The cyclical nature of MS complicates the evaluation of both conventional and complementary treatments. In the early stages of relapsing-remitting MS, almost any intervention works—for a time. Knowing which treatments are truly effective requires patient use of a period of months or years. And that's why anyone making recommendations for an MS diet has to be careful.
No natural intervention for MS has been studied longer than the Swank diet. Developed by physician R. L. Swank in his private medical practice from the 1940’s through 1970’s, this low-fat diet replaces the saturated fat in animal fats and hydrogenated vegetable oils with unsaturated fat from canola (rapeseed), corn, grapeseed, linseed, olive, peanut, safflower, sesame, soy, sunflower and walnut oils, and seeds, nuts, and cold-water fish (such as salmon and trout). Hydrogenated oils, oils that are stable at room temperature due to chemical processing, are not strictly prohibited but a limited to the equivalent 1 tablespoon (or 100 calories) per day. Unsaturated oils are required, at least 1 tablespoon to as much as 3 tablespoons (100 to 300 calories) per day. Other Swank diet rules are summarized in the inset.
While the Swank diet has not and cannot be subjected to strict scientific testing (since it is not possible to confine MS patients for a decades-long trial), Dr. Swank and his colleagues for 144 patients for 34 years. Patients who consumed less than 20 grams of saturated fat had much lower rates of death and disability than patients who consumed more than 20 grams of saturated fat per day, and among patients following the low-fat protocol, fewer than 5 percent became disabled during the 34 years of the study. Dr. Swank himself followed the diet and was still publishing in the medical journals at the age of 87, and at the time this article was being written, was still active at the age of 92.
Dr. Swank’s findings are not unique. In the late 1990’s, doctors at the Haukeland Hospital in Bergen, Norway, gave 16 patients newly diagnosed with MS instructions to take 3.5 rams of fish oil every day and to eat three or four fish meals per week, as well increasing their consumption of fruit and vegetables. At the end of 1 year, the frequency of MS attacks had decreased 95 percent. At the end of 2 years, the patient’s disability index decreased 25 percent, meaning the patients regained a significant measure of mobility. Since MS patients usually do not get better over time, scientists found these results to be startling.
Probably the simplest effective diet for MS is a vegan, whole food diets supplemented by 3 to 10 grams of pharmaceutical grade fish oil, or, for those who eschew animal products, 3 to 10 grams of DHA from microalgae. Scientists believe this diet encourages T cells to progress through their normal life cycle, dying and being replaced before they can damage myelin. Key to any effective diet is avoiding saturated animal fats and including essential fatty acids, as well as avoiding excessive consumption of sugary foods.