decreasing the number of enhancing lesions they do not do a good job of restore of preventing fatigue preventing anxiety preventing depression preventing conversion to needing a wheelchair preventing dementia and preventing nursing home care you got to stop the brain atrophy to do those things I and so and they don't do a very good job of stopping brain atrophy either if we are able to show that we can do a good job of stopping brain atrophy uh the manuscript for that paper will be in neurology and uh and I'll be on NPR oh I I listen to NPR I will be waiting for that podcast okay um the next question you kind of already answered it uh what are the benefits of joining this clinical trial well uh the benefit is that if you are in the randomized two intervention arms you'll get a couple calls with the study dietitian who will help you help you understand how to implement the diet given your culinary preferences and what's going on with your family and you'll have monthly calls with the study dietitians you get to submit questions and I answer and I create videos for the answering the questions for the two intervention groups in the con uh and um there is an app a diet app that we have for the intervention groups to give them some uh tips on uh how to meal plan uh and make this work for them in the control group we have a app for them as well it's the app for dietary guidelines uh and we have a monthly uh email text that what that will have cooking videos and tips for getting the added sugar out of your diet reducing the processed foods so you're getting contact with our study team with tips once a month or you get in contact with an opportunity to be part of a group call once a month and you you get to know that you're helping change the standard of care you're helping make it better for the 2.8 million people with Ms around the world about registering for your study so um well we will send out the study brochure afterwards and you'll have uh on the brochure there's a hot link that will take you to a screening survey you can also go to Terry walls t-e-r-r-y walls w-a-h-l-s.com and there is a gold bar across the top and click there you have to take a screening survey that will answer a few questions and will give us your email so we can contact you in case you filled it out wrong and to be surprised at how many people do so you have to follow up right and then we have to contact you to get permission to contact the neurologist who has to verify the MS diagnosis or send me the medical records so I can verify the MS diagnosis it will then we'll begin the process we we're recruiting 156 people um my sales team told me that we have 75 people in so basically uh it's about 81 people that we have to recruit left and the other thing I want you to do is to sign up for my newsletter uh Terry wall terrywalls.com uh and the reason I want you to do that is every week I look at the research that's coming out and I'll pick two or three uh studies and I'll have a very short commentary about those studies what they mean uh and I look for studies that speak to me in terms of what are the things that we could be doing either supplement wise diet wise exercise wise meditation wise so things that are under our control that can help us have a better outcome thank you um will you be hosting any other conversations about this clinical trial in another platform well one of the things that I'm going to be doing is a Ms and neuroimmune Summit uh July 5 through 11. and I'll be interviewing uh other clinical experts researchers neurologists uh and we'll be talking about basically things that people can do under our control that could help us have a better outcome for Ms and for other autoimmune things that wreck our brain wreck our spinal cord wreck our peripheral nerves and there's actually quite a few things that can do that but there's also a many many things that we can do that you may not be aware of that could help us have either a better quality of life or reduce our symptoms I have 40 people scheduled my team told me that I've invited another round of people that have up to 50 I need to stop inviting folks um so I will do that but uh this this is free it's online if you sign up for my newsletter you will for sure get the announcements we will put this out we'll start promoting it for people to sign up the week of June 20th because otherwise we all forget uh so we tell people about it just before it happens but I'm super excited I think it'll be really very uh very helpful and it's free and you said people can sign up for your newsletter on your website correct yeah if you go to terrywalls.com and you could put forward slash email I think that's the the link but if you just go to terrywalls.com you can scroll down and you'll they'll be a place for you to sign up sounds great well now we are ready for questions if you have a question or a comment you can ask it using the Q a button in the app that allows you to send your question anonymously sorry if you choose to do so or you can ask your question live by raising your hand if you would like to click raise hand button or press star 9 if you are using your phone I will call on you and then you will be able to unmute and ask your question are we ready Dr walls okay let's go all right Christine is asking I've been trying to eat along the lines of minding your mitochondria for years and it has helped some any advice about how to actually consume those nine cups of vegetables every day I can't make a huge salad every day you know um so I would encourage you to pick up the newest version of the walls protocol I've had some more refinements to my thinking so I would do that the the other thing I want to remind everyone is this is where you start when you write a book we put out sort of a public message for everyone if you came to see me I could personalize it I would know how big you are I would know your other medical issues and I could make a much more specific recommendation you don't need to eat beyond your appetite you know I get a bit distressed or I see people struggling to over consume beyond their appetite our appetite is really tightly regulated by our brain I and so eat the correct foods have protein have your greens your sulfur rich and your color about in equal proportions according to what your appetite is telling you to eat thank you Anonymous is asking when I ask my neurologist about the diets the response is always there's not enough data to support the diets to make any clinical difference what do you think about that well I think you're going to get this great abstract that was published in neurology and I encourage you to print it out and leave a copy with your neurologist to say well there is evidence and I want to referral to a uh a registered dietitian and I expect that my health insurance would cover that so please give me a referral and if your neurologist won't do that then ask your primary care Doc and at the very least pick up my book and read it be inspired Bob is excited sorry Sherry from Facebook is asking how do you feel about stopping disease modifying drugs so if we stop disease modifying drugs predictably you can expect a severe rebound and severe Fleur so I have patients ask um when is it safe to stop the drugs after implementing diet and lifestyle I'm doing really well I've not had any relapses my neurologist tells me that my I I don't have any enhancing lesions when is it safe and part of the problem is there is no research there are some disease modifying drug stopping studies going on and actually I've written grants to to investigate this I propose that we take people and randomize them and have everybody get diet and lifestyle uh follow them for six months and have half the folks stop the drugs and half the folks stay in the disease modifying drugs and then we could know did the diet and lifestyle reduce the risk of rebound I was not funded what was funded was people could just either stay on the drugs or stop the drugs and we did nothing to to to reduce the risk of rebound and of course I'm looking at that I'm thinking like that's a terrible terrible design because you're not trying to protect people we know that uh I mean clinically other functional medicine Integrative Medicine practitioners are seeing that people get great response uh the vast majority have reduced fatigue improved quality of life uh the relapse of stop uh in the number of enhancing lesions yeah basically stop we don't know how long you have to watch I tell my patients that we don't know my preference is that they wait at least a year preferably 18 months before trying to transition to a less potent disease modifying drug such as tecfider or Copaxone and then after and then they could decide do they want to try and go off of that I'll also tell you that in my func integrated functional medicine folks will see people after a year decide you know what I feel great I'm not taking those drugs because I'm more worried about the side effects from those very potent diseases modifying drugs um it makes me uneasy but until we have research the kind of research that I'm proposing that we're not going to have any clear answer what we probably need to do are get find a way to get a case Series going of people who have implemented diet and lifestyle successfully I had no relapses no enhancing lesions stopped their dmts followed for a year and that they've had no relapses no enhancing lesions uh that would be ideal uh and uh that's what we need to have happen next thank you Elizabeth is asking any thoughts on the overcoming Ms diet which is essentially Swank with more veggies plus fat flaxseed oil and or limited fatty fish you know I I am so glad that uh overcoming Ms was inspired by my book uh and uh made those changes I am so glad I and so I I think that is another diet and if you have high cholesterol uh you're worried about heart disease that's a fine diet to follow it's basically a low saturated fat version of the walls diet and I'm fine with that if I I do want to make the observation that cholesterol is a big part of our cell membranes is a big part of our brain is a big part of myelin and if your cholesterol is less than 180 you have a much higher rate of suicide homicide anxiety depression dementia cancer and chronic infections including uh Lyme's disease so if your cholesterol is over in the lowest all-cause mortalities at 225. now if your cholesterol is higher than 200 or 225 you have a lower rate of all those diseases that I just listed off but you have a higher rate of heart attacks higher rate of Strokes so when I'm meeting with my patients I you know I understand there are neurologic issues I understand their cardiovascular issues and then we have in the risk of diabetes and then we have a conversation for them what is the optimal cholesterol for them and then we make recommendations based on that thank you Sasha is asking can you translate the measurement of three cups into recommended grams or ounces so do you have a dinner plate foreign plate is three cups and so the amount of uh so no I I don't have a gram uh because this will depend on the type of vegetable uh that you were measuring uh instead of being focused on grams I want you to think about your dinner plate uh a dinner plate of vegetables the goal is if you're six foot or a man it's three three plates if you're female and petite it's two plates I have to start eating more vegetables um all right so I'm going to allow Rob to talk uh he has his hand raised right yes yes I can hear you thank you can you hear me we can beautiful sunset great great um Dr walls wow this this was so timely for me because I was diagnosed four years ago late in life when I was in my early 60s and I actually read your book uh somewhere near that time when I was diagnosed and then didn't do anything about it and recently got it on audio tape and so I've been listening to it you know um every day uh that would be so this presentation was really really timely for me a lot of the the couple of questions I had about your research to date you already answered with the other folks the only other question I have is uh I have ppms that is my diagnosis and my only diagnosis at this point am I eligible for your study um for no we only let relapse in remitting in however please screen so you're in our database because I'm writing grants uh and proposals for progressive MS and we would love to have you in those studies okay very good and school so the if you go to terrywalls.com there's a a gold bar across the top and they'll say click here to take the screening survey take uh click that spot and complete the screening survey okay wonderful thank you thank you thank you Rob okay um before we continue Dr Waltz do you mind sharing the link I noticed that a lot of people are asking for the abstract article link if you could please send that okay no this is going to be a little tricky if you want to email it to me later we can do that too and I can send it to everybody that registered if that's you so that will be easier so I don't mind looking for it but keep in mind while I'm looking for it I am not going to be able to answer questions so you can decide and I can send it to everybody that's asking I will send the abstract link to all of you via email from the registration email that everybody got so can we proceed to questions yes please please I don't I also don't want to take up time on something that can be done later uh Elizabeth is asking is the type of mushroom going to matter yes it needs to be something you can eat there are plenty of poisonous mushrooms so don't go out into the woods and start picking mushrooms wooly Nelly you need to be sure that they're edible mushrooms and so either get them in a grocery store or from a very knowledgeable um uh mushroom expert thank you next question is Christine is asking what about Dairy so for about 200 million years mammals have been raising Are Young with milk It's very effective at growing infants rapidly growing toddlers rapidly and growing humans quite rapidly to the point that our growth plates views in adolescence milk is filled with growth factors all milk once our growth plates fuse all those growth factors can help me grow horizontally which I'd rather not do they could also help me grow pre-cancers and Cancers which I would rather not do so if you're but milk has a lot of protein in it and humans began having milk about 10 000 years ago when we domesticated cows in Europe uh and uh the Europeans developed a genetic mutation that let us digest uh lactose in milk um Africans most Africans don't have that most Asians don't have it uh people of Caucasian ancestry usually happen if you're fine with having cancer fine with getting fat drink milk if you'd rather not have cancer rather not get fat I would get your calcium from greens and protect your bones by doing weight-bearing exercise jumping rope and a vibration plate but again you know no but does have a protein does have some calcium but you know if you're fine with getting cancer drink up thank you uh Terry from Facebook is asking if there was one thing to do to start on the right path of eating what would it be meaning what should I concentrate on adding to my already clean diet which consists of no sugar and very limited processed foods um yeah I think A really lovely place to start is be sure that you have more greens green leafy vegetables learn how to have uh some sauteed greens I think that they are my family's favorite vegetable sauteed greens or you could have greens with some green grapes and ice and olive oil for green smoothies your kids would probably like that um uh and if you're open to eating meat have it deliver once a week well prepared is also one of my family's favorite meals if you don't like liver heart is a really great organ meat oysters and clams mussels are a great organ meat as well thank you Bob is asking why is the new trial focused on rrms I'm just shortening it for now and how were the results of the previous trials on people with primary progressive MS so the the very first study that we did with primary progressive MS showed that people who were severely disabled in the mean disability was between Kane and Walker were able to implement our program and that half of them had clinically meaningful Improvement in walking so if you have Progressive multiple sclerosis get my book and implement it it could make a huge difference in your life um I and I think so and why we limit to relapsing Ms it's easier to recruit their 80 percent of people with Ms have relapsing remitting Multiple Sclerosis that is why the vast majority of studies are in relapsing remitting Multiple Sclerosis we have that big study going on we are now writing for multiple studies uh with progressive MS I agree there is a huge need uh people don't like studying progressive MS because notoriously nothing works I've already shown that my Approach works very well for progressive MS so actually I'm super optimistic that um that will have success getting funding for a progressive MS study so everyone with progressive MS who's on this call please screen sir in my database so you can hear when we are ready to recruit for progressive MS thank you Elizabeth is asking is brain volume standardized enough my neurologist doesn't agree so for research yes for clinical trials uh absolutely it is it's now considered to be one of the important measures that are followed in clinical research for people in clinics uh the question is does your radiologist use a software that standardizes the measurement of brain volume over time I and so there are a number of softwares that are um in place that will do that thank you Ronald is asking do you have any results for people with well you already answered primary progressive MS on the walls diet and I know you said to read the book so read the book read the book I have answers we have our very first paper showed um our first two papers that came out looked at people with uh 10 with primary and secondary progressive MS then 20 with primary secondary progressive MS we could show that they implemented the diet and it was diet supplements exercise electrical stimulation of muscles and meditation so it was everything that I had done we reduced fatigue improved quality of life reduced anxiety reduce depression improved cognitive performance so thinking and we improved walking and hand function wow that's pretty good stuff that's great I mean that's that's really great uh we have somebody who raised their hand Susan I'm going to unmute you can you hear us hello hi I wanted to know Dr walls I wrote your protocol early on if you can follow the protocol without um organ meat and use some more a less saturated oil so you can absolutely follow the protocol without organ meat if you go to my website turwalls.com there are organ meat capsules and certainly we have a bunch of folks who would like to do the organ meat capsules instead I I and you can follow a low saturated fat version of the diet night talk about that in my books so absolutely you can do that thank you thank you uh thank you Dr Walls by the way I know we're nearing the end of the hour um are you okay to stay another 15-20 minutes max um how about we limit it to 15. oh yes we can do that uh did you want to share the slides um okay I know you mentioned that you would like to so people can have more information before we continue so let's see if I can okay are you seeing my slides now yes okay so again it's 18 to 70 uh 156 it's the largest longest diet study that will have been done we're comparing the olive oil ketogenic modified paleo to usual diet we'll look at quality of life and clinical outcomes you're also seeing a copy of the study brochure and we're looking at braid and volume can we get people to healthy rates of Aging the key is you have to come to Iowa City uh that is the email that is the long version of how to join the study uh but you'll if you go to terrywalls.com there is a link to complete the screening survey there and we have the MSN neuroimmune Summit it'll be free online more information will be available about how to sign up the week of June 20th sign up for my newsletter at terrywalls.com so you'll have access because we'll send that information out the week of June 20th and follow me on Twitter follow me on Facebook if you follow me on Instagram you get to see what I'm eating and doing uh and I think it's pretty fun and I'll stop my share and come back thank you Karen is asking what are the basic must-have supplements you know so again I've I've got these on my website um I think everyone should know what their vitamin D is and get their vitamin D optimized and you'll want to take a vitamin D that also has vitamin K in it um I would know what your um uh a couple grams of fish oil uh would probably be super helpful we have multiple studies that show if you take uh between one and four grams of fish oil there's a lower rate of relapse a lower rate of the number of enhancing lesions uh yeah so I think that's very clear uh and a B vitamin is probably also tremendously helpful I would take an activated B vitamin that has because all of our B vitamins will be activated so depending on your genetics my efficiency at that activation step will be normal or depressed and I know for myself I have several genetic variants on how well I activate B12 so I could have a high what looks like a very high level of B12 in my in my blood but I have a high homocysteine and if I take the activated forms of B12 my homocysteine comes down and is appropriate so yeah much better to have an activated form of the B vitamin so if you have these genetic variants that's less of a problem for you thank you Mary is asking what advice do you have for someone older than 70. I am 78 and disappointed that I cannot sign up for your study well Mary please read my book and Implement as many of the concepts as you can you can pick which of the diets speak to you whether it's the ketogenic diet or the modified paleo diet you can also sign up for my registry because some of our online studies that we've done uh let people participate from anywhere in the world and we don't have age restrictions so Mary sign up sign up for the registry so you'll be eligible for some of our future studies thank you Dean is asking does your diet work for any neurological conditions like myasthenia gravis or epilepsy or only for Ms it's been very helpful for myasthenia gravis it's been helpful for rheumatoid arthritis inflammatory bowel disease psoriasis anxiety depression it's been helpful for cognitive decline traumatic brain injury so if you have a autoimmune or psychiatric problem or a neurologic problem I would certainly encourage you to implement the wall Style thank you mine is asking what level of vitamin D do you recommend or and are there any concerns with the calcium level for people who also have osteoporosis so if you have so it's sort of interesting we've steadily increased the amount of calcium people should have in their diets but I've asked people to have more milk but when we look at epidemiologic studies those societies that have the highest intake of dairy also happen to have the highest rates of osteoporosis now Association does not lead to causation but that's certainly an interesting observation I people have osteoporosis or osteopenia I want them to have sufficient vitamin D sufficient vitamin K so that's why I want you to have a vitamin D supplement with K and to have plenty of greens and I want you to have weight-bearing exercise there are a number of studies that have used vibration plate Therapies that let us stand on a vibration plate and have gentle gravitational stress to our bones that have been shown to increase bone density in people with osteoporosis postmenopausal I have I had severe osteopenia I was not osteoporotic but severe osteopenia that was um documented in 2004. I was following a paleo diet at 2004 I just I had started that in 2002 and I'm a wheelchair dependent um now since that time I have uh you know influenced the paleo diet I've ramped up my greens I'm taking vitamin d and vitamin K and I practically get uh bone mineral density and my neurologist and my primary care doc are like okay you're you're older you're in your you're 67 now but every time we measure it your bone mineral density keeps getting better and better and better and that's because I also do vibration plate therapy three to four times a week I have plenty of vitamin K and you know I'm really committed to exercise including strength training thank you Grandy from Facebook is asking if someone with Ms has been doing intermediate fasting with 16 hours on eight hours off and five to two lost over 130 pounds only by doing the 16 18 ratio what would you say about trying to add a dry fasting day a week or once a month now of course that conversation you should have with your personal physician uh and uh the the decisions about am I going to use dry fasting uh I look at all the person's Medical comorbidities Anonymous is asking what are your thoughts or recommendations for sleep and exercise changes in conjunction with these diet changes so I think the question that's being asked is um should people do everything should we diet fix our diet fix our sleep exercise I have some type of stress reducing practice and the answer is add this to improve the self-care at the pace that will work for you and your family now at various times in my life I will I have focused on diet and then I've began to pay more attention to meditation then I began to pay more attention to sleep I and where where I'm and right now I'm I'm really jazzed that I'm jogging again so I'm paying more attention to being able to to jog and it can be really hard to implement everything all at once feels like oh my God that's like two and a half hours a day and I don't have two and a half hours a day so just begin improving things at the pace that is sustainable for you thank you another anonymous question I am pre-diagnosed but my neurologist suspects it's Ms with facial and leg spasms and high white blood cell count in CSF what things can or should I be doing now to slow my progression once again okay we're gonna stop there so so so people will have a variety of problems that may have fatigue may have sensory disturbance may have mood issues and you're going to see your physician any physician is like well I'm checking the labs there's nothing clear I don't know what it is uh and you're frustrated because you don't have a diagnosis I'm thrilled you don't have a diagnosis because that means you're in the prodrome phase that means that you're earlier in the disease process where it is more likely that implementing all of the concepts that I'm teaching here in my book The Walls protocol about things you could do with your diet with meditation with some targeted supplements with exercise can begin to help your cells through the chemistry of life more correctly that can begin to help you do have a healthier microbiome that can reduce your oxidative stress and I predict many many people in that prodrome phase begin to have whatever the symptoms in the program phrase start melting away and you'll go back to see your physician and you'll say like you know I I read this amazing book and it inspired me to start fixing my diet and then I started feeling better and then I started moving more and then you know I was feeling better and my wife and I decided that we would start going in walks together and I'm happier and I'm not as crappy with my kids and you know what I don't care I don't have a diagnosis because I'm not sick anymore that's what I predict happens if you quit chasing the diagnosis and you start chasing how do I get healthier at a cellular level thank you uh the second question was once officially diagnosed is it best to jump straight to dmts or keep with the diet if you are deciding between doing dmts or fixing diet and lifestyle this is a a false choice if you want your brain to have a chance to have healthy aging the best way to do that is diet and lifestyle it is a very separate decision do I want to do dmts or not and you can have that conversation with your neurologist who will insist that um that is the only way to protect your brain and you'll have to make your own independent decision some folks feel better doing dmts immediately plus diet and lifestyle some decide you know what I'm doing that and lifestyle and I'm going to wait on dmts because I don't have many lesions I I don't have much symptoms and I'm going to see if I can control everything without a lifestyle first I'll get a surveillance MRI at six months and that feels like the right thing what you really have to look at is the if you if you get the the package insert and you see the long list of Adverse Events and how often they occur and you see that on the Adverse Events there are a lot of mild things that are not too big a deal then there's some really terrible things that might kill you and some people and they're not very frequent and some people are are very afraid of these infrequent lethal problems some people are very afraid of I don't want to become disabled I don't want to be in a wheelchair I don't want to be in a burden you have to thank for you which list of things that you are most afraid of the disability risk or the rare but serious adverse event risk it'll and I'll tell you when I was in the wheelchair and I didn't want to become a burden I was like okay I'll take drugs that have a two percent chance of giving me acute leukemia I took him every month because I wouldn't be a burden you we all have to decide what which risk you are most comfortable with sad well that brings us to the end of our time if you missed any part of this conference it has been recorded and will be available through the MS Focus Facebook and YouTube channels please reply to your registration email for information on how to access the recordings or sign up for our newsletter to learn about upcoming events also you'll be receiving a short survey when you leave the conference we really greatly appreciate your feedback because it helps us determine what type of information is the most meaningful and helpful to you as the attendees of the conference our next teleconference will be this coming Tuesday evening February 14th at 4 30 PM Eastern our speakers Dr Ben thrower who will be answering all of your Ms related questions in a talk sorry in a town hall style q a come join us for ask the MS expert our sincerest thank you to all of our attendees for your participation and especially to you Dr Wall thank you for taking taking the time out of your busy schedule to share this very helpful information good night everyone and we'll see you next time also just wanted to let everybody know that the book with that Dr walls wrote If you would like to you can request to borrow it from your lending library but there might be a wait list uh due to this program and her showing the book so just keep an eye out and just stay patient I will also be sending the link for the brochure to her study and if you have any questions please just respond to the registration email thank you so much have a great night bye

Channel: Multiple Sclerosis Foundation

Views: 63,652

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Id: ZcRnjtHR6CI

Length: 77min 54sec (4674 seconds)

Published: Fri Feb 24 2023