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Treating Multiple Sclerosis With the Swank MS Diet

A plant-based diet may not only be the safest treatment for multiple sclerosis, it may also be the most effective.

September 25, 2013 |
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Supplementary Info

Sources Cited

P. Riccio. The molecular basis of nutritional intervention in multiple sclerosis: A narrative review. Complement Ther Med 2011 19(4):228 - 237.

R. L. Swank, J. Goodwin. Review of MS patient survival on a Swank low saturated fat diet. Nutrition 2003 19(2):161 - 162.

U. N. Das. Is there a role for saturated and long-chain fatty acids in multiple sclerosis? Nutrition 2003 19(2):163 - 166.

M. A. Kadoch. Is the treatment of multiple sclerosis headed in the wrong direction? Can J Neurol Sci 2012 39(3):405.

A. Shirani, Y. Zhao, M. E. Karim, C. Evans, E. Kingwell, M. L. van der Kop, J. Oger, P. Gustafson, J. Petkau, H. Tremlett. Association between use of interferon beta and progression of disability in patients with relapsing-remitting multiple sclerosis. JAMA 2012 308(3):247 - 256.

J. J. Marriott, J. M. Miyasaki, G. Gronseth, P. W. O'Connor. Evidence Report: The efficacy and safety of mitoxantrone (Novantrone) in the treatment of multiple sclerosis: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2010 74(18):1463 - 1470.

A. Compston, A. Coles. Multiple sclerosis. Lancet 2008 372(9648):150-2­17.

R. L. Swank, B. B. Dugan. Effect of low saturated fat diet in early and late cases of multiple sclerosis. Lancet 1990 336(8706):37 - 39.

Swank MS Foundation. 2009. Dr. Roy Laver Swank.

R. L. Swank. Multiple sclerosis: Twenty years on low fat diet. Arch. Neurol. 1970 23(5):460 - 474.

R. L. Swank. Treatment of multiple sclerosis with low-fat diet. AMA Arch Neurol Psychiatry. 1953 69(1):91-103.

R. L. Swank. Multiple sclerosis; a correlation of its incidence with dietary fat. Am J Med Sci. 1950 Oct 220(4):421-430.

Igarashi K, Tsuji M, Nishimura M, Horimoto M. Improvement of endothelium-dependent coronary vasodilation after a single LDL apheresis in patients with hypercholesterolemia. J Clin Apher. 2004;19(1):11-6.

SWANK RL, LERSTAD O, STRØM A, BACKER J. Multiple sclerosis in rural Norway its geographic and occupational incidence in relation to nutrition. N Engl J Med. 1952 May 8;246(19):722-8.

Kwa VI, van der Sande JJ, Stam J, Tijmes N, Vrooland JL; Amsterdam Vascular Medicine Group. Retinal arterial changes correlate with cerebral small-vessel disease. Neurology. 2002 Nov 26;59(10):1536-40.

Acknowledgements

Images thanks to kenjisekine / Flickr


Transcript

Multiple sclerosis is an unpredictable and frightening degenerative autoimmune inflammatory disease of the central nervous system in which your body attacks your own nerves. It often strikes in the prime of life and can cause symptoms in the brain--cognitive impairment, in the eye--painful loss of vision, tremor, weakness, loss of bladder control, pain, and fatigue.

The most frequently prescribed drug, for multiple sclerosis is beta interferon, which can make you feel lousy and cost $30,000 a year, but hey--it might be worthwhile if, it actually worked. We learned last year that it doesn't seem to prevent or delay long-term disability.

That leaves chemo drugs like mitoxantrone that causes irreversible heart damage in 1 out of every 8 people who go on the drug and treatment-related acute leukemia—it causes leukemia in nearly 1% of people who take it. But hey, MS is no walk in the park. If only there was a cheap, simple, safe, side effect free solution that also just so happened to be the most effective treatment for MS ever described.

Dr. Roy Swank, who we lost at age 99 was a distinguished neurologist whose research culminated in over 170 scientific papers. Let's look at a few.

As far back as 1950, we knew there were areas in the world that had a lot of MS--North America, Europe—and other places—Africa and Asia—that hardly had any. And now we have all these migration studies showing that if you move from a high risk area to a low risk area your risk drops, and vice versa. So it seemed less genetics, and more lifestyle.

Dr. Swank had an idea, as he recounts in an interview with Dr. John McDougall, at the ripe young age of 84: "it seems possible to me that this could be a matter of food, because the further north you go the less vegetarian a life is led and the more people are carnivores you might say, they spend a lot more time eating meat."

After looking at the multiple sclerosis data from world war two in occupied countries where meat and dairy were rationed, and his famous study in '52 finding the frequency of MS directly related to the amount of saturated animal fat consumed daily in different areas of Norway, he concluded it might be the animal fat, so he decided to put it to the test, by restricting people's intake of saturated animal fat.

Here's his first 47 patients before cutting out about 90% of the saturated fat from their diet, and here's after… showing a decrease in both the frequency and severity of MS attacks. Normally, you're lucky if you can get people to stick to a diet for 6 months, and so that's why most dietary trials last a year at the most. This is reporting results from the first 3 and a half years.

Then came the 5 and a half year follow-up—he adds about another 100 patients. Then the 7 year follow-up, published in the Annals of Internal Medicine. Then the 20 year follow-up, 34 year follow-up.

How did they do? If you can get to people early in their disease, when they're only mildly disabled, and restrict their saturated fat intake, Dr. Swank showed he could stop their disease in 95% of cases—no further disability 34 years later. But if they started slacking on their diet—even years in, their disease could become reactivated. They felt so great they were like hey I can cheat a little bit, I got this disease under control. But eating just 8 grams of saturated fat more a day was accompanied by a striking increase in disability and a near tripling of the death rate.

How about a 50 year follow-up! They were able to track down 15 of the original patients that stuck to the diet, now in their 70's and 80's, with multiple sclerosis for over 50 years, and 13 out of 15, were walking around normal in all respects. They were active and, evidently, unusually youthful looking. Conclusion: "This study indicated that, in all probability, MS is caused largely by consumption of saturated animal fat.

He thought it was the sludging of the blood caused by even a single meal of saturated fats that can clog tiny capillaries that feed our nervous system. See diets rich in saturated fat and cholesterol can thicken the blood, and make our red cells sticky. A single meal of sausage and eggs… can stick our blood cells together like rolls of quarters. And this kind of hyperaggregation can lead to a reduction of blood flow and oxygenation of our tissues.

If you put someone's blood through a machine that sucks out about 90% of the cholesterol in their blood, you can demonstrate an immediate improvement in microcirculation in the heart muscle, but what about the brain?

The eyes are the windows… to your brain. You can visualize—in real-time—changes in blood vessel function in the retina at the back of the eye, which gives you a sense of what's happening further back in the brain. And if you lower the cholesterol level in the blood, you can immediately get a significant improvement in vasodilation, the little veins open wider and let the blood flow.

So yes, it could be the animal fat leading to clogging of our capillaries, but now we know animal fats can have all sorts of other deleterious effects such as inflammation, so who knows what the actual mechanism may be by which cutting animal fat can cut MS progression. Regardless, patients with MS that follow a diet with no more than 10 or 15 grams of saturated fat can expect to survive and thrive to a ripe old age. Of course cutting out saturated fat completely might be better, given that heart disease is our number one killer.

The bottom line is that the results Dr. Swank published remain the most effective, treatment of multiple sclerosis ever reported in the peer reviewed medical literature. In patients with early stage MS, 95% were without progression of their disease 34 years later after adopting his low saturated fat dietary program. Even patients with initially advanced disease showed significant benefit. To date, no medication or invasive procedure has ever even come close, to demonstrating such success."

Doesn't cost $30,000 dollars; doesn't give you leukemia—and works, better!

Of course this all begs one big obvious question: If Dr. Swanks results are so stunningly impressive, why haven’t other physicians, neurologists, or centers adopted this method of treatment? Good question.

One reason may be that MRI machines weren't invented until the 1970s. MRIs are how we track the progress of MS today. We don't have to rely on patients’ subjective reports or doctor's clinical judgements, we can see the disease get better or worse right there in black and white.

It's like in the 1970's when Nathan Pritikin appeared to reverse heart disease by the thousands but no one took him seriously until angiography was invented and the likes of Ornish and Essylstein could hold up images like this, proving conclusively that a plant-based diet could literally open up arteries, right there in black and white.

So what we need is someone to repeat Swanks experiment today, with MRI scans every step of the way… and, I'm happy to report that exact experiment was just completed, by Dr. John McDougall. Dr. Swank was one of Dr. McDougall's medical mentors, and Dr. McDougall is one of mine. Study enrollment was completed last year and we should have the results sometime soon.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Ariel Levitsky.

To help out on the site please email volunteer@nutritionfacts.org.

Dr. Michael Greger

Doctor's Note

I touched on this in my live 2013 year-in-review lecture More Than an Apple a Day, but I’m excited to be able to take a deeper dive into this extraordinary story.

Those interested in supporting Dr. McDougall’s landmark study (headed by Dr. Dennis Bourdette, M.D. and under the supervision of Dr. Vijayshree Yadav) can donate to his nonprofit McDougall Research & Education Foundation (you can also donate to NutritionFacts.org to help keep us bringing you similarly underreported yet life-saving science by clicking on the Donate button above).

Another reason Dr. Swank’s work hasn’t been embraced may be The Tomato Effect.

Other videos on the role diet may play in neurological disorders include:

What’s in sausage and eggs that may cause so much inflammation? See my video series on endotoxins described in my blog How Does Meat Cause Inflammation?

Where is saturated fat found? See Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero.

Those unfamiliar with Pritikin can watch a short introduction in Engineering a Cure, and Ornish and Esselstyn’s great work is profiled in videos like Our Number One Killer Can Be Stopped and China Study on Sudden Cardiac Death.

For more context check out my blog: Top 10 Most Popular Videos from 2013 and How to Treat Multiple Sclerosis with Diet.

If you haven't yet, you can subscribe to my videos for free by clicking here.

  • elsie blanche

    Is there anything in Swank’s literature that draws distinctions or similarities between animal-based saturated fats vs. plant-based saturated fats, in this regard?

  • DanielFaster

    This is fantastic news! THANK YOU Dr. G. Let’s get the word out. Any ideas on how we can get the annual MS150 ride from Houston to Austin to offer an I BEAT MS lunch break and rest stop snacks???? They are big on BBQ here, it is ‘ethnic food’.

  • M85

    My esteem for Dr. Mcdougall just skyrocketed…

    • Adrien

      I wonder why he was not already high in your esteem. John is close to be a hero for me. He stand and speak the truth since so long. All the credit for this study will go to Dr Swank as John requested.
      http://www.youtube.com/watch?v=1WHn6DFZmwk

  • Toxins

    This is one of my favorite volume 15 videos. I love when Dr. Greger presents such compelling data in the quantity of studies that he shares. I find it comparable to the Rheumatoid arthritis video. The evidence against saturated fat and animal product consumption continues to pile up on the mountain.
    http://nutritionfacts.org/video/diet-rheumatoid-arthritis/

    • Thea

      Toxins: I agree! This video is simply awesome and so compelling.

      Thanks for reminding us of the Rheumatoid arthritis video too. Anyone who hasn’t seen that one will want to take a look.

      • Veganrunner

        I agree about the arthritis video. Prior to watching it I was gluten, dairy, sugar and junk-free. That video convinced me that eating less animal protein wasn’t good enough to decrease inflammation–I had to stop it completely! And that I did.

        • DanielFaster

          Yes I have personal experience with it as does my wife, arthritis is better without meat. We or rather she recognized it is an inflammatory process and became low fat vegan after seeing Sanjay Gupta’s report on Bill Clinton. A few relapses early on brought instant pain.

          • Thea

            DanielFaster: Another great comment. Particularly telling was this part: ” A few relapses early on brought instant pain.” That’s some serious bio-feedback. Enough to convince anyone that they are on the right track (when abstaining from animal products and high fat).

        • Thea

          Veganrunner: Thanks for this update! I know that while some people go cold turkey, the rest of us follow a path to health, going step by step. I find it so interesting what event or information causes people to take the next step in eating healthier.

          That Nutrition Facts played a part in helping you take the next step is just so cool. It makes me proud to be part of the Nutrition Facts community.

          • Veganrunner

            Thanks Thea. Food is the best medicine!

  • Caleb

    I’d also like to hear if there would be a difference between animal-based fats and plant-based in this regard? Namely, I eat an enormous amount of nuts (pecans, almonds, walnuts) which all have high levels of saturated fat. Is that still bad when it comes to some of these chronic illnesses?

    • Raw and Cooked Vegan

      You’ve probably already gotten the answer to this but yes, go easy on the nuts and seeds. Too much fat, even if it is healthy, causes problems. See Dr. Esselstyn’s yell out to audience, “No Oil!”, this also implicates excessive intake of nuts and seeds and avocados.

  • LHH

    Great story, I would like to ask the same question as elsie. Can we eat plant based saturated fats like Coconut oil?

    • Toxins
      • Vickey

        And I can tell you anecdotally that my own symptoms are made worse by coconut oil, as well as very much in the way of chocolate.

        • Vickey

          I’d like to add that Dr. Jelinek advocates an even lower-saturated fat diet than did Swank, and those fewer grams of saturated fat make a difference for me.

          • Thea

            Vickey: I wanted to thank you for taking the time to share your personal experiences. While anecdotal evidence is not science, it sure is helpful in making the science real for people. I’m sure that your comments will be helpful to people in similar circumstances. Thanks.

    • Darryl

      If Dr. Swank’s leaky gut theory of why saturated fats cause MS is true, then coconut oil is problematic. A study this year, demonstrated that n-3 fatty acids (like those in flax) reduce endotoxin transport from the gut by 50%, olive and most vegetable oils had no effect, but coconut oil increased transport by 60%.

      So, are endotoxins in particular (the lipopolysaccharide cell walls of gram-negative bacteria, found both in food and in gut microbiomes), responsible for MS? Well, as far as I can tell MS is a multifactorial disease, but one can find plenty of articles demonstrating that LPS receptors and inflammatory cytokine cascades, like those brought about by LPS, play a role, at least in animal models.

  • Sally

    Any research on chondrocalcinosis and diet? Is this also autoimmune?

    When I had a knee X-ray due to an injury I was diagnosed with this. I’ve been low-fat vegan, (Esselstyn) for the last 4 years, but ate SAD before that.
    Sally

  • Plantstrongdoc M.D.

    Very interesting.
    Lets turn it around. Are there any studies suggesting that saturated fat and animal product consumption improves any inflammatory condition (MS, bowel, rheumatoid arthritis) or any type of cancer?

    • DanielFaster

      The only things I’ve seen are the coconut oil for Alzheimer’s which only appears to be a mild transient delay of progression (addressed by an NF video already) and didn’t make it for long term studies; and the conjugated linoleic (linolenic?) acid from beef fat (CLA are the trans fats from beef) which appear in some studies as a supplement to have a very mild positive effect on cardiovascular health in some people (NF video says transfats from animal sources must be bad but does not address the CLA claims). It may also not be that bad if you are treating starvation and there’s nothing else to eat (you can always devise a study to show something has a benefit under special circumstances or is harmful under special circumstances). But you are right you can’t find any breakthroughs to treat and reverse heart disease or cancer or anything else with unhealthy food as a medicine.

  • Darryl

    MS is a horrible, horrible disease. Much of my first three decades were spent aiding my mother in caring for my grandmother (who had primary progressive MS). In my earliest memories, my grandmother was on crutches, but for her last decade, we learned to interpret whether she wanted water, a trip to the bathroom, analgesic, or anxiolytic by the way her eyes rolled. My mother tried some ineffective complementary interventions (I recall accupuncture), but at no point do I recall a neurologist mentioning a low fat diet. Cream cheese and kielbasa sausage were normal fare.

    Dr. McDougall has gives a presentation on diet and MS to his study weekend participants, and there notes he won’t appear in the author list of the forthcoming paper. I suspect Dr. Bourdette, who wrote Dr. Swanks obituary in Neurology, now holds Dr. Swank’s chair, and has continued his work, will have that honor.

    • Thea

      Darryl: I’m sorry to hear about your grandmother.

      While I did not have such a prolonged or close experience, I did have a friend who came down with MS when we were both in our early thirties come. It hit her pretty hard, pretty fast and she died about a year later. I saw how awful it was for her near the end when she couldn’t even scratch her own head. I would bet she wasn’t told about diet changes.

      I saw Dr. McDougall this last weekend at a nutrition conference near where I live. He mentioned his MS research and that it would be published soon, but he didn’t give any details. I’m excited to hear what happened in this latest study.

  • Barton van Buskirk

    wow how one doctor can fix soo many things is just mind bogaling .proof after proof of how our own goverment has put all of ask risk when the real cure for most disease is cured or controled thru diet ..and the food chains feed us poison and nobody does anything about it…..if it wasnt for the internet or library’s .our own goverment could keep killing us and we wouldnt be the wiser …i am ashamed at what this country has become …

  • Alma

    I just looked at the details of the Swank diet (on this page: http://www.swankmsdiet.org/About%20The%20Diet) and it’s not a vegan or even vegetarian diet. Whether you consider it “plant-based” is debatable.

    It recommends two servings of (nonfat or 1%) dairy and a teaspoon of cod liver oil every day, and allows unlimited white fish and shellfish, 1-3 ounces of fatty fish, and 4 ounces of skinned poultry daily, as well as 3 eggs a week. After the first year it also allows 2-3 ounces of red meat each week as long as the meat is not too high fat.

    Nor does it seem that low-fat. It allows up to 65g of fat a day. On a 1750 calorie a day diet (typical for a sedentary woman) that’s 33% of calories from fat a day. Not super higher fat but not what I think of when I think of “low fat” diet either.

    Surprisingly, the diet only recommends two servings of fruit and two cups of vegetables a day!

    It also restricts all processed foods containing fat, saying “No processed foods containing saturated fat.” and “Commercially-prepared pastry usually contains shortening, butter, margarine and/or processed oil. Therefore, you should avoid these foods.” It explicitly forbids hydrogenated oils and margarines. It encourages whole grains over refined grains. So it’s clearly changing a number of aspects of people’s diets, and probably has the result that people end up eating at home and doing more from-scratch cooking. All good things, but there’s much more going on here than a “low-fat plant-based diet.”

    • M85

      Are you sure that’s the original “Swank diet” or is it a modern super watered down version? I remember Dr. Mcdougall saying how the Pritikin diet was slowly watered down over the years and is now a much more moderate version of what Nathan Pritikin taught.

      • Alma

        Yeah, from what I can tell it is Swank’s original diet. The criticism on Mcdougall’s webpage of the “Swank diet” seems to correspond to the diet on the website I looked at. Scroll down to the part titled “The Swank vs. The McDougall Diet” on this page: http://www.drmcdougall.com/misc/2009nl/jan/ms.htm

        It says “The Swank Diet focuses on drastically reducing saturated fats, which are abundant in red meats and high-fat dairy products. Included in his diet are low-fat dairy foods (skim milk, fat-free cheese, fat-free ice cream, etc.), egg whites, skinned white-meat chicken, white fish and shellfish. Meats with significant amounts of saturated fats are allowed only in very small amounts. Dr. Swank also included additional vegetable and fish oils in his diet.”

    • elsie blanche

      Alma, this is very interesting. Thank you for posting the link. I wonder if the current Swank Protocol is the protocol Swank used in the studies Dr. Greger sourced. If so (and why wouldn’t it be) Swank was not suggesting a vegan diet to cure/help MS. Low fat, and absence of certain types of fats, yes.

  • Merio

    Great video!

    Here i found the food do not allowed by the McDougall Program (i don’t know if it is the only program)…

    http://www.drmcdougall.com/health/education/free-mcdougall-program/steps-to-recovery/foods-not-allowed/

    I think is very similar to a plant based diet… other users more expert than me could give a feed back about this?

    • Toxins

      Dr. McDougall offers, in my opinion, the best program. It is based on science and is extremely satiating and practical. Not to mention there is an incredible forum section with Jeff Novick to answer any question you may have.

      • Merio

        This is awesome… if i remember correctly one of my friend when i was studying physics suffer from this pathology and she was really young, so i will try to find her email in my old contacts… i think this information could really help…

        Thanks Toxins for the reply!!

  • Mary Anderson

    My niece has primary progressive MS which accounts for maybe 10% of MS patients. Any known results among that population?

  • ritab2012

    Wouldn’t you be mad if you had MS and your doctors never shared this info with you?

    • LN

      You are absolutely correct. I’ve had MS since ’99. The only doctor,
      out of the millions I have ever seen or known, who has EVER talked to me
      about MS and diet, is my own step-father.
      He is a psychiatrist. I started the Swank diet in 2001, except I
      decided to go totally vegetarian right away. I have not had a relapse since
      2002! I began the McDougall diet a few
      years ago and went totally vegan from there.
      Dairy is a hard thing for a WI girl to give up! When I presented
      the results from this most recent study to my neurologist last week, she still
      looked at me like I was a rare bird or something. It is hard to find doctors who take more into
      consideration than drug therapy, especially where I live. I make an
      annual long trip to see a “more” open neurologist who is located
      six hours from me once a year. I hope to
      be able to attend a McDougall ten day program some day. For now, I will have to continue to rely on
      the live video feeds he has available for his advanced study weekends. The state of “modern” medicine and medical
      training infuriates me. I absolutely
      believe the stable status of my disease is due to Drs. Swank and McDougall!

      • Tan

        Thanks for sharing. Best wishes for more success.

  • Charles Peden

    Why are the most recent comments at the bottom? Recent comments should be at the top like Youtube. But, hey, why do it the popular and familiar way? :)

    • Toxins

      You can organize it by “newest” oldest” and “best”. Its based on your settings.

      • Charles Peden

        Awesome and thank you!

  • Charles Peden

    Okay, I have a serious question. We know that if a person consumes too many carbohydrates, the human body has an ability to convert some of those excess carbs into fat. But not just any old fat. It converts them into SATURATED fat.

    So our bodies thrive on glucose…but saturated fat is problematic and detrimental. Scientists also try to explain that this ability to generate and store SATURATED fat evolved to get us through times of famine. Huh? We evolved a means of generating and storing copious amounts of the most harmful fat to help us survive in the long term? This is the absurd paradox science seems to be telling us.

    Dr. Greger, will you please resolve this?

    • Toxins

      We store the fat from excess carbohydrates as triglycerides although saturated fat serves certain structural needs. The point being we make enough saturated fat so we have no dietary need to consume any more.

      From the National Academy of Science:

      “Saturated fatty acids are synthesized by the body to provide an adequate level needed for their physiological and structural functions; they have no known role in preventing chronic diseases. Therefore, neither an AI nor RDA is set for saturated fatty acids. There is a positive linear trend between total saturated fatty acid intake and total and low density lipoprotein (LDL) cholesterol concentration and increased risk of coronary heart disease (CHD). A UL is not set for saturated fatty acids because any incremental increase in saturated fatty acid intake increases CHD risk”

      http://www.nap.edu/openbook.php?record_id=10490&page=422

      Also, I know of no information suggesting our body struggles to conserve excess macronutrients as fat. This is not a problem regardless when you are eating whole, minimally processed plant foods when your hungry till your full.

      • Charles Peden

        Thanks Toxins,

        You said: “I know of no information suggesting our body struggles to conserve excess macronutrients as fat.”

        I was inquiring about converting carbohydrates, not conserving macronutrients.

        The message I’m getting from science is this: Saturated fats are bad for us and we evolved the ability to generate and store them to help us survive.

        That is a logical absurdity. I honestly can’t blame low-carbers and paleo dieters when science presents this kind of mixed message. It is the saturated fat paradox.

        • Toxins

          Let me clarify what a macronutrient is. A macronutrient is Protein, Fat, or carbohydrates. Too much of either, and it will be stored in the form of triglycerides. Rarely, unless there is a medical condition, will we ever urinate out glucose. Our kidneys are very good at conserving glucose.

          The message from the nutritional community is that EXCESS saturated fat does not promote health. There is a difference between consuming saturated fat and our body creating all that it needs.

          • b00mer

            How could someone possibly downvote this? They are offended by recitation of biochemical and physiological facts? Would they downvote an anatomy phys textbook if they could? People these days are reading blogs and drawing their own conclusions that contradict what the experts with decades in the field have to say, all the while not even having a handle on the basic vocabulary. Sad in more ways than one.

          • Charles Peden

            How could someone possibly downvote this? Because it did not answer the question. Would they downvote a textbook? If the textbook is wrong I would hope so. Are you suggesting textbooks are always correct? Are you suggesting blogs are always wrong and scientists are always right? How about we stick to the question at hand and set aside the tangential (and irrelevant) cheering and jeering?

          • Guest

            LOL, low carb troll, who else.

        • b00mer

          A paradox? Your body requires something, so your body produces it. Because your body produces it, you don’t need to consume it. Because you don’t need to consume it, eating what are relatively huge excess quantities of it causes problems. Where is the paradox again?

          • Charles Peden

            Your body requires something, so your body produces it…therefore it is not bad for you. Is vitamin C bad for animals that produce their own? What about amino acids? Please give one other example in nature where an animal produces their own nutritional factor that is bad for them if they consume it?

          • Duke

            Your intuition makes sense. But nutritionally almost anything in excess has been shown to not be beneficial to long term health. Multivitamins and nutritional supplements are a good example. No long term benefits.

  • Jen Drost, Physician Assi

    Hi Duke
    It does seem confusing at first, doesn’t it?!…However, in looking closely at the articles you mention, it becomes a little a clearer…The first study you mention included just 16 people total and did not include a non-treated (control group) for the duration of the study, so difficult to assess if any conclusion would be statistically meaningful (or useful). Additionally, MS can produce many symptoms: muscle weakness/spasm, fatigue, memory problems, bowel and bladder incontinence, and more. This study (which may or may not be useful given the above-mentioned limitations) only speculates that beta-interferon helps with the memory issues…it is not felt to help with symptoms of weakness, fatigue, incontinence, etc.

    The second study states that it was funded by pharmaceutical companies and that the physician-authors are also funded by pharmaceutical companies. The last line reads “The study was funded by Bayer HealthCare Pharmaceuticals. Dr. Ebers reports that he has financial relationships with Roche, UCB, and Bayer-Schering. Dr. Gooding discloses that he has financial relationships with Novartis, Bayer-Schering, Teva, and EMD Serono. Dr. Weinstock-Guttman discloses that she has financial associations with Biogen Idec, Teva Neuroscience, EMD Serono, Pfizer, Accorda, Novartis, Aspreva, and Cognition.” For more about research design and conflicts of interest, please check out Dr. Greger’s piece on study funding:

    http://nutritionfacts.org/questions/arent-studies-funded-by-corporations-bias/

    • Duke

      Thank you,

      Here is the response:

      I agree with a lot of stuff in the article you sent, especially the de-stressing obviously…and the healthy diet and exercise.

      Their credibility got hurt when they did not mention that the geographical relationship is mostly based on how far you grew up from the equator during your adolescent before 15 years old years. The research points to a strong relationship with Vitamin D from the sun.

      And the fact that they are biased toward the Swank Diet, just like they accuse the doctors of bias toward the drugs. Everyone has biases. There are many other studies supporting the beta interferon links, especially the ones that has to be done to get Avonex approved. There is no sense them cutting it down, it has been proved to work…. That does not say that plant based diets from birth might be preventative also.

      They would be more creditable if they did not try to prevent their case so one-sidedly….that really hurts their credibility.

      Geographic Distribution

      There is a very specific geographic distribution of this disease around the world. A significantly higher incidence of the disease is found in the northernmost latitudes of the northern and the southern hemispheres compared to southernmost latitudes. This observation is based on the incidence of the disease in Scandinavia, northern United States and Canada, as well as Australia and New Zealand. The data from migration studies shows that if the exposure to a higher risk environment occurs during adolescence (before 15 years of age,) the migrant assumes the higher risk of the environment. This concept is nicely illustrated in studies of native-born South African white population with low incidence of the disease versus high incidence of MS among white immigrants from Great Britain, where the disease is much more prevalent (Saud A. Sadiq,James R. Miller et al.) “Epidemics” of MS have been reported and these provide further evidence of importance of environmental factors in MS. The most notable “epidemic” was described on the Faroe Islands after they were occupied by British troops in W.W.II. Similar increases in incidence of the disease were seen on Shetland and Orkney Islands, in Iceland, and in Sardinia. A specific “point agent” for these “epidemics” never was identified.

      Many experts, on the basis of epidemiological data showing less MS where there is more sun, animal work on improving experimental auto-immune encephalomyelitis with light therapy, reduced risk of MS with adequate sunlight or vitamin D supplementation and limited human studies, believe that sunlight improves MS. The evidence is convincing. People with MS can feel comfortable that sunlight is likely to improve their outcome from the disease, and protect them from many others in addition. Provided the amount of UV radiation is not excessive, this is a very safe therapy. In winter, in most places in the world, a vitamin D supplement is necessary to keep vitamin D levels optimal at above150nmol/L (60ng/mL for those in the US). Regarding vitamin D and multiple sclerosis, research suggests strongly that high-normal levels are required, so some people with MS aim even higher, perhaps at 200nmol/L. In my view, this will soon become accepted medical practice in the treatment of MS. The medical community is rapidly coming to an acceptance of the importance of adequate vitamin D levels for good health.

      And even Avonex’s site, Active Source, http://www.msactivesource.com/ms-diet-and-exercise.xml?utm_campaign=Health%2520and%2520Wellness&utm_source=google&utm_medium=cpc&utm_content=Diet%2520%2526%2520Nutrition&utm_term=ms%2520and%2520diet says medication is only part of the answer, diet and exercise are important. So the folks pushing the Swank diet are trying too hard in my opinion.

  • pjohns

    I started reading and studying the Swank Diet when I was first diagnosed with Secondary Progressive MS in 2006. At that point, I was grossly overweight and got to the point of using a cane/walker to get around. I have been following the Swank Diet all these years. Not only have I lost over 120 lbs but I am now running. I just finished running my first 1/2 marathon! Does nutrition make a difference – YES!!!!

    • fineartmarcella

      OMGosh, you could be the poster child pjohns!

  • fineartmarcella

    I’m so proud of Dr McDougall for creating the new MS study, it is doctors like him that do the work that the snob nosed ‘reject anything the boys at the club’ would not approve, and in doing so safe lives. He did it and will go down in history as a leader.

    There is no excuse anymore for people to get these diseases, if they have a computer and can type ‘google’ then they have no excuse, and I have no pity for them. Thank you Dr Greger for putting this information up with the scientific proof to back it up!

  • notclaimingtobesmart

    Update from a McDougall admin: “soon” has now turned into an April 2014 release date for the Oregon study. They keep pushing back the release date so I wouldn’t be surprised if we don’t see results until late 2014.

    • http://www.DonForresterMD.com/ Don Forrester MD

      Dr. Yadav, who is one of the co-investigators for the Oregon Study, presented some of the results of the one year study at the McDougall Advanced Study Weekend in September. The results in compliance and non MS parameters were very impressive. She did not present the MS results. Dr. Bourdette had spoken previously at another McDougall Advanced Study Weekend at the beginning of the study. He mentioned that given the number of participants, the length of the study and the nature of MS it would be unlikely to show significance. He was hoping that this study will lead to larger studies. Dr. Yadav mentioned that Dr. Bourdette will be presenting results in April at a national convention. The jury may still be out but two things are clear… one there is no downside to the prescribed diet and two if you have MS you certainly don’t want to add another chronic disease such as diabetes, arterial disease or obesity to the MS diagnosis. Given the nature of the disease and the efficacy of the drug therapy I believe it is prudent to recommend the McDougall diet for patients with MS.

  • Ronald Chavin

    Dr. John A. McDougall was once my neighbor who lived about 2 blocks away from where I lived in Maunawili, which is on the windward side (southeastern area) of the island of Oahu.

    Dr. McDougall advocates plenty of solar exposure, which I feel is very unwise because of the permanent damage to our skin and eyes. The healthiest way to get the vitamin D that we need is from supplements, mushrooms, fish, and/or only a very limited amount of solar exposure.

    In the 1980s and 1990s, Dr. McDougall was severely criticized by many nutritionists for advocating zero calcium supplementation. At the other extreme, the National Osteoporosis Foundation encourages everyone to become obsessed with calcium supplementation and memorize the calcium content of various foods. Both extremes are wrong. The optimal dosage of calcium supplementation is 300mg to 600mg per day of calcium carbonate. Calcium carbonate is superior to all other forms of calcium supplementation because it strongly lowers our risk of developing colorectal cancer by binding with up to 70% of the total heme iron in our intestines. Like copper, manganese, and aluminum, iron is a pro-oxidant which, if consumed in excess, will damage every cell in our bodies and increase our risk of developing numerous killer diseases. All other forms of calcium supplementation can bind with only 10% to 20% of the total heme iron in our intestines.

    At a dosage of 300mg of calcium carbonate daily, we would derive about 90% of the maximum benefit to our bone health and suffer 0% of the maximum damage to our arteries. At a dosage of 600mg of calcium carbonate daily, we would derive 100% of the maximum benefit to our bone health and suffer about 10% of the maximum damage to our arteries.

    If blood calcium levels are low and need to be increased, the smart way to accomplish this is by eating shiitake mushrooms and not by swallowing forms of calcium supplementation that are different from calcium carbonate. Shiitake mushrooms contain vitamins D1, D2, and D4. Vitamin D4 has health benefits that vitamin D1, D2, and D3 lack. Some medical doctors prescribe vitamin D4 pills to increase blood calcium levels in patients with low blood calcium levels.

    About half of all people who suffer from heart disease have calcified arteries when examined by chest X-ray. The statin drugs that medical doctors prescribe will greatly improve our cholesterol numbers but will also make our calcified arteries much worse. The delicious, fermented, whole soybean food from Japan called, natto, will remove the calcium from our arteries and put that calcium in our bones where it will prevent future bone fractures. No other food and no prescription medicine can reverse arterial calcification:
    http://en.wikipedia.org/wiki/John_A._McDougall

    • Annie L

      Ronald, you wrote “Like copper, manganese, and aluminum, iron is a pro-oxidant which, if consumed in excess, will damage every cell in our bodies and increase our risk of developing numerous killer diseases.”

      What about vegan foods that contain a lot of manganese and copper? Rye bread and some beans and certain nuts and seeds, multiple times per day, can send these metal levels well above the 100%RDA. I find manganese is easy to surpass 200-300%, depending on the foods and quantity. And iron as well in beans. Are these plant-based metals you have mentioned what you are referring to, or are you speaking specifically about meat-based forms?

      Also, thanks for the natto information. I had no idea.

  • ReluctantVegan

    Update from Dr. Yadav:
    The abstract has been submitted. They should know by the end of Jan 2014 if it will be accepted. They think they may be able to release results by April 2014.

  • ReluctantVegan

    Update from Dr. Yadov:
    Results will be presented at the American Academy of Neurology’s Annual Meeting in Philly on May 1, 2014.

  • Elyse

    Has the study about low fat diet and MS with patients that could received MRI by Dr McDougall and yourself been completed? If so, are the results published and available for consultation?

  • rick

    The huge question is why the MS Society doesn’t promote the Swank diet. If a drug could freeze ms in its tracks in 95% of cases, some company would make billions. I assume that they don’t believe the data that Dr. Swank published.

  • Kevin Cross

    I firmly believe this!! PLANT BASED diet it is !!

  • D.A.

    So where is the published study? The “randomized control trialed” results that Dr. McDougal mentions will be out “in the next year”? If the study report was completed in 2012… Any word if the results were as predicted?

    • Darryl

      Just published a week ago (as a poster abstract). It was disappointing:
      Yadav, V., Marracci, G., Kim, E., Spain, R., Cameron, M., Overs, S., … & Bourdette, D. (2014). Effects of a low fat plant based diet in multiple sclerosis (MS): results of a 1-year long randomized controlled (RC) study (P6. 152). Neurology, 82(10 Supplement), P6-152.

      After baseline difference adjustment, the groups showed no significant changes in the number of active lesions (0.4, 95% CI -1.2 to1.9, p=0.6) or other MR parameters, relapse rate, disability expanded disability status score, timed 25-foot walk and fatigue severity score.

      • Adrien

        I was waiting for this study to come out ! So “no significant changes in the number of active lesions” do not mean that there desease are undercontrol and no longer progress ?

        • Darryl

          No significant changes between the experimental and control groups. Basically, the variation of disease progression was big in both groups before the study, and any benefit was small and overwhelmed between the groups, statistically, by this individual variation.

          If saturated free fatty acids are directly mediating inflammation in MS, perhaps its more difficult to achieve Swank’s results in the short term in modern, more overweight populations (those fats get released upon weight loss). Swank’s studies were also done in the pre-MRI era, so perhaps were more prone to selective recall by patients. Most importantly, perhaps, was the limited 1 year duration of the experiment;some forms of MS progress by fits and spurts, and Swank’s results may have required inhibiting several of these before a measurable benefit was seen.

          • Adrien

            I see, thanks for precising things. So we can’t see any difference at least for one years on overweight people. I hope they will do a follow up..

            I send you a message on FB by the way, if you might look at it. Thanks again.

          • Darryl

            I visit FB once every few months, if at all. I found your message and responded.

          • Adrien

            Thanks :)

  • Kat

    Just found out about Dr.Swank. I have Multiple Sclerosis and can barely walk with a walker anymore.I’m at a terrible point with this disease. Could you please tell me what the name of the book is by Dr.Swank that focuses on Multiple Sclerosis? Thank you.

    • JacquieRN

      Hi Kat, sorry to hear you are dealing with MS. Check out the Swank Foundation website: http://www.swankmsdiet.org/.

    • Right wing

      LDN(low dose naltrexone) has been found to stop the progression of MS in about 85% of patients. http://www.ldninfo.org
      It is FDA approved at 50mg, but used in a low dose of 1.5 – 4.5 mg/day. It is inexpensive, no side effects except some sleeplessness the first week or so in some people, and is used by thousands with success. Join the Yahoo LDN group mentioned on the LDN link above and ask any of the over 11,000 people there who use LDN any questions you may have.
      Another supplement that can have astoundingly positive results for MS is Lion’s Mane Mushroon. Best wishes.

  • Jay

    Dr. Greger, an even more interesting fact looking at the map is why is the southern hemisphere completely void of MS?

  • Lawrence

    The Swank Diet appears to include meat, eggs and dairy. It is not a vegan diet. To really benefit one needs to go Vegan Plus and eat a diet of whole organic plants while avoiding salt, sugar and refined carbohydrates.