Plant-Based Diets for Multiple Sclerosis

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The distinguished neurologist Roy Swank‘s low saturated fat diet remains the “most effective treatment of multiple sclerosis ever reported in the peer review literature.” In patients with early stage MS, 95% were without progression of their disease 34 years after adopting his meat and dairy-restricted diet. Even patients with initially advanced disease showed significant benefit. To date, no medication or invasive procedure has ever come close to demonstrating such success.

To understand one reason why a plant-based diet may be so successful in treating the disabling auto-immune disease, one has to first understand how the immune system works. This was one of the greatest mysteries in all of biology—solved by a brilliant scientist who won the Nobel in 1960 for figuring it out.

As I illustrate in my 3-min. video Clonal Selection Theory of Immunity, each one of our antibody-producing immune cells, called B-cells, produces only one type of antibody. Antibodies are one of the main weapons our immune system uses to attack foreign invaders. And they’re specific. It’s not just like we have one B-cell that covers grass pollen and another that covers bacteria, we have a B-cell in our body whose only job is to make antibodies against the pollen of purple Siberian oniongrass! (whether or not we ever come in contact with it). Another whose only job is to make antibodies against the tail proteins of bacteria that live only in the thermal vents at the bottom of the ocean…

Wait a second. There must be a billion different things in the world. If each of our B cells produces only one type of antibody, then we’d need to have a billion different types of B cells. And we do!

So, let’s suppose one day you’re walking along and get attacked by a platypus (they have poison spurs on their heels you know). And so for your whole life up until that point the B-cell in your body that produces antibodies against duck-billed platypus venom was just hanging around, twiddling its thumbs, until that very moment. As soon as the venom is detected that specific B-cell starts dividing like crazy, making copies of itself, and soon you have a whole swarm of clones specialized for platypus poison protection. Fending off the toxin, you live happily ever after. That is how the immune system works. Aren’t our bodies spectacular?

If we have a billion different types of antibody-producing B cells, each capable of recognizing a different molecular signature, why then do we tend not to attack ourselves? And how can what we eat sometimes undermine this inherent protection from autoimmune disease?

As I describe in my 3-min video Clonal Deletion Theory of Immunity, the reason that we don’t often fall prey to friendly fire is because before we’re even born we  kill off each and every B cell that recognizes us. That’s what our thymus gland is for. When we’re still a fetus, our body lines up all our immune cells, holds up a picture of our self and asks them one by one: “do you recognize this person?” And if any of our immune cells says yes, they’re killed on the spot, death by apopotosis (programmed cell death) and good riddance.

Turns out this process of ridding our bodies of self-recognizing immune cells happens throughout our lives, mostly in our bone marrow. If you remember, though, in my video series on IGF-1 (starting with The Answer to the Pritikin Puzzle) animal protein consumption increases the level of a cancer-promoting growth hormone that prevents apoptosis, prevents our body’s killing of cells it wants to get rid—that’s why IGF-1 levels are linked to cancer. So IGF-1 might contribute to the inappropriate survival of self-reactive white blood cells in autoimmune or inflammatory conditions. Maybe that’s why people who eat plant-based diets appear protected from autoimmune diseases, explaining, for example, the extraordinary rarity of most autoimmune diseases among sub-Saharan rural blacks following a traditional plant-based diet.   Before they changed their diets, evidently not a single case of MS had been diagnosed among a population of 15 million.

 –Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my videos for free by clicking here and watch my full 2012 – 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.

Image credit: GerryShaw / Wikimedia Commons

  • Laloofah

    Thank you for this! There seems to be so much they don’t know about MS, yet the connection between it and diet has always seemed so undeniable to me.

    I was diagnosed with MS in 1994, learned about and adopted the Swank Diet (only took it a step further, finding it simpler to eliminate most meat and all dairy fat) within a month, became fully vegan in 2000, and adopted the McDougall diet (Dr. Swank was his mentor) in 2007. Going vegan reduced my symptoms greatly, eliminating added fats has left me completely symptom-free for nearly six years.

    I was finally badgered into submission by multiple (no pun intended) neurologists to take Avonex a few months before going vegan, and I took it for 2-3 years until I could stand it no more, it made me feel so awful. I figured anything that made me feel that bad couldn’t be doing me much good, and indeed I’ve done SO much better using food as my medicine! I don’t even bother with neurologists anymore, devoting time I would have spent in their office, waiting room and MRI machine for more pleasant and productive things – like watching your videos! :-)

    • Thank you so much for taking the time to share your story Laloofah!

      • Laloofah

        My pleasure, Dr. Greger – thank you for all the valuable info you share!

    • I devoted few years of my life in clinical research in MS, I was honored by the then president of the American MS society. I did my thesis of medicine with honors about a longitudinal ob servation of genotyped MS patients. I demonstrated with epidemiological studies how diet was the main concern, I opposed the said new treatment because I knew enough to know they will hurt more than than help. I had to stop neuro sciences and I switched in cardiovascular diseases where diet is also a main concern. I am glad to see today the growing trust in eating right to be healthy

      • Laloofah

        Claude, thank you for your interesting reply! It had to be frustrating to know what you do about diet and MS, but have to bump up against the Big Pharma juggernaut and mainstream medicine idea that there’s a drug for everything (and lots of money to be made for every drug). But it must be gratifying now to have more and more voices joining yours.

        I have experienced frustration too, since I’ve been approached by so many people with MS, some newly diagnosed and some not, who hear about me through a mutual acquaintance and are intrigued with how well I’m doing, especially after so many years since being diagnosed, and without “benefit” of drugs. But as soon they hear they’ll have to give up their cheese, their Dairy Queen, their fill-in-whatever-animal-product-or-over-processed-food they think they can’t live without (despite my telling them about all the delicious plant-based alternatives, and all the other benefits they’ll derive from transitioning to this way of eating), the excuses start and I never hear from them again. It’s happened every time and it baffles me no end. I felt so empowered when I learned there was something I could do that was safe, easy, cost-effective, kind, and had only beneficial side effects, that even extend far beyond my own health. But, I’ll keep sharing my story and my example with anyone who wants to hear it! :-)

        • Ellen

          Good for you! I am amazed that so many people are unwilling to question an authority figure even if the treatments they offer are not helping, and in some cases make a person’s health even worse. Ultimately our health is up to us. The doctor is not there every time we put food in our mouths.

          I find it really sad when a person with any chronic illness is unwilling to try something (like diet) that has no real downside. What have they got to lose?

          • Laloofah

            Thank you, Ellen! I couldn’t agree more with everything you said. As for the “what have they got to lose” question, I’ve asked myself that a lot, and have come up with a few (perhaps lame) theories, but honestly it’s just too hard for me to figure out because my own response was so very different.

            Several years ago I had a friend who was a counselor/therapist, and at the end of every orientation visit with a prospective new client she would ask them, “Are you ready to be healed?” I figured that was just a rhetorical question – who wouldn’t say yes to that? She said it was amazing how many people thought about it and then said, “No,” at which point she took no further appointments with them unless/until that answer changed. Maybe something similar is at work here – perhaps being unwell seems to serve some people in some way. And perhaps taking responsibility for our own well-being seems too intimidating for many, who would prefer to “outsource” the job!

        • Emily Blanchard West

          Same experience here, again… :(

    • Gayle

      Laloofah, thank you for sharing. May I ask, is there any certain food that you realized was essential when going Vegan? I’ve been Vegitairian for a couple years and just went vegan 40 days ago. Giving up dairy, especially cheese made my body feel better, at first. But the past 2weeks I have struggled with the MS overwhelming fatigue issues and cognitive issues. The timing of this flare-up makes me wonder if I am missing something in my vegan diet….I have not had a flare-up in several years…can’t even remember the last one. (Diagnosed in 1992) I too take no MS drugs…they all made me feel sick. When I started eating a more healthy diet about 10 years ago I noticed a immediate improvement in my MS health, gradually giving up all meats.
      I am surprised by this flare-up…any advise on eating Vegan and MS is greatly appreciated. Thank you and Blessings

      • Laloofah

        Hi Gayle!
        Congratulations on going vegan, and for having the wisdom and courage to “just say no to drugs” and manage your MS with this healthy and holistic approach! I’m sorry to hear about your recent exacerbation and have no explanation for it, except to say that I too had a couple of exacerbations in the seven years between going vegan in 2000 and eliminating added fats (oils, margarine) from my diet in 2007 when I attended Dr. McDougall’s live-in clinic. Since that time I have had no MS issues at all. I was a skeptic that simply eliminating oils (I used a lot of olive oil especially) would make such a difference, but it sure has. Like many new vegans, I started out eating a lot of processed “transition foods” like meat and cheese analogs, but now the vast majority of our diet is whole foods, and that probably made a big difference too, as has better self-care to handle stress (like yoga and massage).

        I’m surprised that you are experiencing fatigue issues, because the first noticeable change when I went vegan, which I experienced quite quickly, was the return of my normal energy levels.

        As for there being any foods I found essential when going vegan, not really. We eat a lovely variety of plant foods – especially lots of green leafies and cruciferous veggies, beans and legumes, potatoes and rice and sweet potatoes, and fruit (esp. apples and berries), etc… all organic as much as possible. We also very little sugar, caffeine or liquor , make sure to supplement B-12, and thanks to Dr. Greger we’ve added things like hibiscus tea, alma powder, and plenty of ground flax and turmeric into our diet.

        I hope that’s helpful! Maybe you’ve come down with a bug, or are de-toxing – I didn’t experience anything like that myself, but know that many people have said they feel worse for a time after changing their diet for the better. If it persists, you might want to consult with a healthcare practitioner (preferably one who practices lifestyle medicine!) to make sure there isn’t some underlying cause. I don’t know if 40 days is long enough to experience any nutritional deficit that would cause your symptoms, but someone can be eating a vegan diet of oreos, potato chips and Smarties, so I suppose it’s possible (doubt they’d be on this site, though, asking intelligent and well-informed questions!) :-)

        Best of luck to you, Gayle, and do keep me posted if you wish to! I hope you experience profound healing!

    • Emily Blanchard West

      Nice to hear you have the same story I do!! I had my PPMS for 7 years, and had developed about 20 brain and spinal cord lesions and had had a positive csf result. I developed numbness and tingling, L’hermitte’s sign, girdle-band pain, and vision, bladder and balance problems, and my fatigue and chronic nausea were unbearable. I had no idea that changing my diet would help my MS- I had been a long-time vegetarian, and my suffering with MS made me also unable to bear the thought of the suffering of dairy cows and laying hens. It’s been about 6 years since I dropped eggs and dairy, and I have had zero disease progression since then. My fatigue is gone, and all the other problems have become much more manageable– I can even mountain bike again, and I thought my balance issues had taken that away from me forever. Three times now, I have been accidentally given food that contained dairy, and every time I had a brutal attack of vomiting and vertigo with no fever within 12-15 hours of the ingestion; my only MS flares during that time. It might not work for everyone, but it’s a crime that so few people with MS get the message that they should try dropping dairy.

  • Annie

    I scratch my head at why physicians don’t recommend this to all their MS patients? They might prescribe their medications too but what would it hurt them to prescribe the Swank or McDougall diets?

    • Plantstrongdoc

      Good point. A combination wont hurt.

    • Joseph

      why would you bite the hand that feeds?

    • For the last 7 years I have given educational presentations to physicians on the prevention and reversal of chronic diseases. I believe the main reason physicians don’t recommend this approach is because they don’t know the studies showing the benefit. We also aren’t exactly sure of the mechanism. For some it would involve adopting approaches that would require them to change their practices and start talking about an areas (e.g. nutrition) that they are unfamiliar with. To adopt they would also have to consider personally changing their habits. The resistance to change is high. I have a close personal friend who is also a neurologist. I asked him about the Swank studies… he said that Dr. Swank “dealt with a healthier population”. I and others are anxiously waiting to see the results of the Oregon Study funded by Dr. McDougall. The investigators understand that the numbers involved may not be large enough to show a big effect. However if a significant difference is shown they will move toward a larger study. If significant results are shown I share Dr. McDougall’s belief that if will go a long way to persuading patients and physicians to adopt the recommended diet.

    • Ellen

      The connection to drug companies cannot be underestimated. The idea, in my opinion, is to treat any chronic illness rather than to cure it. Treatment can go on indefinitely and is very profitable to the entire medical system. Doctors are part of this system.

  • Lynda

    Please watch for Dr. Yadav’s upcoming article on her study out of Oregon State University using the McDougall diet for MS – should be very helpful up-to-date information for MS treatment.

    • Plantstrongdoc

      Any info when it is out? Any accessible preliminary data?

      • Laloofah

        I’m wondering the same thing, as I’ve never heard of Dr. Yadav. Is she working with Dr. McDougall’s MS/diet study? (I volunteered to participate in that study while at Dr. McDougall’s 10-Day Live-In Program, but he told me I was “too healthy!” I guess if you’re going to be rejected, there are worse reasons!) :-)

  • Guest

    Dr. Greger,

    what do you think about a vascula etiology for MS?

    • I reviewed the two abstracts cited by Alessio Giorgio in the post below. The research has not apparently been replicated re: venous insufficiency. I also would be very skeptical about applying the recommended approaches of stenting to the venous system when clearly the bulk of evidence doesn’t support the use of stenting in the arterial system. It is clear that adopting a “Swank” diet or the McDougall diet (whole plant food based starch centered) which was used in the Oregon study (results due out later this year) would benefit arterial disease… see the McDougall website, research by Drs. Ornish & Esselstyn, and numerous studies cited in video’s on NutritionFacts.org. I think the best explanation at this time is that MS is an autoimmune disorder. That doesn’t mean that vascular impairment doesn’t contribute to the disease. The science keeps mounting that the best nutritional approaches will prevent most chronic diseases. Further adopting the proper approach will allow us to slow, stabilize, reverse and/or cure many chronic conditions… of course it is always best to start earlier before damage occurs which can’t be reversed.

  • Guest

    Dr. Greger,
    what do you think about a vascular etiology for MS?

  • Alessio Giorgio

    Dr. Greger,
    what do you think about a vascular etiology for MS?
    Look at these studies: http://www.ncbi.nlm.nih.gov/pubmed/21059535
    http://www.ncbi.nlm.nih.gov/pubmed/22012819

  • Daniel Dunér

    According to Wikipedia and it’s cited sources (Cochrane Database etc.), there is insufficient or weak evidence for diet as a treatment for MS.

    “overall evidence is insufficient to indicate any potential benefit from diet interventions in MS”

    http://en.wikipedia.org/wiki/Swank_diet
    http://en.wikipedia.org/wiki/Treatment_of_multiple_sclerosis#Alternative_treatments
    http://en.wikipedia.org/wiki/Multiple_sclerosis#Alternative_treatments

    What makes you disagree with that assessment? Are you making an optimistic/biased interpretation of the data or are they overly pessimistic/biased?

    • Joseph

      What makes you agree with an open source informational website that is edited by the public?

      • Daniel Dunér

        I’m not sure what you mean by “agree”? I trust in the scientific method and try to believe only in things with sufficient evidential support.

        I am a vegan and I also know someone who has been diagnosed with MS, so really want Greger’s claim about MS to be true. But I only want to recommend a lifelong MS-specific diet change if the science behind it is sound. At the very least I would like to know if the criticism made towards Swan’s study is well founded or not.

        Secondly, Wikipedia is one of the most reliable and comprehensive encyclopedias in existence. It is self-correcting and requires reliable sources for everything; which makes it relatively easy to verify any claims that are made.

        I specifically did not reference Wikipedia as an authoritative source, but as a stepping-stone to a number of primary sources (The Cochrane database’s meta analyses on diet’s effect on MS, for example).

        • Joseph

          I guess I’m jaded because I’ve lost my legs to lyme disease and had to accept a mainstream diagnosis of MS for insurance purposes. It doesn’t get any more evidence based than my test results and yet it’s simply dismissed by “great” institutions like Mayo and J Hopkins.

          And definitely, Wikipedia has my disease completely inaccurate in almost every paragraph. It may be a great encyclopedia but it’s a work in progress as is all human endeavors, especially medicine.

          I don’t know about MS, but this diet saved my dad’s life and reversed stage 3 prostate cancer in 6 months and no dr’s would buy into it. We watched it happen as did his dr’s yet no acknowledgement of diet, just that it’s a miracle. You are smarter than the average dr in the sense that you are seeking evidence.

        • I agree that the published science is not all that impressive but the past work and experience by Dr. Swank and the recent study by the Neurology Department at the Oregon Health Science University in Portland should help our understanding. The size and duration of the recent study are such that the investigators are not expected a large effect. They are hoping to see enough of an effect to use as the basis for a larger study. But I have no reservations recommending the McDougall diet to patients with MS… I can see no downside as it has been shown to prevent or delay a large variety of chronic conditions. MS is bad but it would be worse to have that and another chronic condition. The other issue is that once the disease has progressed the damage probably can’t be reversed. It is always better to start earlier. I would at a minimum give your friend the information so s/he can decide.

  • This is an excellent article to help people with MS. I was the first in the world to publish in the Lancet (december 1980) about the inbalance of lymphocytes in blood of MS patients, then in cerebro spinal fluid then in signs before relapse damage the myelin etc. My thesis let me set as a fact that eating right was a major part of the treatment in MS. Strong on the conclusions on my work I opposed most of the treatments proposed these last 30 years, As a consequence I switched to vascular clinical research and did a patent for cardiac assist device for babies. I am back working on nutrition because science has demonstrated my theories, more MD are considering the eating problem we have to face urgently today.

  • Jerry Amos

    A much updated version of Dr. Swank’s work is “Overcoming MS” by Dr. George Jelinek in Australia. Results in his web site show average 20% improvement in MS symptoms in 5 years so far on the ongoing study. Now some patients got worse anyway, and some are nearly symptom free, average 20% better. See http://www.overcomingmultiplesclerosis.org/ also book on Amazon and other bookstores.

    Our son was mis-diagnosed with MS. He likely has “Brikerstaffs Encephalitus” whatever that is, and has been improving steadily with following the Overcoming MS regimen. Do note that both Dr. Swank and Dr. Jelinek add omega 3 oil, in Jelinek’s case to a vegan diet. With typical Omega 6, the nerve cell walls are hard and sticky while with Omega 3 they are soft and not sticky which helps on the immune reactions. Far more in Jelinek’s book. Why isn’t this well publicized? Simple, big Pharma won’t make money from this treatment, neither will Fee for Service….

  • Chris Goeser, DC, MD

    I was diagnosed with MS four years ago, learned about the Swank and McDougall diets, and began eating as Dr McDougall suggests. My mindset at first was to use all tools available, so I also began Rebif (interferon beta-1a) injections, and used Ampyra (dalfampridine) and a NESS L300 functional electrical stimulation device to help with walking. My mindset changed as I learned about the minimal effect these medications provide, and became confident that diet was more powerful in slowing, and had a chance to reverse, the disease’s progression.

    Today, and for the past two years, I no longer take these drugs or use the device. With the addition of yoga, my strength, balance, and stamina are far greater than they were four years ago. I work full-time as a radiologist, travel, bike ride, and kayak. I feel that the diet has stopped the progression of my disease, and allowed me to exercise without excessive fatigue.
    I too recommend “Overcoming MS”, by Dr Jelinek. For those who hesitate to recommend a dietary approach, Dr Jelinek has done the literature search for you, and has published his own research showing the benefits of diet, exercise, sunlight, and meditation. In support of Dr Swank, his long term studies should not be dismissed because they do not meet the highest level of scientific investigation. We do not criticize the validity of the work of Edward Jenner, the discoverer of the smallpox vaccine, because he did not run a double-blind placebo-controlled randomized study. Dr Swank’s work is strong evidence that diet plays a role in the development and treatment of MS.

    And what is the downside of eating a low-fat vegan, plant-strong, whole-food diet? In practical terms, it is the social implications. Humans are conformists, whether we like to admit it or not. So the thought of being different, of having to explain your diet to friends and family, and to admit that you were ruining your health because you failed to learn about the importance of nutrition, all run through the mind of the patient hesitant to change.

    Even if my change to a low-fat vegan diet did not alter my MS, I am by far healthier and happier because of my decision. I have decreased my risk of developing cardiovascular disease, dementia, and many cancers, strengthened my immune system, stopped contributing to the torture and death of hundreds of food animals, and in the process am living a greener life on planet Earth.

    Do not be discouraged if others do not see the answer as you have. I needed a chronic disease to open my eyes. Live by example, be compassionate, and sleep well at night.

    • Thank you so much for sharing!

    • Laloofah

      I second Dr. Greger’s thanks! :-)

  • Maggie Danhakl

    Hi,

    I hope this finds you well. I represent Healthline Networks, and we were wondering if you could include Healthline’s Multiple Sclerosis Center (http://www.healthline.com/health/multiple-sclerosis) as a resource on your page: http://nutritionfacts.org/2013/05/21/plant-based-diets-for-multiple-sclerosis/

    Healthline provides a very comprehensive overview of Multiple Sclerosis as a critical starting point for individuals and/or their loved ones.

    Why you should include Healthline as a resource:

    -An educational tutorial on understanding, diagnosing, and treatment for MS
    -Breaking news (ex. http://www.healthline.com/health-news/ms-new-3D-scanning-technique-helps-diagnose-ms-fast-100913) and in-depth, doctor-reviewed content

    For more information about our rigorous editorial process, to view our board of directors and more visit the Healthline about page: http://www.healthline.com/health/about-healthline.

    Please let me know if you are open to adding Healthline’s MS center as a resource. Thank you in advance for your consideration, and I look forward to hearing back from you.

    Warm Regards,
    Maggie Danhakl- Assistant Marketing Manager
    p: 415-281-3124 f: 415-281-3199

    Healthline Networks, Inc. • Connect to Better Health
    660 Third Street, San Francisco, CA 94107 http://www.healthline.com

  • Maggie Danhakl

    Hi,

    Healthline just launched a video campaign for MS called “You’ve Got This” where individuals living with MS can record a short video to give hope and inspiration those recently diagnosed with MS.

    You can visit the homepage and check out videos from the campaign here: http://www.healthline.com/health/multiple-sclerosis/youve-got-this

    We will be donating $10 for every submitted campaign to the National MS Society, so the more exposure the campaign gets the more the videos we’ll receive and the more Healthline can donate to MS research, support groups, treatment programs, and more.

    We would appreciate if you could help spread the word about this by sharing the You’ve Got This with friends and followers or include the campaign as a resource on your page: http://nutritionfacts.org/2013/05/21/plant-based-diets-for-multiple-sclerosis/

    Please let me know if this is possible and if you have any questions. And, if you know anyone that would be interested in submitting a video, please encourage them to do so.

    Best,

    Maggie Danhakl • Assistant Marketing Manager

    p: 415-281-3124 f: 415-281-3199

    Healthline • The Power of Intelligent Health

    660 Third Street, San Francisco, CA 94107

    http://www.healthline.com | @Healthline | @HealthlineCorp

    About Us: corp.healthline.com

  • Lauren

    My mother has been eating plant based for over 6 months now and has not had ONE flare up!!

  • Emily Blanchard West

    I’m another person who saw their primary progressive MS go into complete remission after beginning a vegan diet. It’s been 6 years or so now, and even though I had gotten about 25 lesions and 5 major areas of impairment in the 5 years before going vegan, since I did it I have led a normal life and had zero disease progression. My old lesions still act up when I get sick with something else (false exacerbations), and I am still on baclofen, but I’ve never gone on any disease-modifying therapy. And I have never been happier, or enjoyed my food as much, as I do as a vegan.