Can You Use the Terry Wahls Diet for Chronic Pain? Part 1: Introduction

Can You Use the Terry Wahls Diet for Chronic Pain? Part 1: Introduction

 

Terry Wahls is a physician who happens to have progressive multiple sclerosis. Against all odds, she used a special diet to go from wheelchair to mountain bike, and became an inspiration to many. An MS diet may also help those with chronic pain. Let’s explore the diet’s application to chronic pain in this three-part series.

Fruits and veggies – your new BFFs

First things first. This diet involves eating fairly massive amounts of fruit and vegetables. More than you’ve ever dreamt of eating, but less than you’ve had nightmares of eating.

How many cups of fruits and vegetables do you eat a day? Be truthful please.  You won’t be in trouble if the answer is somewhere around one or two, or even zero. In fact, that would be good news, because it means you have lots of room to improve. The average American only eats a little under two cups of fruits and veggies per day. {blue links open to original sources, green links open to further explanation}

Tracking intake can be confusing — should you use cup measurements, “servings” as defined on the nutrition label, “servings” as defined by the Internet or USDA, or something else? Let’s use cup measurements to make things more simple. Meaning a standard kitchen “1 cup” measurement. What should you include as a fruit or vegetable? Let’s go with any fruit or 100% fruit juice, and any vegetable except for potatoes of any kind. Again, this is just to keep things simple, not because of anything bad about white or sweet potatoes.

Who is Terry Wahls?

Terry Wahls, MD is the answer to the question: “How do we know fruits and vegetables are good for us?” If someone asks you that question, you can simply sit them down and make them watch this video, a now-famous talk in which Terry Wahls explains her story. In short, she developed secondary progressive multiple sclerosis, meaning she was likely going to have to stop practicing medicine and watch her body deteriorate while confined to a wheelchair. Instead, she said “screw you” to MS, and used her big brain to do a ton of research on the science behind MS. Her conclusion? A natural-food diet that includes pretty huge quantities of specific types of fruits and veggies can help slow down MS, due to certain compounds in these foods helping nerves and other tissues in the body.

What is the Wahls Diet?

Terry Wahls has a book on Amazon that lays out her diet plan. Although I’d recommend it, it’s kind of expensive. Her website has forums that are an excellent resource for those using her diet, and some other blogs are helpful. For now, all you need to know is these three things:

1. Eat 3 cups of fruits and veggies from each of these categories: green stuff, colorful stuff, and sulfur-containing stuff.

2. Don’t eat things that cause you to have a bad reaction, or that cause many humans to have a bad reaction. This includes wheat, legumes, milk, and seed oils.

3. Eat plants and animals, plus these four things on occasion that are missing from modern diets: seaweed, liver, fermented foods, and bone broth.

There’s another way of summarizing this diet. It’s an “auto-immune paleo diet” with lots of fruits and veggies. See here and here for details.

The above list is slightly different than Terry Wahls’s suggestions. Dr. Wahls says to eat at least 9 cups of fruits and veggies a day. Using the above rule number one, that won’t always happen, since you could eat a food that covers more than one category (for example, red cabbage has sulfur and is colorful, and kale has sulfur and is green). In my opinion, this makes it easier at first to adhere to the diet, and you can make sure to get 9 servings as you progress on the diet.

Track your diet, using something like this

Studies are notoriously bad at showing that eating well makes a consistent difference in health. The best way to analyze the results of different diets is to experiment yourself.

Why do study results flip flop so much, and why is there so little nutrition research compared to drug research? Well, for one, Pfizer or Merck is probably not going to fund a large trial of optimal diets, especially for chronic pain. Not much profit to be had from such a therapy. For two, diet is much harder to study than drugs because of nutrient interactions, compliance issues, and some other stuff.

But also, there are just so many pain conditions, ranging from autoimmune-related conditions to failed back surgery to chronic sports injuries. Pain is subjective and difficult to measure, and placebo treatments often perform quite well due to the psychological component.

I made a handy little Google Docs tracker for the Wahls Diet, which you can recreate.

I personally tried to make sure to get all the fruit and veggie categories filled in, and tried to get at  least one of the other columns (fermented food, seaweed, and liver or oysters) filled in each day. If I ate 1.5 cups of something, I’d enter it in two cells, using just the first letter followed by a dot in one of the cells.

In the second tab of the spreadsheet, I started listing fruits and veggies that I’d commonly eat. This will make it easier for you to plan things out. And in the third tab, I’d list groceries to buy. Note that this tab has a “travel” category. When I saw Terry Wahls speak in Boston, she emphasized that it’s hard to stick to the diet when travelling unless you plan, so it might be a good idea to have some portable stuff in your pantry.

What about apples and bananas?

There are very few fruits and veggies that don’t “count” on this diet. I don’t count apples, pears, or bananas, for example. Only the peels are colorful. The logic behind not counting these is that they don’t have as many beneficial nutrients as colorful plants, which have more pigments that may have health benefits. You can use this website to roughly estimate the antioxidant properties of a given food. You’ll see that things like apples and bananas are lower than things like strawberries and blueberries.

Another benefit of excluding apples and pears is that they contain much more fructose than they do glucose. Too much fructose without glucose makes it hard for the fructose to get through your intestinal lining, and it can end up sitting there and causing you tummy aches, especially when paired with certain soluble fibers from fruits. Hence, for some people who get tummy problems when eating too much fruit, eating berries is a better idea than eating apples and pears. Note that Bananas, grapes, and many other fruits don’t have this “extra fructose” problem.

Help me get enough fruits and veggies!

Terry Wahls emphasizes getting fresh vegetables and fruits in her talks and book. Which is great. But initially, it’s going to be hard to get in enough cups. So try a few of these options to increase your intake:

1. Make a super-extremo-fruit-and-veggie smoothie! Get a cup of spinach or romaine and a cup of berries or other colorful fruit. Add in a cup or two of liquid, either water or a mix of water and coconut milk,  or something else. Blend and enjoy.

2. Eat veggies that count in more than one category. This includes kale, broccoli, and red cabbage. Speaking of kale…

3. Make kale chips. This is probably the most important tip of all. Kale chips are delicious, and kale counts as a green and as a sulfur. Terry Wahls says she feels different when she goes for too long without kale. I’ve found that baking at 275 degrees for 20 minutes is more reliable than a higher temperature for a shorter time, and avoids getting any burnt chips. You can mix it up by making lettuce chips as well.

4. Make a soup or a stew. Pumpkin soup is yummy. You can throw a bunch of sulfur-containing onions into a stew along with colorful veggies.

What about nightshades and dairy?

Terry Wahls recommends trying a nightshade and dairy elimination to see if it helps. I’ve written about nightshades here, and would also advise the same, as long as it doesn’t make you feel like cheating. As far as dairy goes, only eat dairy that doesn’t have any dairy proteins in it, such as butter or ghee. That means no milk, cheese, or yogurt.

Alright, that does it for part 1. The next article is going be loads of science thrown right in your face. I’ll also cover things like supplements and exercise as they relate to the Wahls diet. So get pumped, and eat your veggies.

Welcome! I'm a PhD candidate researching nutrition and pain, with an MPH and MBA from Johns Hopkins and a specialty in mint ice cream and cat pictures. I'm also in constant pain from a few failed surgeries and a condition called Ehlers-Danlos syndrome, so I figured sharing knowledge would be a nice thing to do. Share these articles with pals in pain, and become my facebook friend to read more research.

4 Comments

  1. I just started this protocol 2 weeks ago. I was following a fairly generic very low carb + dairy Paleo for the past 2 years. Literally, within the first 5 days the stiffness and achiness I wake up with every day was gone. I think the VLC thing worked great that first year for my awful digestive issues but it wore out its welcome and was no longer healing me. I now pay absolutely no attention to macros. Just a crap ton of dark greens, berries, seaweed, and small amounts of organ meat and shellfish. I’ll be really interested to see if my CRP is lower after a few months of this.

    Reply
    • Woohoo! Yeah, macros are fun to argue about sometimes, but food is where it’s at. The greens/berries/seaweed emphasis is also something I’m focusing on. I fell of the Wahls wagon after 9 days on it, probably due to expecting a miracle plus tummy problems from too much FODMAPs. Hopefully if I spend more than a week or two on it, I’ll have a similar response as you.

      Reply
  2. What’s up, I wish for to subscribe for this blog to take hottest updates,
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