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Making life easier in the kitchen

Chopped’ winner offers practical tips — and a recipe — for cooking with MS.

Chris Holland went from paralegal to restaurant chef and three-time winner of the cooking competition show “Chopped” in the span of about a decade. And he credits it all to multiple sclerosis.

Holland, who was diagnosed with MS in 2004, says his life “fell apart when I got sick.” But he put his life back together and, with encouragement from his wife, Marge, decided there was no better time to pursue his lifelong dream of becoming a chef. Today, he’s chef and part owner at DVine Bar in Rockland County, New York, where he specializes in what he likes to call “eclectic, weird fine-dining.” He concocts menu items that run the gamut from duck fat potato chips with cipollini onion crema to seared tuna and chanterelles.

“I love it there,” Holland says. “I have a great boss who really understands about my MS.”

Holland figures he applied to be on “Chopped” about 10 times before he got the call. Since then, he’s had an impressive run. He notched his third championship in November 2019, donating the $10,000 prize money to the National Multiple Sclerosis Society as a way to give back to an organization that he says has given so much to him and others. He’s also had a great response to his appearances on the show. He’s particularly happy when he hears from “the young people who were diagnosed. They say it’s so nice to see somebody who’s able to do something like I do.”

It’s not always easy. Standing for long hours in a hot kitchen, wielding knives and other cooking utensils while whipping up that cipollini crema can take its toll on somebody with MS. So, who better to offer a variety of practical tips for making life easier in the kitchen?

Here are chef Holland’s tips, along with a bonus recipe you can make while dreaming about being a “Chopped” chef yourself:

Get a Microplane grater
This grater is one of the most important tools in my kitchen and the best $15 you could ever spend. In addition to providing the delicious zest from a citrus fruit, it has other uses for the quick processing of ginger or garlic. Simply grate the ginger or garlic and avoid the tedious task of chopping these aromatics. You don’t even have to peel them.

Get some help from the supermarket
While I encourage everyone to cook your food rather than buy it, there is nothing wrong with using precooked foods for a head start. Rotisserie chickens are available in most supermarkets and are very affordable. Use them in anything that calls for cooked chicken as an ingredient and save those bones for a stock. Check the salad bar for ready-to-go ingredients that you can use in your own culinary creations.

Slow cookers are your friend
Slow cookers are a great way to stay out of a hot kitchen and avoid spending time on your feet. Many recipes call for 15–20 minutes of prep time, then set it and forget it. Just remember to start cooking early, as many recipes take hours to finish cooking. Slow cookers are also great for soups.

The microwave is not just for reheating coffee and for frozen dinners
This much-maligned kitchen tool does impressive work with vegetables. Hearty greens such as broccoli, green beans and carrots cook beautifully in a microwave. Just wash the vegetables (do not dry) and place them on a ceramic plate and cover with plastic wrap. Microwave on high for three minutes. Check for the desired doneness and add more time as needed. Season afterward with olive oil, lemon, and salt and pepper.

A salad doesn’t have to just be lettuce
A salad is an easy vehicle for incorporating foods beneficial to those living with MS, such as avocado, whole grains such as quinoa or chia seeds (high in fiber), fatty fish such as salmon, trout and tuna (omega 3s), walnuts (omega 3s), and lean proteins such as chicken, turkey and pork tenderloin.

Mediterranean chicken tacos

Cook Time: 15 minutes

Servings: 4

Ingredients:

1 small rotisserie chicken
3 cloves of fresh garlic (grated with a Microplane)
½ teaspoon dried oregano
½ teaspoon ground cumin
Pinch chili flakes (optional)
½ cup extra virgin olive oil plus 3 tablespoons
Juice of half a lemon
Zest of 1 lemon
1 English cucumber (diced)
½ red onion (diced)
2 tablespoons fresh dill (chopped)
1 tablespoon red wine vinegar
½ cup Greek yogurt
Salt and pepper
8 flour tortillas (6-inch)

Directions:

  1. Pull the meat off of the chicken and shred into a large bowl.
  2. In a medium sauté pan, heat the olive oil over medium heat. Check the heat by putting one piece of the diced onion into the pan. It should sizzle immediately upon hitting the oil.
  3. Once the oil is at the correct temperature, turn off the heat, and add the garlic, oregano, cumin and chili flakes. Stir the oil for one minute or until the pan stops sizzling.
  4. Add this oil mixture (reserving 3 tablespoons) along with the lemon juice to the shredded chicken. Season with salt and pepper to taste.
  5. In a separate bowl, add diced cucumber, diced red onion, reserved olive oil, chopped dill, red wine vinegar, and salt and pepper to taste.
  6. In a separate bowl, add Greek yogurt, lemon zest, and salt and pepper to taste.
  7. In a small sauté pan, toast flour tortillas.
  8. To assemble, spread one side of tortilla with the yogurt mixture. Top with chicken and the cucumber “salsa.”

For the leftovers, consider adding shredded mozzarella and making a Greek chicken quesadilla served with lemon yogurt and cucumber salsa.

From:  NMSS

More on COVID-19 and MS

Coronavirus Risk for People Living with Multiple Sclerosis (MS)

MS itself does not increase the risk of getting COVID-19. However, certain factors associated with your MS may increase your risk for complications:

  • Chronic medical conditions, such as lung disease, heart disease, diabetes, cancer, smoking and asthma
  • Significantly restricted mobility, such as needing to spend most of your day seated or in bed
  • Age 65 or older
  • Possibly taking certain disease modifying therapies that deplete immune system cells
  • Severe obesity or BMI higher than 40
  • Living in a long-term care facility

Sometimes, the body’s response to infections, including COVID-19, may cause a temporary worsening of MS symptoms. Typically, these symptoms settle down once the infection clears up. If you are experiencing new MS symptoms or have any concerns about any of your MS symptoms, please contact your MS healthcare provider.

Protecting Yourself from Coronavirus

The Centers for Disease Control and Prevention (CDC) provides recommendations on how to prevent the spread of COVID-19 and what to do if you show symptoms.

Working and Coronavirus (COVID-19)

MS Healthcare ProvidersHealthcare providers who treat people living with MS can find additional information in our Professional Resource Center.

Healthcare Workers Who Have MS

  • There is no increased risk of you getting COVID-19 because you have MS.
  • If you are concerned about your risk of getting COVID-19 because of the DMT you take, please contact your MS provider for advice.
  • There are no special PPE instructions for people with MS. You should follow the same precautions as other healthcare workers. If you are concerned about your risk due to your DMT, please contact your MS provider for advice.

Employee RightsThere are many protections that could be available to you if your employer is not being flexible with work from home options or workplace accommodations. Visit our employment resources page to learn more or contact an MS Navigator to discuss your individual rights and options.

Children with MS

There is no specific advice for children with MS; they should follow the advice above for all people with MS. The CDC has specific recommendations for children and COVID-19.

Pregnancy

At this time there is no specific advice for women with MS who are pregnant. There is general information on COVID-19 and pregnancy on the CDC website.

Additional Resources

New Study Links Obesity to MS, and to Worse Treatment Responses in Children and Teens

SUMMARY:

In a new study from Germany of 453 children and teens with MS, compared with more than 14,000 children without MS, those who were overweight or obese had twice the risk of developing MS, compared with non-overweight children.

They also had significantly more relapses on treatment with first-line treatments, and increased use of second-line treatment. Otherwise, there was no association found between obesity and disease activity, imaging scans, EDSS progression, or other measures.

These findings need to be confirmed with further study. It is important to note that not everyone who is obese during adolescence will develop MS, and also that many people develop MS without having been obese during adolescence.

The team (Brenda Huppke, MD, Peter Huppke, MD, and colleagues at University Medical Center Göttingen, Germany) published their findings in JAMA Neurology (posted online July 15, 2019)
DETAILS
Background: Several risk factors, including genes, exposure to infections, and environmental factors, have been identified as increasing a person’s susceptibility to developing multiple sclerosis. In addition, there is a growing body of evidence that childhood/adolescent obesity can increase the risk of developing MS. In one study, being overweight or obese was associated with an increased risk of developing MS or clinically isolated syndrome (CIS, a first clinical episode suggestive of MS, indicating increased MS risk) in girls, in a study that compared 75 children or teens with MS or CIS with the health records of more than 900,000 healthy children or teens.

Additional research is needed to understand this association. It is important to note that not everyone who is obese during adolescence will develop MS, and also that many people develop MS without having been obese during adolescence.

The Study: The researchers reviewed the medical records of 453 children and adolescents with relapsing-remitting MS. They looked at disease activity captured on imaging scans; treatment information, and EDSS scores measuring levels of physical disability. They also compared body mass index with information obtained on 14,747 children/adolescents in a Germany-wide child health survey.

Results: The team found that both boys and girls who were overweight or obese had twice the risk of developing MS, compared with non-overweight children or adolescents. Comparing responses to treatment with interferon beta or glatiramer acetate, the team reported that obese children had significantly more relapses on treatment, and were more likely to have switched to second-line treatment. Otherwise, there was no association found between obesity and disease activity, imaging scans, EDSS progression, or other measures.

The team (Brenda Huppke, MD, Peter Huppke, MD, and colleagues at University Medical Center Göttingen, Germany) published their findings in JAMA Neurology (posted online July 15, 2019)

Conclusions: This study provides strong support for a link between obesity and development of MS in both boys and girls. It also indicates a significantly worse response to first-line MS treatments and a greater likelihood of switching to second-line treatments among obese children. The authors suggest that obesity may affect pharmacokinetics – how a drug moves into, through, and out of the body. Further research is necessary to confirm these findings, and to understand the mechanism.
 

Stem cells hold promise for MS

Stem cells

There is exciting and innovative research and progress occurring related to the potential of many types of stem cells for slowing MS disease activity and for repairing damage to the nervous system. In light of the urgent need for more effective treatments for MS, particularly for those with more progressive forms of the disease, we believe that the potential of all types of cell therapies must be explored.

Stem cell therapy is any treatment that uses or targets stem cells, which are the types of cells that differentiate into many different specialized cells in our bodies. Stem cells are found in both embryos and adults.

Many types of stem cells are being explored for their potential benefits for treating multiple sclerosis. Only when the results of these and subsequent clinical trials are available will it be possible to determine what the optimal cells, delivery methods, safety and actual effectiveness of these current experimental therapies might be for people with MS.

Although cell based therapy has generated a great deal of interest and holds promise, the field is in its infancy and much more research is needed before cell based therapies become a MS treatment option.

Different Types of Stem Cells

  • HSCs (haematopoietic stem cells) – adult stem cells that are found in bone marrow and blood. HSCs are capable of producing all of the cells that make up the blood and the immune system.
  • MSCs (mesenchymal stem cells) – adult stem cells found in several places in the body, including the bone marrow, skin and fat tissue. They produce cells which help other stem cells function properly.
  • NSCs (neural stem cells) – specialized stem cells responsible for repairing nerve-insulating myelin in the brain. These can be derived from other types of stem cells such as mesenchymal cells.
  • hESCs (human embryonic stem cells) – stem cells derived from donated embryos. They can naturally produce every type of cell in the body. One concern about their potential therapeutic use is that they have been found to cause tumors.
  • iPSCs (induced pluripotent stem cells) are engineered from adult cells to produce many types of cells. One concern about their potential therapeutic use is that they have been found to cause tumors.

www.nmss.org  The National Multiple Sclerosis Society

Multiple Sclerosis and CBD

Multiple Sclerosis (MS) is a disease that impacts the body’s central nervous system (CNS) including the brain, optic nerves, and spinal cord. MS consists of an abnormal response of the body’s immune system. From here, the immune system targets myelin (a substance that surrounds and insulates the body’s nerves), and myelin gets damaged, which then produces scars (sclerosis). These scars are believed to be the cause of the painful symptoms MS patients experience.

Although MS causes various painful symptoms, over 85 percent of MS patients experience spasticity. Fortunately, though, based on the studies have been conducted on cannabis and MS so far, most indicate that cannabinoids are associated with self-reported spasticity improvements. It has also been found that CBD contains anti-spasm properties. Additionally, the American Academy of Neurology has expressed that cannabis is effective for the treatment of pain and spasticity. Then, one Israel study discovered that cannabis can safely alleviate pain in older MS patients and those with other chronic conditions, such as Crohn’s Disease.

Currently, 20-60 percent of MS patients consume cannabis, and many use topical cannabis products as their primary delivery method. To help treat muscle spasms and pain, it’s common for MS patients to use cannabis topically, so they can apply the medicine onto specific areas of their body. To achieve localized and rapid relief though, it’s recommended to use topical products with one example being CanniMed’s products, from which numerous Canadian MS patients have benefited.

Prevalence of MS More Than Doubles Estimate

A new study funded by the National MS Society has confirmed that nearly one million people are living with MS in the United States, more than twice the original estimate from a previous study. This breakthrough is a pivotal moment in the MS movement as a scientifically sound measure of prevalence helps us better understand the disease and its impact. With twice as many people living with MS, solutions for MS are now twice as important.

In addition to the main paper outlining these results, two companion papers providing background information on prevalence in the U.S. and reviewing the study methods were also published in the February 15, 2019, online issue of Neurology®, the medical journal of the American Academy of Neurology.

Q: What is prevalence and how is it different from incidence?
A: Prevalence is the number of people living with a disease. Incidence is the number of people newly diagnosed with a disease within a given period of time.

Q: How many people are living with MS in the U.S. according to the new prevalence estimate?
A: Nearly 1 million people (913,925)

Q: How is the new estimate different than numbers used before?
A: More than twice as many people are living with MS than was previously thought.

Q: Where did the earlier MS prevalence number of 400,000 come from?
A: The previous figure of 400,000 was an estimate calculated from population growth since the national study of MS prevalence that was published in 1981.

  1. How did the prevalence number jump from 400,000 to 913,925?
    A. As part of a Society-funded study, researchers developed a novel method for estimating the number of people who are living with MS using large medical claims datasets. This method has produced a higher, and likely more accurate, count.

Q: Why is this information important? And what does it mean for people affected by MS and the work of the National MS Society?
A: Having this scientifically sound prevalence estimate will facilitate a better understanding of the needs of people with MS and the economic burdens imposed by the disease on families and society. It will be a starting point for researchers to understand if MS is increasing, or if there are MS geographic clusters that hold clues to factors that trigger MS. These data will also help ensure that the National MS Society is able to connect to and support all people affected by MS.

Q: Does this mean more people are getting MS than before?
A. We don’t know. Since solid information on the number of people being diagnosed with MS has not been available, it has been difficult to tell whether more people are getting MS or if the total number is just a reflection of overall population growth, better diagnostic procedures, the availability of disease modifying drugs, or other changes in the MS landscape. Going forward, this should become easier. Outside of the U.S., some studies have reported increases in the incidence of MS. More work is needed to understand all the factors that led to this increase.

Q: What was the process to reach this new number and why has it taken so long to get an updated prevalence number of people living with MS in the U.S.?
A: After an examination of what it would take to identify a scientifically sound estimate, the Society funded the work and established a work group of experts across the fields of epidemiology, statistics and health care. This group labored for nearly four years to develop and implement a plan for estimating prevalence as rigorously as possible given the sources of information available. They obtained the proper mix of administrative datasets, developed and validated a formula to identify people with MS then applied it, and the findings were published in a peer-reviewed journal.

Q: Will this change the global number?
A: Yes, this will change the global number (which is most recently estimated at 2.3 million). The global number is calculated through input from MS societies across the globe to the MS International Federation. The MS International Federation is planning to do an update of the “MS Atlas” and when complete, the global number is likely to increase not just from the new U.S. estimate but from other nations as well.

Q: How confident are we in this number?
A: A team of experts led a thorough study based on a sound, scientific process and followed the peer-review process to affirm these results. We have trust and confidence in the approach and methodology that produced these results. In addition, the figures for the US are as high or higher than figures found in other countries using a variety of different methods to calculate the number.

Q: Will this new prevalence estimate help us get to a cure for MS faster?
A: Research breakthroughs related to what causes MS and how to cure it are happening at a faster pace than ever before. Having sound information on how many people are living with MS and who gets MS is an important pathway to a cure.

Q: When and how will the prevalence number be updated again?
A: The National Neurological Conditions Surveillance System, which was authorized in 2016 through the 21st Century Cures Act, has been funded and will be able to update prevalence estimates on a regular basis. This is a culmination of more than a decade of work by MS activists and others across the neurologic community. This system will provide important demographic data to help researchers move more quickly toward cures for the millions of people who live with diseases like MS and Parkinson’s.

Q: Why do we only have an estimate of the number of people with MS, versus knowing the exact figure?
A: Unlike for certain infectious disorders, there is no requirement for healthcare providers to report to health authorities when a person is diagnosed with MS. Although a nearly exact count could be made by contacting doctors, hospitals, and other health care facilities, such a study would be prohibitively expensive and almost impossible to implement.

Novel Molecule May be Used to Track and Treat MS

Scientists at Purdue used a novel approach to show that a molecule called acrolein is elevated in blood and urine from mice with MS-like disease and from people with MS, compared to those without the disease. Acrolein is normally a waste product, but seems to accumulate in people with neurologic disease, becoming toxic to nerve cells. They are now testing whether acrolein levels correlate with disease activity, to determine if this molecule may eventually be used to identify MS with a simple blood test. Medications targeting acrolein are already on the market, raising its potential as a therapeutic target for MS.

 

Read more in Purdue University News

Read the paper in Frontiers in Neurology

 

Results Published from Trial of Siponimod in Secondary Progressive MS

  • Results of a 60-month, phase III clinical trial of the experimental oral therapy siponimod (BAF312, Novartis Pharmaceuticals AG) involving 1,651 people with secondary progressive MS have been published. The results were originally presented in September 2016 at the ECTRIMS conference.
  • The trial met its primary endpoint of reducing the risk of disability progression compared with inactive placebo. Those on active treatment had a 21% reduced risk of disability progression compared to those on placebo. Secondary endpoints suggested that those on active therapy had 23% lower average change in brain volume and reduced lesion volume. There was no significant difference seen between groups in the timed 25-foot walk.
  • The therapy was generally well tolerated and similar to adverse events reported for similar compounds. The serious adverse events reported to be more likely for those taking siponimod included nervous system disorders and infections.
  • Dr. Ludwig Kappos (University of Basel in Switzerland) and a large team of investigators report detailed results of the trial in The Lancet (online March 22, 2018). A commentary about the results by Drs. Luanne Metz and Wei-Qiau Liu (University of Calgary) is also published online.

DETAILS
Background: Siponimod (BAF312) is an experimental immune system-modulating therapy that was designed to be a more selective sphingosine 1-phosphate receptor modulator than Gilenya® (fingolimod, Novartis International AG). Gilenya, was approved in 2010 for adults with relapsing forms of MS to reduce the frequency of clinical relapses and to delay the accumulation of physical disability. Siponimod previously demonstrated safety and efficacy on MRI scans in a phase II study in people with relapsing-remitting MS (The Lancet Neurology, 2013 Aug;12(8):756-67).

Siponimod is thought to act by retaining certain white blood cells in the body’s lymph nodes, keeping them out of circulation and from entering the central nervous system. Siponimod also distributes effectively to the central nervous system (brain and spinal cord) where it may have direct anti-inflammatory or other effects.

The Study: Participants with secondary progressive MS were randomly assigned to take siponimod or placebo capsules daily for up to 60 months. The primary endpoint of the study was reducing the risk of disability progression, as measured by the EDSS scale that was sustained for at least 3 months. Secondary endpoints included reducing the risk of disability progression as measured by the EDSS at six months, the risk of worsening mobility as measured by the timed 25-foot walk test, disease activity as observed on MRI scans, relapse rate, and safety/tolerability.

Results: The results were originally presented in September 2016 at the ECTRIMS conference. The trial met its primary endpoint of reducing the risk of disability progression compared with inactive placebo. Those on active treatment had a 21% reduced risk of disability progression (confirmed at 3 months) compared to those on placebo. Secondary endpoints suggested that those on active therapy had a 23% lower average change in brain volume, and reduced MRI-detected brain lesion volume. There was no significant difference seen between groups in the timed 25-foot walk. Relapse rates were significantly lower in those taking siponimod.

Safety: The therapy was generally well tolerated and similar to adverse events reported for related compounds. Serious adverse events occurred in 16.7% of participants. The serious adverse events reported to be more likely for those taking siponimod included nervous system disorders and infections. More of those taking siponimod than the placebo experienced adverse events (89% vs 82% patients), such as a slower heart rate, high blood pressure, reduced white blood cell counts, macular oedema (swelling at the back of the eye), increased liver enzymes, and increased numbers of convulsions.

Dr. Ludwig Kappos (University of Basel in Switzerland) and a large team of investigators report detailed results of the trial in The Lancet (online March 22, 2018). A commentary about the results by Drs. Luanne Metz and Wei-Qiau Liu (University of Calgary) is also published online.

Comment: “While the magnitude of this response is somewhat modest, it represents a milestone in our unrelenting search for treatments that will benefit people living with progressive forms of MS,” said Bruce Bebo, PhD, Executive Vice President of Research at the National MS Society.

Resources
Read about secondary progressive MS
Read about the International Progressive MS Alliance, an unprecedented global collaboration of MS organizations, researchers, clinicians, pharmaceutical companies, and people with progressive MS, transforming the landscape of multiple sclerosis.

 

Zinbryta (daclizumab), a Therapy for Relapsing MS, is Withdrawn from Market

  • Biogen and AbbVie have announced the voluntary withdrawal Zinbryta ™ (daclizumab) from the worldwide market.
  • Zinbryta is an immune-modulating therapy that was approved in 2016 for people with relapsing MS and generally reserved for people who had an inadequate response to two or more MS therapies.
  • According to a company press release, the European Medicines Agency had raised new safety concerns related to reports of inflammation of the brain or its surrounding tissues (inflammatory encephalitis and meningoencephalitis) among people taking Zinbryta.
  • Individuals currently taking Zinbryta should contact their healthcare providers to determine alternative treatment options, and to continue safety monitoring. According to the medication guide, this would include monthly blood tests to monitor liver function for up to six months after the last dose.

Best MS Books (29 books)

29 books based on 16 votes: Break The Spell by A.M. Bostwick, Mom’s Story, A Child Learns About MS by Mary Jo Nickum, Multiple Sclerosis: The Questions Y…
goodreads.com

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