Review of 2 Diets That May Benefit MS Patients: A Nutritionist’s View

Review of 2 Diets That May Benefit MS Patients: A Nutritionist’s View

I recently came across the article “Review of Two Popular Eating Plans within the Multiple Sclerosis Community: Low Saturated Fat and Modified Paleolithic,” published in the journal Nutrients, which compared the efficacy of the Swank diet and the modified paleolithic Wahls Elimination (WE) diet in influencing the prognosis of multiple sclerosis (MS). I found the comparisons interesting in relation to how consciousness has evolved around the connection among diet, immunity, gut health, and neurodegenerative conditions.

The first insight I had was that the Swank diet is more broad-scale and old school. It was developed 70 years ago and therefore reflects the ideology of the time period. It prioritizes calorie deficit and lower fat intake over nutrient diversity in regards to increasing health and limiting risk for disease.   

Its guidelines are consistent with the U.S. Dietary Guidelines for Americans, including all food groups in the plan. Its significant intervention for MS focuses on macronutrient and energy regulation, specifically reducing saturated fat and calories to reduce the progression of MS based on the theory that an increased body mass index, high cholesterol, and triglycerides from saturated fats affect the brain and its functionality.  

The WE diet doesn’t disagree with the Swank diet, but rather expounds on its principles with a little more refinement. This diet focuses less on reducing saturated fat and calories and concentrates more heavily on how specific micronutrients and foods’ individualized composition breakdown affect the gut microbiome, absorption of nutrients, and subsequent impact on inflammation, immunity, and neurological health.

In the WE diet, complete food groups are eliminated, and there are specific guidelines for fruits and vegetables due to their phytonutrient properties and effect on reducing oxidative stress. Nine servings of fruits and vegetables are recommended, divided among leafy, sulfur-rich, and deeply colored varieties. Consumption of seaweed algae and nutritional yeast is also encouraged. Gluten-free grains and legumes are allowed in very limited quantities, and eggs, which have been shown to increase inflammation, are eliminated from the diet.

Both diets agree that reducing inflammation and metabolic syndrome is important, but Swank’s diet theory of reducing saturated fat as a means of increasing vascular integrity does not take into consideration the positive impact certain saturated fats such as coconut oil and ghee can have on the microbiome when combined with fiber-rich fruits and vegetables. The addition of fats in the WE diet also balances out the calorie deficit from the reduction of grains and other carb sources including dairy.

The WE diet specifically recommends saturated fatty acids for high-heat cooking, as unsaturated fats at high temperatures can cause free radicals, leading to inflammation and potential mutation of the cell DNA, which can contribute to a decrease in neurological health and immunity on the whole.   

The WE diet emphasizes the importance of essential fatty acids and recommends an omega-3:omega-6 ratio of 4:1. This means that unsaturated fat oils that are allowed on the Swank diet such as vegetable oils including canola, corn, and soybean are not allowed on the WE diet, as it would throw off this ratio. Vegetable oils are very high in omega-6 fatty acids. Omega-3 fatty acids are found in sources such as fish, flax, hemp, and chia.

According to WE, a favorable omega fatty acid ratio modulates neuronal membrane fluidity, neurotransmitter manufacturing, and central nervous system inflammation and does more good than harm. Both Swank and WE prohibit trans-fats from sources such as margarine, deep-fried foods, and processed foods.

Organ meats also raise a debate between the two diets and highlight the main themes mentioned above. Swank does not allow organ meat due to the high saturated fat content, but WE encourages eating these meats as they are an excellent source of important micronutrients that affect the enzymes and neurotransmitters associated with neuronal and neurological integrity.

In my opinion, the Swank diet approach for treatment is based around the hypothesis that outside diet conditions affect vascular health, ultimately leading to a dysfunction in the central nervous system, whereas the WE diet approaches MS as an autoimmune condition potentially triggered by causative factors rooted in the gut microbiome, lifestyle factors, and nutrient malabsorption. The theory is that reinfusing the body with essential nutrients can potentially reverse and reprogram the autonomic nervous system processes that influence the central nervous system.

As more research continues to be published on MS and the root of autoimmune disorders, nutrition will be more and more the focus of these conversations related to treatment and plan of care.

***

Alana Kessler, MS RDAlana Kessler, MS, RD, CDN, E-RYT, is a registered dietitian, nutritionist, weight management expert, and an accredited member of the CDR (Commission on Dietetic Registration) and the American Dietetic Association. She is also a yoga and meditation teacher, Ayurveda specialist, and the founder of the New York City-based fully integrated mind, body, and spirit urban sanctuary, BE WELL. Alana’s BE WELL ARC System and Method Mapping technique is a holistic multi-disciplinary approach to health and wellness that blends Eastern and clinical Western diet and lifestyle support to effect long-lasting behavior change.

A graduate of NYU with a BA and MS in clinical nutrition, Alana is dedicated to helping others learn how to nourish themselves, create balance, and understand their true nature through nutrition, yoga, and inner wellness. She leads Yin Yoga workshops and trainings as well as wellness retreats at international locations. Her health, fitness, and lifestyle expertise has been featured in Aaptiv.com, Droz.com, EatThis.com, RD.com, Redbook, WomensHealthmag.com, and Vogue. For more information, visit her website at bewellbyak.com.

11 comments

  1. Robert says:

    Diet plays a role, and I have used the Wahls, and it helped me loose wait, and moderate some symptoms, yet, one wonders how much of it all is placebo effect (which, is ok, of course, as it can promote healing). I suggest this as it puzzles why this blog does not pay more attention to the theories of the role of mental and stress and repressed emotional states, as published by others, including Dr. Gabor Mate. Is it that nobody wants to discuss the elephant in the room ?

    • Adrian says:

      I too have tried the wahls diet
      I lost weight from 185-162 lbs in 6 months.
      It was a bit puzzling as I ate till I was full, I didn’t limit the amount of food I ate, just the kind of food
      Meat chicken and fish
      Fruits and vegetables
      That was it.
      I lost weight but my ms did not resolve!
      Darn!!

  2. Maria S Mead says:

    It sounds like the author has not heard of the Overcoming Multiple Sclerosis Diet, which is a part of a plan developed by Dr. George Jelinek. Professor Jelinek puts science behind each one of his principals, including diet, and has been following thousands of patients with MS, who have been shown to improve over time. I believe his theories to be much more sound, and indeed beneficial, for those with MS.

    Here is a URL to familiarize yourself with the plan:

    https://overcomingms.org/about-us/professor-george-jelinek

    Sincerely,

    Maria Mead, MD

    • FB says:

      OMS is derived from Swank. Quite a bit of the evidence used to support OMS principles is tied to the “getting a bit old” sat fat paranoia of the last few decades. There are many healthy elements in OMS such as eating more vegies, but it also cuts out foods which are not necessarily unhealthy. It uses a “molecular mimicry” theory to justify elimination of all dairy products – claiming that the fats in dairy products stimulate your body to attack the myelin sheath around nerves – however real evidence on this is very thin on the ground or even non-existent. Research which does not support OMS is conveniently ignored – but this is also the case with virtually all of the other “MS diets” as well.

      There are also some rather psychologically unhealthy elements in OMS – victim blaming is common on the OMS forum if someone deteriorates or has a relapse – almost without fail the relapse is attributed to someone not following OMS strictly enough and people jump in with advice to the poor relapsee around tightening up their diet and Vit D intake. In the OMS forum a few years ago one poor person actually blamed their relapse on having eaten a single meal of steak and fries and salad. I felt so sad for this poor brainwashed individual, but what was really disturbing is that other people were agreeing with him.

      OMS endorses megadoses of Vit D – up to 100,000 and 200,000 IUs at a time as a “fix” for low Vit D. Furthermore, OMS espouses that low Vit D causes relapses, when at this time the actual scientific evidence is that there is a correlation, but whether it is cause and effect or reverse causation has not yet been shown.

      Regardless of the claims of scientific evidence, Jelinek himself occasionally lets slip glimpses that he holds a viewpoint which is not all about the science. Clearly unscientific and very much a philosophical viewpoint, these are his own words, from the OMS forum, in December 2014.
      “After 15 years on the Program I find the smell of burning animal flesh repulsive, just as I cannot bear the thought of drinking the breast milk of another animal. Plant-based whole food for me!”

      As for “following thousands of patients with MS” – if this is a reference to the HOLISM study then there are questions about potential bias in the study cohort – vast numbers of the subscribers to this voluntary study were recruited via the OMS website, and then the MS societies’ assistance was enlisted to help get more participants. There was even a paper published several years ago by the HOLISM study itself about recruiting participants by using the internet, and that paper acknowledged the potential for bias in the HOLISM study’s cohort given the recruitment methods used.

      There are many worshippers of the OMS protocol and like all of the “MS diets” it does have some good elements which are beneficial to overall health. However, none of the MS diets is going to “overcome” or “cure” someone’s MS no matter what its proponents claim. The real message here is that people need to look a bit further than the glossy MS diet websites before they jump in unreservedly.

  3. Donna says:

    I am so thrilled to finally see some some mention of ‘diet’ and ‘gut health’on this site. I have RRMS and have been following the Swank diet for 20+ years and I feel that it’s definitely helped with keeping relapses at bay. Lately, I’ve been looking into the Wahl’s diet guidelines but have backed down because of the high saturated fats and red meats that are included. This article makes sense, though, and has piqued my interest. Thanks for shedding light on the benefits of the diets.

  4. I understand that the Mediterranean Diet has actually been proven to reduce inflammation of the myelin sheath, and is, therefore, important to incorporate into the diets of individuals with MS. How do you feel about the Mediterranean Diet, and how well does it compare to the Swank and Wahls Elimination Diets for people with MS? Thank you very much!

  5. Glenda Hendry says:

    To me, a review of diets is not what is needed, but actual scientific evidence through quality studies. While I appreciate the time required to review guidelines of diet plans, we need data and hard evidence, not opinions.

  6. Mary Wenger says:

    My advice for anyone attempting a high saturated fat diet is to first have a genetic saliva test called Nutrigenomix(500$ Cnd). This test showed that my body does not metabolize saturated fats as well as the average person. This confirms why I have plaque in my Carotid Arteries. It took a few years of decreasing my saturated fat intake, without taking statins, to decrease the plaque from 50% to 36% diameter reduction in one of my Carotids. These results have proven to me that you can reverse vascular disease just by diet alone. As for my MS symptoms, it’s been stable for 10 years.

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