(A free radical is an atom with a single electron. The electron attracts an electron from a different atom and that atom
THE ALS DIET David A Steenblock, BS, MS, DO 26381 Crown Valley Parkway, Suite 130 Mission Viejo, CA 92691 1-800-300-1063 Amyotrophic lateral sclerosis (ALS) is characterized by brain and spinal cord motor neuron degeneration that cause progressive weakness and atrophy of the body’s skeletal muscles. Most sufferers have chronic neck and/or back injuries that have damaged the peri-spinal (around the spine) blood vessels creating a spinal cord that is barely getting enough oxygen. A primary contributor to ALS is endotoxins from bacteria, yeast and parasites in the intestinal tract that pass into the blood and lymph and finally reach the cerebrospinal fluid. Once in the cerebrospinal fluid these endotoxins are phagocytized (grabbed up) by the microglia that surround the motor neurons. Once these endotoxins get into the microglia they make them “go crazy” and begin churning out a tremendous quantity of noxious chemicals that injure and kill motor neurons. Many other toxic compounds can also enter the body, reach the microglia, and overwhelm them. The goal of our treatment program is to rid the body and intestine of these poison producing bacteria, strengthen and heal the inner lining of the intestines, repair the damaged blood vessels leading into the spinal cord, remove the inflammation within the spinal cord and support the motor neurons return to health. If followed religiously this program should result in impressive improvements. The program is a three week intensive program carried out in my office and includes the use of stem cell rich bone marrow (aspirate) to repair the gut, the tissues around the spine and the
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spinal motor neurons. This booklet will present some of the leading research on diet, foods and supplements that can help reduce the destruction to motor neurons.
I.
The Ketogenic Diet and ALS A. The Mitochondria Within all our cells are little energy factories called mitochondria that produce high energy
molecules called ATP (adenosine triphosphate). The first phase of energy production is called Complex I which is blocked by the kind of mutant SOD1 that characterizes ALS. It has since been found that ketones can restore complex I function so that the mitochondria can continue producing energy for the muscles.
Dr. Zhao and his coworkers showed a ketogenic diet
produced a 3.5 fold increase in circulating ketones in the blood of mice models of ALS compared to control mice that were given standard laboratory diets. The ketones that were increased in the animals included acetone, acetoacetate and hydroxybutyrate (D-3-β hydroxybutyrate). The ketogenic mice maintained their muscle strength longer than the standard diet-fed mice and had significantly more motor neurons at the end of the study than the control mice. As the experiment continued, the ketogenic mice also lost weight at a slower rate than the control mice. Hydroxybutyrate has the highest ketone content and was found to correct the defects and override inhibiting agents by improving mitochondrial respiration and ATP production. This improvement also reduced free radical production and neuronal die-off. This significantly reduced the number of dying motor neurons in the ketogenic fed mice compared to the control mice, whose neurons showed degeneration and death from the mitochondrial defects. 1
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The ketone, hydroxybutyrate, has the potential of slowing down the rate of motor deterioration and death that is caused by SOD1-induced complex I inhibition.
In addition, with both familial and sporadic or acquired ALS, the level of glutathione, the main antioxidant in every cell, are usually lower. With d-β-hydroxybutyrate as an energy alternative in the ketogenic diet, glutathione levels are higher. The researchers suggest that mitochondrial dysfunction is caused by reductions in glucose-derived pyruvate that alter glutamate metabolism and lower glutamate and glutathione levels.2 In addition to the ketogenic diet, the addition of pyruvate supplementation to assist aerobic metabolism may slow the progression of symptoms and improve motor performance.3 Trehalose, a sweet tasting sugar substitute with neuroprotective qualities, may also confer benefits in both familial and acquired ALS patients. Very minute (millimolar) concentrations of trehalose in neurons can reduce the aggregate formation of misfolded proteins. It can also reduce mutant SOD1 resistance to being broken down (Its insolubility).4
B. Glucose and ALS The early stages of ALS are often characterized by impaired glucose tolerance. 5 Interestingly, but not surprisingly, heavy metals, pesticides, smoking, endotoxins and other toxic insults can cause hypoglycemia (low blood sugar).6 In advanced stages, hyperglycemia (high blood sugar) predominates.7 Six meals a day can help with providing more energy to the body when in the throes of hypoglycemia. This is especially important in those with hypermetabolism.
As blood
glucose falls below 65 mg/dL, it stimulates adrenaline and glucagon release (Glucagon is a Page 3 of 43
pancreas produced hormone that raises blood sugar levels). Some of the symptoms of hypoglycemia include hunger, sweating, tingling, shakiness, shakiness, anxiety, heart palpitations, weakness, fatigue and confusion. The body counters low levels of glucose by increasing secretions of growth hormone and cortisol, provided they are not deficient. According to Positron Emission Topography (PET) images of the brains of people with hypoglycemia they were unaware of, they had reduced glucose uptake in the subthalamic area of the brain that is involved in glucose sensing. Subjects with type 1 diabetes and hypoglycemia showed reduced glucose uptake during PET imaging in the amygdala (memories of fear), occipital cortex (processes visual information), cerebellum (coordinated movement), and brain stem (vital factors, including heart and lung function, consciousness and sleep cycles). As a response to hypoglycemia, a mechanism called glycolysis kicks in which increases the production of lactate and ketones (“Alternative fuel” for sustaining cells). 8 The amino acids L-alanine and L-glutamine can help restore glucagon activity.9,10 Alanine is found in gelatin, eggs, turkey, beef, chicken breast, and wild salmon.
11
Glutamine is found in beef, chicken, wild salmon, eggs, diary products, cabbage, beets, beans, spinach and parsley.12 Bitter melon, Astragalus, and Guava can help normalize blood glucose levels in hypoglycemia.13,14,15 One of the active compounds in Guava was found to be quercetin. Quercetin is also found in apples, red onions, raspberries, black and green tea, red grapes, citrus, cherries, broccoli and other green leafy vegetables. 16 In addition, L-arginine plays a role in glucose metabolism and helps regulate and modulate nitric oxide (NO) levels (Thus blunting its negative effects or downside). In Page 4 of 43
addition, L-arginine is usually depleted in ALS which creates a deficit that facilitates the glutamate excitotoxicity to motor neurons that characterizes ALS. When mice models of ALS had their L-arginine levels beefed up they showed a slowing of progression of symptoms in the lumbar spinal cord plus an extended life span.
17
Cottage cheese, ricotta
cheese, yogurt, whey protein, gelatin, poultry light meat, wild game, seafood, wheat germ, buckwheat, oatmeal, nuts and seeds all contains lots of L-Arginine. 18 Mutations in SOD-1 (superoxide dismutase, an antioxidant enzyme that reduces free radicals to oxygen and hydrogen peroxide) can reduce the glucose levels in synapses (junctions where chemical signals are transmitted from one nerve to another).
These
mutations can also reduce glutamate transport in the brain and spinal cord. The result is fatty acid membrane destruction or rancidity, called lipid peroxidation. This causes inflammation in neurons that leads to greater neuronal damage.19 And there’s more. With ALS, there is also an increase in advanced glycation end products (AGEs) from glucose binding with proteins and causing structural injury. This glycation of proteins results in abnormalities in neurons, enzymes and DNA. The process is both caused by and increases free radicals or oxidative stress. (A free radical is an atom with a single electron. The electron attracts an electron from a different atom and that atom becomes a free radical. The accumulation of free radicals, one after another, creates a path of molecular destruction). The effect is an increase in neuronal degeneration and dysfunction.20
Advanced glycation
end products (or AGE) are associated with premature aging and diabetes. Foods that can help reduce glycation and normalize glycemic levels include Hibiscus sabdariffa that can be used as a tea.21 Grape seed extract22, Salvia miltiorrhiza,23 astaxanthin, Page 5 of 43
lutein and eicosapentaenoic acid in microalgae such as chlorella24, green tea, red grapes, olives, citrus,25 cinnamon and clove,26 ginger,27 milk thistle, olive leaf,
28
n-acetyl L-cysteine
(a glutathione precursor)29 and vitamin E can also reduce glycation end products.
Something to keep in mind: The more sugar a person consumes, the more oxidative stress is created which can result in greater glycemic imbalance, advanced glycation end products and protein dysfunction.
C. Ketone Bodies from reduced glucose With the ketogenic diet, ketone bodies (B-hydroxybutyrate and acetoacetate) are used as an “alternative fuel” as opposed to glucose. Ketone bodies have been found to protect cells in various neurodegenerative diseases such as epilepsy, stroke, traumatic brain injury and cancer. The ketones are also anti-inflammatory and reduce oxygen free radicals. This is especially important in ALS where antioxidants can diminish with increasing age.30
The ketogenic diet has been used to treat intractable epilepsy and many other neurological conditions with often impressive clinical improvements.
D. Fatty Acids Butyrate is a short-chain fatty acid containing less than six carbon bonds which reduces inflammation and oxidative stress in the gut. Medium-chain fatty acids have six to twelve carbon bonds. These fats include coconut oil and palm oil. Long-chain fatty acids have more than twelve carbons and include arachidonic acid and alpha-linolenic acid.
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In a study by Dr. Tisdale, a group of mice was given medium chain fatty acids and another group was given long chain fatty acids. The medium chain group of mice showed reduced weight loss. They also had an elevated plasma level of 3-hydroxybutyrate that helps reduce generation of free radicals.31
1. What do saturated and unsaturated mean? Saturated fats are have a high amount - or saturation of hydrogen atoms. When a fat is less saturated, hydrogen atoms are eliminated. Animals have both saturated and unsaturated fats and most plants have different kinds of unsaturated fats. A monounsaturated fat contains one carbon double bond (C=C) and less hydrogen than the saturated fats. This group includes oleic acid, an omega-9 fatty acid that is antiinflammatory and is found in olives, olive oil, avocado, macadamia nuts, hazelnuts (or filberts), pecans, almonds, cashew, pistachios, and peanuts. Polyunsaturated fatty acids have less hydrogen. They also have fewer calories than the saturated fats. The fatty acids with more double bonds are also more prone to rancidity (“Going rancid”), called lipid peroxidation. For this reason, long chain unsaturated fats are not recommended for ALS. The following is a graphic of the fatty acid composition.
C
C C
C C
HO Short chain fatty acids
C C 9
C C 12
Medium chain fatty acids
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C C 15
C C 18
Long chain fatty acids
C 21
The short chain fatty acids have fewer than six carbon bonds, the medium chain fatty acids have six to twelve carbon bonds and the long chain fatty acids have more than twelve carbon bonds. The short chain fatty acids (like butyric acid) are produced by the fermentation of dietary fibers in the colon. The medium chain fatty acids include coconut oil and palm oil and the first part of the ALS diet will require higher levels of these fats. Long chain fatty acids include linoleic acid (18 carbon bonds) and arachidonic acid (20 carbon bonds).
These are also called omega-6 fatty acids, which can promote
inflammation and in smaller doses are associated with an increased cancer risk. Because these fatty acids can cause inflammation and undermine the ALS program, it is requested that you avoid the following omega-6 oils:
Corn oil Safflower oil Soy oil (May also be genetically engineered and should be avoided) Sunflower oil
2. Omega-3 fatty acids
Omega-3 fatty acids from fish and plants are anti-inflammatory and by virtue of this are helpful to ALS patients. The two omega-3 fatty acids are eicosapentaenoic acid (EPA), with 20 carbon bonds and docosahexaenoic acid (DHA), with 22 carbon bonds. EPA and DHA are neuroprotective in both the brain and spinal cord. DHA slows the release of glutamate by astrocytes and its subsequent excitotoxicity to neurons.32 DHA also plays a role in astrocyte signaling during oxygen and glucose deprivation thanks to Page 8 of 43
its ability to enter the endoplasmic reticulum and curtail oxidative stress that adversely impacts the mitochondria (energy factories of the cell). It does this by removing stress markers and inhibiting calcium (Ca2+) release and dysregulation when ischemic (lack of oxygen/blood flow) is present.33
DHA also plays a role in the regulation of brain-
derived neurotrophic factor (BDNF) which is involved in the development of new neurons.34 When DHA is deficient, there is a reduction in BDNF levels in the frontal cortex. Both DNA and EPA also promote production of anti-inflammatory lipids called “resolvins” that play a role in resolving acute pain and inflammation.35
EPA also
reduces axonal injury and microglial activation in spinal cord injuries.36 These fatty acids are in cold water fish such as sardines, mackerel, herring, salmon, halibut, cod and tuna. However, tuna, halibut and cod plus farm raised salmon have been shown to have higher levels of mercury and other toxic chemicals than their wild counterparts. Farmed Atlantic salmon has been a challenge because the salmon frequently contain toxic compounds such as chlorinated pesticides and polychlorinated biphenyls that are associated with obesity, metabolic syndrome, insulin resistance and type 2 diabetes. Farmed Atlantic salmon is widely available in grocery stores and restaurants and should be avoided until there are better regulations on its production and screening for heavy metal contamination. Farmed salmon is also used in supplements, which means that ALS patients should avoid those that do not state that its contents are free of pesticides.37 Wild salmon from Alaska and Norway may still be OK. Krill oil supplements do not have mercury and are both anti-inflammatory and provide sufficient EPA and DHA to support the brain, heart and kidneys. Since the 20 and 22 carbon bonds
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of these omega-3 fatty acids are long chain fatty acids, fish oil supplements require fat soluble vitamins such as vitamin E to be consumed along with them to prevent rancidity. Plant sources of omega-3 fatty acids have alpha-linolenic acid (ALA). This fatty acid requires the activity of the enzymes delta-6 desaturase and delta-5 desaturase to produce omega-3 fats. Foods with alpha-linolenic acid include flaxseed, pumpkin, chia seeds, walnuts and seaweed.
In addition, cranberry seeds, marionberry, boysenberry, red
raspberry and blueberry seed oils contain significant levels of alpha-linolenic acid. In a study carried out to see the effects of mustard oil and linseed oil on astrocytes, scientists found that the alpha-linolenic acid in these oils increased the growth and function of the astrocytes.38 Hemp oil also is rich in omega-3 fatty acids but is not recommended due to the fact its use can lead to dizziness. Usually people with glucose intolerance need to eat less. However, ALS patients need to eat more! In fact, elevated triglycerides and cholesterol in ALS patients are associated with greater longevity!
So lipid metabolism and nutritional status are important
prognostic factors in ALS. 39
3. What can we eat? Saturated fats, monosaturated fats, medium chain fats like coconut and palm oil, and omega-3 fatty acids with vitamin E should help ALS patients maintain and increase their weight. Eggs, chicken and turkey (free range, if possible) are recommended for animal proteins. For those who like red meat, they should consider buying it from a reputable natural food store that sells meat free of hormones and preservatives. Meats can be a challenge to the kidneys and for this reason poultry and dairy foods should be consumed Page 10 of 43
when possible. A high intake of fruits and vegetables is associated with a reduced risk of ALS and contains antioxidants that will likely benefit those already afflicted with this condition. ALS patients should eat at least six meals a day and keep a record of their weight. If swallowing is difficult, a blender can be used to create drinkable smoothies, soups and custards. Nuts and seeds can be soaked overnight and then pulverized in a blender.
E. Fiber Fiber helps produce more butyrate in the gut which is anti-inflammatory. It also helps with constipation. ALS patients should drink about eight glasses of pure water (eight ounces) a day, drink a glass of prune juice in the evening and exercise their muscles, including stomach muscles, several times a day. Fruit such as bananas is helpful. Magnesium drinks such as Calm can assist with stress reduction, sleep, maintaining ionic calcium, and constipation (www.calmnatural.com). Dr. Steenblock recommends 30-35 grams of fiber a day for men and 20-25 grams of fiber a day for women. Moderate amounts of fiber are good for the digestive tract and the entire system but excess amounts over 35 grams a day can reduce the absorption of important minerals like calcium. There are two kinds of fiber – soluble and insoluble. Soluble fiber reduces diarrhea and constipation, reduces sugar absorption and normalizes blood lipids. Soluble fiber also produces short-chain fatty acids such as butyrate. The short-chain fatty acids help with glycemic control support the immune system and help fight any cancer cells that arise. Insoluble fiber helps reduce the risk of diabetes and also helps generate short-chain fatty acids. Page 11 of 43
Soluble fiber is found in bitter gourd, beans, flaxseed, almonds, artichokes, lima beans, kidney beans, soybeans, sesame seeds, sunflower seeds, tomatoes, eggplant, broccoli, spinach, cauliflower, carrots, kiwi, apples, bananas, oranges, blueberries, lentils and celery. Insoluble fiber is found in bulgur, barley, wheat bran, cocoa powder, oat bran, carrots, brown or white beans, coconut, rye, wheat germ, peas, rose hips, mango, papaya, peach, almond, lentils, barley, sesame seeds, whole grain rice, sunflower seeds, muesli, prunes, figs, buckwheat, walnuts, and chickpeas (garbanzo beans).40
F. Exercise Moderate exercise has been found to delay the decline of motor function in animal models of ALS. Dr. Carreras and his coworkers studied the effects of exercise on body weight, motor performance and motor neuron counts in the ventral horn of spinal cords in mouse ALS models. High levels of exercise slightly hastened the onset of deficits but moderate exercise delayed the appearance of deficits. Motor neuron density in the lumbar spinal cord was also significantly higher in the moderate exercise group compared to the sedentary group of mice.41
Regular exercise has been found to induce the production of metallothionein in the spinal cord of mice.
Metallothionein are strong scavengers of free radicals and provide some
neurotrophic assistance. Dr. Hashimoto and his team found that exercise increased mRNA expression of MT-1 by up to 193%, MT-2 by 298% and MT-3 by 196% in the mouse spinal cords twelve hours after treadmill running. The metallothionein levels of the daily exercise group of mice were significantly higher than those of the sedentary mouse group. With the mice running the treadmill for two weeks, there was a gradual accumulation of metallothionein
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proteins in their spinal cords. Metallothionein were also found in the astrocytes, particularly in the spinal cord gray matter.42 Rarick and associates found that moderate exercise increases insulin-like growth factor-1 binding proteins in normal mice.43 Kaspar found that the combination of exercise and insulinlike growth factor-1 in ALS mice created a synergistic effect on survival and function. Kaspar suggests that this combination is the most promising therapy for ALS at this time.44
Another advantage of exercise for ALS patients is that it stimulates the production of vascular endothelial growth factor (VEGF) and brain-derived neurotrophic growth factor (BDNF). VEGF helps build new blood vessels to organs and tissue that need more oxygenation which is especially important in ALS.
BDNF helps in the maintenance and repair of the
pancreas and the brain. In the brain, BDNF promotes neural development and neurite outgrowth. In terms of metabolism, BDNF lowers blood glucose, improves pancreatic function and reduces fatty liver in obese diabetic animals. Interestingly, the administration of BDNF to obese diabetic mice once a week (50 mg/kg) or twice a week (25 mg/kg) lowered blood glucose, increased the plasma and pancreatic insulin levels and prevented pancreatic exhaustion. 45 There are several ways to increase brain derived neurotrophic factor in our brains. One method is frequent exercise that helps the pancreas as well as our neurons. Another method is the use of herbs that promote BDNF.
These include Angelica, Ginkgo biloba, Panax
notoginseng (ginseng), rosemary and curcumin.46,47,48,49,50 Exercise training can also help prevent and reverse chronic kidney disease.
Exercise
improves insulin sensitivity, blood pressure, endothelial cell function in the blood vessel walls, and reduces oxidative stress, all of which helps improve kidney function. 51
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II. What more can food and supplements do to help ALS? A. Oxidative Stress Antioxidants use electrons to capture or neutralize free radicals, making them productive molecules once again. Other antioxidants can chelate or bind to free radicals and carry them out of the body through the kidneys or GI tract. The more fresh vegetables and fruits we eat that are rich in these antioxidants, the stronger we will feel. Canned foods are all too often filled with salt, sugar and preservatives and do not have the enzymes and potency of fresh or frozen foods.
Oxidative stress causes glucose intolerance. Inflammation from the oxidative stress also promotes glucose intolerance. Antioxidants that help promote glycemic control include n-acetyl cysteine (a glutathione precursor), lipoic acid, l-carnitine, taurine, melatonin and coenzyme Q10. These antioxidants can also support the functioning of the mitochondria.
II. The first three days (or week) of the ketogenic diet During this first phase, the glucose levels are gradually lowered as the circulating ketones (Bhydroxybutyrate) are elevated. 1. Keeping records! ALS patients will need to keep a record of the glucose and ketone levels three times a day, e.g., before breakfast, two hours after lunch and two hours after dinner. The Medisense Precision Xtra blood glucose and ketone monitor by Abbott Laboratories can be used. This is available for about $16 from http://www.amazon.com. There are additional websites that sell Medisense monitors plus any meter that measures glucose and ketone levels in the blood
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will be fine. The record book will also need the amounts of total calories, total fat, total carbohydrate and total protein for each meal to show me (Dr. Steenblock) when needed. For most patients, blood glucose levels should be between 3.0-3.5 mM (55-65 mg/dl) and B-hydroxybutyrate levels should be between 4-7 mM. These levels are within normal range and are considered the zone for metabolic management of tumors that reduces the growth of blood vessels to the tumors (anti-angiogenic), reduces inflammation and promotes tumor growth arrest and programmed cell death (apoptosis).
2. Beginning the Diet While a water fast for the first two days is often recommended to kick start the ketogenic diet, ALS patients are advised to gradually increase the ketone bodies to the required zone of medical management while using the KetoCal product. The levels for blood glucose should be between 3.0-3.5 mM (55-65 mg/dl) and B-hydroxybutyrate levels should be between 4-7 mM.
The KetoCal product has essential nutrients in a 4 to 1 ratio of fats to protein and carbohydrates. KetoCal has been used successfully in both animals and humans to arrive at a more gradual level of ketogenic medical management. A week or two of the KetoCal is suggested. However, foods that provide a 4 to 1 ratio can also be used as the ketone bodies will approach the desired zone. KetoCal is a children’s energy powder. The lowest price we have seen to date is from http://www.healthykin.com for $11.95.
3. The calorie restricted ketogenic diet When the ketogenic diet is restricted for the first week and medium-chain triglycerides are used, blood ketone levels are higher. Page 15 of 43
The medium-chain fatty acids have saturated fatty acid chain lengths of 6 to 12 carbons. They do not need pancreatic enzymes or bile salts for digestion so they are quickly utilized by the body. These fats include virgin coconut oil (about 66% medium chain fatty acids), palm kernel oils (about 15%), and butter (about 15%). For women nursing their babies, human breast milk also contains medium-chain fatty acids. After the first week, ALS patients should eat as much as they can to maintain a healthy weight.
4. The ratio of fats to carbohydrates and protein The ketogenic diet is a 4:1 ratio of dietary fats to combined carbohydrates and protein. Some recipes are included at the end of this monograph. In addition, there are several ketogenic cook books that are available from online book sellers. This diet should also be cut by about 25% so it doesn’t exceed the person’s total energy needs. It is important to keep in mind that the lower the intake of carbohydrates (glucose), the more effective the treatment will be. So this is both a ketogenic diet as well as a calorie restricted diet.
5. Foods/products to be avoided for two months (and longer) 1. No alcohol (even wine) – related to ochratoxin A levels and cancer risk 2. No smoking 3. No high-fructose corn syrup 4. No margarine (trans fatty acids) 5. No fried or grilled red meat 6. No mutton/lamb – related to ochratoxin A levels and cancer risk Page 16 of 43
7. No processed meats (including sausage, salami, bacon, frankfurters) – related to ochratoxin A levels and cancer risk 8. No honey – related to ochratoxin A levels and cancer risk 9. No heavy metal exposure 10. No refined sugars, cereals, breads 11. No aspartame 12. No monosodium glutamate
III. The Ketone Diet We have created a different ketone diet! From a review of the medical literature on foods that are good and not so good for patients, there aren’t many foods left that can support a high fat diet! A. Meats Some of the medical studies talk about high total meat consumption as being a cancer risk factor. Beef, lamb and processed meats also pose a cancer risk. So, ketogenic diets that include a steak, two eggs, bacon and sausage for breakfast can be counterproductive to a healthy lifestyle over the long term. One of the factors that can show up in these foods that are not good for ALS patients is ochratoxin A, which gets into feed grain fed animals to sustain and beef them up. Melatonin, which is part of this program, reduces the harmful effects of this toxin. One very illuminating study showed an inverse relation with turkey and chicken and cancer risk. This means that as the amount of turkey and chicken goes up, the cancer risk goes down. So these proteins, plus wild fish are included in the diet.
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B. Cream So what is left? Cream! Some of our meals include heavy cream but not enough to make the target 4 fats to 1 carbohydrates and protein ratio. In fact, Dr. Atkins recommends that a person not have more than 2 or 3 tablespoons a day. So much for the 4:1 diet using just foods!
C. Coconut Oil, Red Palm Oil and Omega-3 fatty acids This diet is “low carb” with the recommendation that a tablespoon of one of the following fatty acids – extra virgin organic coconut oil, red palm oil or omega-3 fatty acids -- be taken with the meals that have less than a 2 to 1 ratio of fats to carbs and protein. Coconut oil appears to be safe in moderate doses. Red palm oil has tocotrienols, a vitamin E component as well as omega3 fatty acids that appear to be safe in moderate doses. This combination of high fat, high protein and low carbohydrate meals with a tablespoon of either coconut oil, red palm oil or omega-3 fatty acids at each meal (2: 1 ratio or below of fats to carbohydrates and proteins) should help ALS patients stay in the “zone of medical treatment”.
D. Experience is the best teacher (!) This is the first draft of this diet monograph. So whatever meals can be improved by adding or subtracting ingredients and/or amounts to make the foods more inviting, just let us know. If the food is healthy and you are (eventually!) satisfied with the meals, then we have reached our goal of providing a good diet plan that complements a great treatment program! If you would like to check out the nutritional values for the foods that you like, an online program is available at http://www.myfooddiary.com. The first 7 days are free, and then $9.00 a month must be paid to continue enjoying access to this valuable service.
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E. The First Week The following meals are suggestions for the first week. The goal is to keep glucose levels down by increasing intake of fats and proteins.
Some of the ratios between fat and
carbohydrates/proteins are 2:1 and some ratios are 1:1 or 1:1.25. In these cases a tablespoon of coconut oil or red palm oil after a meal may help maintain the desired higher fat content. There is only one meal (Sloppy T-Joes) that uses bread (low carbohydrate bread). ALS patients should check the labels on the foods they buy to make sure that the low carbohydrate brands are only 2 or 3 grams of carbs and free of aspartame or other sugar substitutes.
THE KETONE DIET FOR ALS PATIENTS Calorie Restricted, Low Carbohydrate, Ketogenic Diet Small, high protein meals through the day WEEK ONE
Day 1
Day 2
Day 3
Day 4
Day 5
Day 6
Day 7
Breakfast
KetoCal Drink KetoCal Drink KetoCal Drink 4:1 ratio 4:1 ratio 4:1 ratio
KetoCal Drink 4:1 ratio
KetoCal Drink 4:1 ratio
KetoCal Drink KetoCal Drink 4:1 ratio 4:1 ratio
Lunch
Clam chowder Cucumber 2½:1 salad w/eggs 2½:1
Broccoli soup 2:1
Bean and Egg salad 1:1
Spaghetti squash, & tomato sauce 1:1.25
Broccoli salad 1.5 :1
Dinner
Curry chicken salad 1:1
Eggplant Parmesan 1:1
Turkey & Rosemary 1:2
Snacks
Veggie dip With avocado Dip 1:1
Pickled Herring with Sour Cream And onions 1:1
Pumpkin Walnut Loaf 1:1
Salmon w fennel Lentils and 1: 1.25 Spinach Casserole 1:1 Blueberry Almond custard Muffins 2:1 1: 1.5
Leek & Cauliflower Soup 1:1 Nut loaf 1.5:1
Tomato Puree 1:1
Raspberry Gelatin 1:1
Drinks
Additional Drinks:
Additional Drinks:
Additional Drinks:
Additional Drinks:
Additional Drinks:
Additional Drinks:
Additional Drinks:
Chamomile tea
Echinacea tea
Ginseng tea
Green tea
Hibiscus tea
Mulberry tea
8 glasses of Spring Astragalus tea Water (8 oz glass) Per day
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Sloppy Joe w/turkey 1:1
Again, blood glucose levels should be between 3.0-3.5 mM (55-65 mg/dl) and Bhydroxybutyrate levels should be between 4-7 mM.
For ALS patients whose levels are in this
range, they can try introducing more variety in their breakfast choices.
1. Breakfast a. KetoCal Drink b. Eggs c. Smoothies with vitamins and minerals
a. KetoCal Drink b. Eggs Egg Omelet with Cauliflower and cheese for two; 1:1 ratio One serving is 391 calories, 31.5 g fat, 7.6 g carbohydrates and 21.4 g protein.
until
4 eggs Olive oil Cheese, cheddar, shredded Cauliflower, cut Parsley, cut Onions, cut
4 large 1 tbsp .5 cup
1 cup 1 tsp .25 cup
1. Sauté the onions in a portion of the olive oil tender.
2. Heat the eggs with the remaining olive oil over medium heat. 3. On half of the egg, create an omelet with the cauliflower, parsley, onions and cheese and then bring the other layer of egg over it. Cook on both sides until done. 4. Add salt (or a salt substitute) and pepper to your individual taste. A similar recipe can be made using broccoli or other vegetables (one veggie at a time). Page 20 of 43
c. Smoothies (Add vitamins and minerals): 2.5:1 ratio The following blueberry smoothie makes two drinks. One serving is 393 calories, 39.7 grams of fat, 10.5 grams of carbohydrate, And 3.4 grams of protein. Coconut, shredded Cream, heavy Blueberry Coconut oil– organic Banana, medium Walnuts, ground Water, as needed
.5 cup .25 cup .25 cup 2T ¼ .25 cup
Put the ingredients in a blender and pulse until blended. If glucose levels stay low enough, patients could try taking the KetoCal every other day and making alternative choices. Additional smoothie combinations can include apricots, cherries, dates, cranberries, peaches, etc. – but only one fruit at a time because the carbohydrates add up very quickly.
2. Lunch a. Clam chowder b. Cucumber salad c. Broccoli soup d. Bean and egg salad e. Spaghetti squash and tomato sauce f. Leek and Cauliflower soup g. Broccoli salad
a. Clam chowder for two; 2:1 ratio One serving is 305 calories, 28.5 g fat, 7.4 g carbohydrates, and 6.7 g protein. Parsley Onions Celery Butter Clams Chicken broth Heavy cream
1 tbsp .25 cup .25 cup 3 tbsp .5 cup 1 cup 1 cup Page 21 of 43
Thyme Cauliflower
1 tsp .5 cup
1. Remove any brown spots from the celery and other vegetables. 2. Sauté the onion and celery in butter until they are soft. 3. Remove from the pan or skillet. Add clam juice, cauliflower, chicken broth and thyme. Cover and cook over medium heat for about 5 minutes. 4. Put the heat on low and add the heavy cream and clams plus the onion and celery. 5. Serve in bowls with parsley. 6. Add salt (or a salt substitute) and pepper to taste.
b. Cucumber salad for two, 2.5:1 ratio One serving is 264 calories, 25 g fat, 4.85 g carbohydrates, and 6.85 g protein. cucumber Red bell pepper Chives Olives, green Heavy cream Feta cheese Lemon Almond oil Hard boiled egg Romaine lettuce Alfalfa sprouts
1 2 tbsp 1 tbsp 10 1 tbsp .25 cup .5 2 tbsp 1 .5 cup .5 cup
1. Boil about 4 eggs until they are hard boiled. Put 3 in the refrigerator for future deviled egg snacks. Put the remaining egg in cool water and then take off the shell. 2. Mix half a lemon and almond oil in a bowl. Take out any seeds. Mix all the ingredients, except feta cheese. Crumble the feta cheese on to the salad and serve. 3. Add salt (or a salt substitute) and pepper to taste. This salad can also be made with a dill sauce, using dill and heavy cream. c. Broccoli soup Serves 4; 2:1 ratio One serving is 333.7 calories, 31.1 g fat, 4.6 g carbohydrates, and Page 22 of 43
10.2 g protein. Broccoli, cut Heavy cream Garlic, minced Cheddar cheese Parsley, cut Chicken broth
1 cup 2 cups 1 tsp 1 cup 1 tbsp 1 cup
1. Combine the cream, broth, and garlic in a pot using medium-high heat. 2. Cut the broccoli into small pieces and add to the pot. Simmer until broccoli is tender. 3. Grate the cheddar cheese and add it to the pot, blending it in 4. Serve with parsley as a garnish. 5. Add salt (or a salt substitute) and pepper to taste.
d. Bean and egg salad Serves 4; 1:1 ratio One serving is 172.25 calories, 14.15 g fat, 9.42 g carbohydrates, and 4.35 g of protein. Egg, hard boiled Green beans red beans Red onion Olive oil Sesame seeds Lettuce, iceberg Red bell pepper Dill lemon Coconut oil
1 .5 cup .5 cup .25 cup 2 tbsp 2 tbsp 1 cup .25 cup 2 sprigs 1 fl oz 1 tbsp
1. Create dishes that start with iceberg lettuce. 2. Cut the green beans, red onion, dill and red bell pepper in small sections. 3. Sauté the red onion in olive oil and let it cool. 4. Mix the coconut oil and lemon with the egg, beans, sesame seeds and dill. 5. Put sections of the salad on the lettuce and surround it with the red bell pepper. Page 23 of 43
6. Add salt (or a salt substitute) and pepper to taste.
e. Spaghetti squash and tomato sauce Serves 2; 1:1.25 ratio One serving is 188 calories, 14.4 g fat, 11.6 carbohydrates, and 6.15 g protein. Squash Tomatoes Heavy cream Garlic Oregano parsley Basil Thyme Parmesan cheese
1 cup 1 cup .5 cup 2tsp .5 tsp 1 tsp 1 tbsp 1 tsp 4 tbsp
1. Heat the squash in the oven (350F for 30 minutes) or microwave. Slice it in half and scoop out the seeds. Then as the tomatoes and heavy cream are cooking, remove the squash meat in long strands to look like spaghetti. 2. Mix the tomato sauce with garlic, oregano, basil, and thyme and cook on medium heat. 3. Place the squash on the dish first and cover with the sauce. Add the parmesan cheese and parsley as a garnish. 4. Add salt (or a salt substitute) and pepper to taste.
f. Leek and Cauliflower soup Serves 2; 1:1 ratio One serving has 172 calories, 13.2 g fat, 8.4 g carbohydrates, and 6.5 g protein. Leeks cauliflower Chicken stock Heavy cream Nutmeg Parsley Thyme Egg yolk
.25 cup .5 cup 1 cup .5 cup 1 tsp 2 tsp 1 tsp 1 Page 24 of 43
Water as needed
1. Cut the white sections of the leeks (fewer carbohydrates than the green part) in small portions. 2. Cut the cauliflower and parsley into small portions. 3. Combine the leeks and cauliflower with chicken stock in a sauce pan, using medium heat. Add extra water, if needed. 4. Simmer the mix and add the heavy cream and egg yolk slowly and stir the blend. 5. Add nutmeg, parsley, thyme and salt (or a salt substitute) and pepper to taste.
g. Broccoli salad Serves 4 people; 1.5 :1 ratio One serving has 212.5 calories, 18.2 g fat, 9.6 g carbohydrates, and 4.7 g protein. Broccoli Mayonnaise Heavy cream Lemon juice Ginger (ground) Almonds, sliced Coconut flakes
2 cups .5 cup 2 tbsp 2 fl oz .25 cup .25 cup .25 cup
1. Cut the broccoli into small portions. 2. Combine the broccoli with mayonnaise, almonds and coconut flakes and then add the heavy cream, lemon juice and ginger. Mix until blended. 3. Add salt (or a salt substitute) and pepper to taste.
Page 25 of 43
e. Green Bean Parmesan Serves 4; 1.4: 1 ratio One serving has 205.5 calories, 18 g fat, 7.3 g carbohydrates, and 6.15 g of protein. Green beans Red onion Olive oil Ginger Cheddar cheese Almonds Heavy cream
2 cups 2 tbsp 2 tbsp 1 tsp .5 cup .25 cup .25 cup
1. Steam the green beans until slightly tender. 2. Mix in the onion, oil, ginger, almonds and cover with cheese. 3. Cook covered under medium heat until the cheese is melted. 4. Serve and add salt (or a salt substitute) and pepper to taste.
3. Dinner a. Curry Chicken salad b. Eggplant Parmesan c. Turkey with Rosemary d. Salmon with fennel e. Lentils and spinach casserole f. Nut loaf g. Sloppy T-Joes h. Whitefish and kale
a. Curry Chicken Salad Serves 2; 1:1 ratio Chicken Curry powder Lemon juice Mayonnaise Celery, cut Alfalfa sprouts Romaine lettuce
1 cup 1 tbsp 1 oz 2 tbsp .25 cup .5 cup .5 cup Page 26 of 43
1. Cut small chicken pieces from a previously cooked chicken. 2. Mix the curry powder, lemon juice and mayonnaise and then add the celery, sprouts and chicken. 3. Place in refrigerator for an hour and then serve on romaine lettuce. 4. Serve and add salt (or a salt substitute) and pepper to taste. b. Eggplant Parmesan Serves 6 (for leftovers); 1:1 ratio One serving provides 246.16 calories, 19.05 g fat, 8.65 g carbohydrates, and 13.55 g of protein. Coconut flour Eggs Parmesan cheese, shredded Eggplant, cut to ¼ inch slices Olive oil Garlic Tomatoes, chopped Mozzarella
.5 cup 2 1.5 cups
1 small
1. Mix eggs in a bowl. .25 cup 2 tsp 1.5 cups .5 cup
2. Put the Parmesan cheese on a plate. 3. Put the flour on another plate. 4. Dip the eggplant slices in the flour,
then into the eggs, and then into the cheese. 5. Put the eggplant slices in a pan and put in a refrigerator for an hour. 6. When the slices are ready, preheat the oven to 350 degrees F. 7. Pour a tablespoon of olive oil in a pan to sauté the garlic until tender, and then remove the garlic pieces. Now sauté (medium-high temperature) the eggplant in the garlic-olive oil, adding more olive oil if needed. 8. Spread a half cup of chopped tomatoes in the bottom of a small roasting pan. Place eggplant slices over the tomatoes. Cover with half of the mozzarella. Place another layer of eggplant over the cheese and cover that with another layer of chopped tomatoes. Place the rest of the cheese on the top. 9. Bake the casserole for about 30 minutes. Page 27 of 43
10. Serve, adding salt (or a salt substitute) and pepper to taste.
c. Turkey with Rosemary Serves 2; a 1:2 ratio (turkey has more protein) One serving has 238 calories, 13.7 g fat, 4.4 g carbohydrates, and 24.85 g of protein. Turkey, precooked Leeks, chopped white section Oregano Sage Rosemary Paprika Cheddar cheese, shredded Asparagus
1 cup .25 cups 1 tsp 1 tsp 1 tbsp 1 tsp .5 cup .5 cup
1. Preheat oven to 350 degrees F. 2. Mix the turkey, leeks, asparagus and spices and put in a baking dish. 3. Place the cheese on the top of the mix. 4. Bake for 15 minutes. 5. Serve, adding salt (or a salt substitute) and pepper to taste.
d. Salmon with fennel Serves 2; 1: 1.25 ratio (Salmon is high in protein) One serving is 176 calories, 15.65 g fat, 5.7 g carbohydrates, and 15.25 g Protein. Salmon, wild Onion, chopped Fennel Lemon juice Ginger Cabbage Butter
4 oz .25 1 tsp 1 oz 1 tsp .5 cup 1 tbsp Page 28 of 43
1. Preheat oven to 375 degrees F 2. Mix salmon with onion, fennel, lemon and ginger and place in a baking pan and bake for 15 minutes. 3. Place butter in a skillet on medium heat and when melted, cook the cabbage for about 5 minutes. 4. When the salmon is ready, serve the cabbage and salmon together. 5. Add salt (or a salt substitute) and pepper to taste.
e. Lentils and spinach casserole Serves 2; 1:1 ratio One serving has 269.5 calories, 21.65 g fat, 10 g carbohydrates and 10 g protein.
1.
2.
Butter Button mushrooms Onions, chopped Chicken broth Lentils, brown Oregano Thyme Spinach Heavy cream Egg Monterey Jack cheese, shredded
1 tbsp .25 cup .25 cup 1 cup .25 cup 1 tsp 1 tsp .5 cup .25 cups 1 .25 cups
Melt half of the butter in a saucepan using medium heat. Sauté the onions and mushrooms for 4 minutes.
3. Put the heat on low (simmer), add the broth, lentils and spices, cover the pan and cook for 20 minutes. 4. Add the spinach and cook for 10 minutes. 5. Remove the pan from the heat and add the heavy cream and egg. 6. Preheat the oven to 350 degrees F. Page 29 of 43
7. Coat a baking dish with the rest of the butter and add the spinach mixture. Cover it with the Monterey Jack Cheese and bake for 20 minutes, until the cheese is fully melted. 8. Serve, adding salt (or a salt substitute) and pepper to taste.
f. Nut loaf Serves 4; 1.25: 1 One serving has 323.75 calories, 26.76 g fat, 10.45 g carbohydrates, and 11.62 g protein.
Onions, chopped Celery, chopped Carrots, chopped Walnuts, ground Chicken broth Parmesan cheese, shredded Parsley Basil Thyme Sage Eggs, beaten Olive oil Portabella Mushroom, chopped Coconut flour Tomato, chopped
.5 cup 1 cup .25 cups 1 cup .25 cup 8 tbsp
1 tsp 1 tsp 1 tsp 1 tsp 2 1 tbsp half
1 tbsp .25 cup
1. Put the olive oil in a pan and sauté the onions, carrots, celery, mushroom and tomatoes for 5 minutes. 2. Mix all the ingredients and put into a baking dish at 350 degrees F for an hour. 3. Serve, adding salt (or a salt substitute) and pepper to taste.
g. Sloppy T-Joes Serves 4; 1:1 ratio Page 30 of 43
One serving has 199.5 calories, 15.82 g fat, 5.35 g carbohydrates, and 9.37 g Protein. Garlic, minced Onion Butter Stevia powder Dry mustard Paprika Chili pepper Salt Pepper Water Tomatoes, chopped Cilantro (coriander) Ground turkey
1 clove .5 cup 4 tbsp 1 scoop 1 tsp 1 tsp 1 tsp 1 tsp 1 tsp 1.5 cups 1 cup .25 cup 1 cup
1. Make small turkey balls and cook them with one-half of the butter on medium heat. 2. Cook the garlic and onion in another pan with the butter on medium heat. 3. Mix in the Stevia, salt, pepper, mustard, paprika, chili powder and water. 4. Simmer the mixture for 20 minutes. 5. Add the chopped tomatoes and simmer for another 5 minutes. 6. Place the turkey balls on a low carb hamburger bun (one slice) and cover with the chili sauce. (Low carb bun should only be 2 or 3 grams – otherwise use lettuce). 7. Add salt (or a salt substitute) and pepper to taste.
4. Snacks a. b. c. d. e. f. g. h. i.
Veggie dip with avocado dip Pickled Herring with sour cream Pumpkin Walnut loaf Blueberry muffins Almond custard Tomato Puree Raspberry Gelatin Rhubarb with cream Deviled Eggs Page 31 of 43
j. Cherries (or other fruits) with plain yogurt
a. Veggie dip with avocado dip Serves 2; 1:1 ratio One serving has 226 calories, 19.2 g fat, 15.5 g carbohydrates, and 2.8 g protein. Avocado Garlic Cilantro Lemon juice Heavy cream Carrots, slices Celery, slices
1 .25 cup 1 tbsp 1 tbsp .25 cup 1 1
1. Cut the carrots and celery into about 3 inch slices. 2. Mix the avocado meat, spices, lemon juice and heavy cream together until there are no lumps. 3. Serve the veggies with a side section of avocado dip. b. Pickled Herring with sour cream Serves 2; 1:1 ratio One serving has 84.5 calories, 5.65 g fat, 4.25 g carbohydrates, and 3.2 g protein. Pickled Herring Sour cream Onions, cooked
.25 cup 2 tbsp .25 cup
(Can also be bought in stores.)
Mix the ingredients and serve.
c. Pumpkin Walnut loaf Servers 4; 1:1 ratio One serving has 177.5 calories, 13.6 g fat, 8.17 g carbohydrates, and 3.82 g protein. Butter Pumpkin Walnuts,
1 tbsp 1 cup .25 cup Page 32 of 43
chopped Eggs Cinnamon Allspice Ginger Vanilla extract Cloves Heavy cream
2 1 tsp 1 tsp 1 tsp 1 tsp 1 tsp .5 cup
1. Beat eggs in a bowl and mix with all ingredients. 2. Butter a baking pan and pour the ingredients in the pan. 3. Cook at 400 degrees F for 30 - 40 minutes. Put in refrigerator for an hour. 4. Serve chilled. Add salt (or a salt substitute) and pepper to taste.
d. Blueberry muffins Serves 4; 1:1.5 ratio One serving has 86.3 calories, 5.96 g fat, 5.7 g carbohydrates, and 3.4 g protein. Blueberries Almonds Eggs Butter Coconut milk Vanilla Coconut flour Baking powder Nutmeg Cinnamon Stevia powder (granulated)
½ cup ¼ cup 3 1 tbsp 2 tbsp ¼ tsp ¼ cup ¼ tsp 1 tsp 1 tsp 1 scoop
1. Blend the coconut milk, butter, eggs, almonds and spices. 2. Mix in the coconut flour and baking powder until there are no lumps. 3. Add the blueberries and add salt and/or Stevia powder if desired Page 33 of 43
4. Place the batter in muffin cups and bake at 400 degrees F for 16 to 18 minutes. 5. When done, let cool for 10 minutes and serve. e. Almond custard Serves 4; 2:1 ratio One serving has 324 calories, 27.32 g fat, 9.15 g carbohydrates, and 5.65 g protein.
Stevia powder Egg yolks Coconut flakes Coconut milk Ground almonds Vanilla extract
1 scoop 4 1/4 cup 2 cups .25 cup 1 tbsp
1. Mix the Stevia powder with the egg yolks and then mix in the coconut flakes. 2. Heat the coconut milk to close to boiling, then add gradually to the eggs. Beat the mixture until well blended. 3. Pour the mixture back into the pan and cook at very low heat until it thickens. Stir the mixture so as to avoid lumps forming or the cream sticking to the bottom of the pan. 4. Add the almonds and vanilla extract and cook for a few minutes longer. 5. Serve with salt (or a salt substitute) and pepper to taste.
f. Tomato Puree Serves 2; 1:1 ratio Tomato Heavy cream Basil
1 cup .25 cup 1 tbsp
1. Puree the tomato, basil and cream in a blender and serve. 2. Add salt (or a salt substitute) and pepper to taste. Page 34 of 43
g. Raspberry Gelatin Serves 4; 1:1 ratio One serving has 49 calories, 4.95 g fat, 3.02 g carbohydrates, and 2.02 g protein. Gelatin Water Stevia powder Raspberries Coconut milk Heavy cream
2 tbsp 4 cups 1 scoop .5 cup ¼ cup .25 cup
There are various no sugar gelatin products but some use aspartame. Great Lakes Gelatin (http://www.greatlakesgelatin.com) doesn’t have sugar or sugar substitutes and also creates a brand for joints and tendons. 1. Mix gelatin with one cup of water in a microwave-safe cup or bowl (eventually needs a cover). 2. Let the mixture set for 8 minutes. 3. Use the microwave for 30 seconds to heat the mixture. 4. Add the remaining 3 cups of water, the Stevia, raspberries, cream and coconut milk, stir, cover and put in refrigerator for 8 hours.
h. Rhubarb with cream Serves 2; 1:1 ratio One serving has 72 calories, 5.85 g fat, 5.05 g carbohydrates, and .9 g protein. Rhubarb Heavy cream Stevia Powder Cloves
1 cup, diced .25 cup 1 scoop 1 tsp
1. Cook the rhubarb in an ounce of water for 3 minutes, then cool for 5 minutes. 2. Mix the rhubarb with the cream, Stevia and cloves and serve.
i. Deviled Eggs Page 35 of 43
Serves 4; 2:1 ratio One serving has 148.5 calories, 12.57 g fat, .92 g carbohydrates, and 6.35 g protein. Eggs Mayonnaise Dijon mustard Salt Paprika Parsley
4 3 tbsp 2 tsp 1 tsp 1 tsp 1 tsp
1. Hard boil the eggs and then cool in the refrigerator. 2. Remove the shells and slice in half. 3. Remove the yolks and mix in a dish with mayonnaise, parsley, mustard and salt or a salt substitute until creamy. 4. Add the mixture back to the egg white and top with paprika.
j. Cherries (or other fruits) and plain yogurt Can be store bought.
5. Drinks (in addition to 8 eight-ounce glasses of water each day) a. b. c. d. e. f. g. h. i. j. k.
Astragalus tea Bilberry tea Chamomile tea Echinacea tea Eucalyptus tea Ginseng tea Goldenseal tea Green tea Hibiscus tea Kefir (no sugar) Mulberry tea
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IV. The Glycemic Index The following chart provides an overview of how much blood glucose increases according to the foods consumed. The glycemic index (GI) shows how soon the carbohydrate becomes a sugar (a score of 55 is medium and a 70 score is high). The glycemic load (GL), of how much the body needs to work to turn the food to sugar, is important as well. A score of 10 or less is low, 11 to 19 is medium and a score of 20+ is high. We recommend low numbers on both the glycemic index and the glycemic load.
A full version of the University of Sidney’s
Glycemic Index and Glycemic Load Table can be found at http://www.mendosa.com
V. Dr. Steenblock’s Treatment Program for ALS Dr. Steenblock’s treatment program includes chelation to remove heavy metal toxicity, intravenous nutrients and supplements to reduce endotoxins in the gut and blood stream, hyperbaric oxygen therapy, stem cell revitalization followed by bone marrow aspirate treatments. For further information, call his clinic at 1-800-300-1063.
FREE ALS VIDEO: “ALS Treatment - Dr. Steenblock Discusses Amazing Tips for ALS Treatment (Lou Gehrig's Disease)” http://www.youtube.com/watch?v=f12xLlqPBeE
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Copyright 2011 by David A. Steenblock, D.O., Inc.
DISCLAIMER: The use of stem cells or stem cell rich tissues as well as the mobilization of stem cells by any means, e.g., pharmaceutical, mechanical or herbal-nutrient is not FDA approved to prevent, treat, cure or mitigate any disease or medical condition mentioned, cited or described in any document or article in this document. This document and the information featured, showcased or otherwise appearing on it is not to be used as a substitute for medical advice, diagnosis or treatment of any health condition or problem. Those who peruse this document should not rely on information provided on it for their own health problems. Any questions regarding your own health should be addressed to your physician or other duly licensed healthcare provider. This document & all affiliated websites make no guarantees, warranties or express or implied representations whatsoever with regard to the accuracy, completeness, timeliness, comparative or controversial nature, or usefulness of any information contained or referenced in or on same. This document & all affiliated websites and its owners and operators do not assume any risk whatsoever for your use of same or the information posted herein. Health-related information and opinions change frequently and therefore information contained on this Website may be outdated, incomplete or incorrect. All statements made about products, drugs and such in this document and all affiliated websites has not been evaluated by the Food and Drug Administration (FDA). In addition, any testimonials appearing in this document or on any affiliated website are based on the experiences of a few people and you are not likely to have similar results. Use of this document or any & all affiliated websites does not create an expressed or implied professional relationship.
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