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The Multiple Sclerosis Diet Book: A Low-Fat Diet for the Treatment of M.S.
by Barbara Brewer Dugan , Roy L. Swank 
Barbara Brewer Dugan
Roy L. Swank (Biography)
|Dr. Swank began studying the correlation between diet and MS in the late 1940's. His book, The Multiple Sclerosis Diet Book, has achieved wide acclaim from both within and outside the medical community. At age 92, Dr. Swank is no longer actively seeing patients; however, his work continues to touch the lives of thousands of MS sufferers who have found hope through his diet.Comments from Roy L. Swank, M.D., Ph.D.|
A fascinating history.
About July 1948, I was offered a five-year-long opportunity to investigate Multiple Sclerosis with adequate financing for my family (wife and two children), and three months travel to observe others and their work. I was also given full financial support for my research.
September 1, 1948, I arrived in Montreal and established a home for my family. I spent the rest of the year examining the MS patients at the Montreal Neurological Clinic and researched information in the McGill University library. The four months of intense study of MS led to three possible leads:
Usually the onset of severe attacks developed rapidly.
The onset of most individual attacks suggested vascular origins.
The disease was found worldwide but particularly common in the industrial countries.
During the Second World War several countries in Europe occupied by the Germans had been deprived of much of their fat because it had been shipped to Germany. I elected first to go to Western Europe to see if this change in diet had influenced the frequency of the disease.
In Norway, Professor Monrad Krohn, Chief of Neurology, suggested that he seldom saw cases of MS from along the coast, where fishing was the primary industry, but further inland, where farming was the primary industry, and in the mountains the frequency of MS was more common. He suggested that I see Julia Backer who was in charge of recording the geographic distribution of the disease. She was very interested, and the same day we designed a questionnaire requesting age of onset of MS and its place of onset, among other things. The questionnaires were sent to all hospitals and neurologists in Norway.
I then traveled to Switzerland where it was known that MS was common where German was spoken, and rare where Italian was spoken.
Three months later I received a complete report of the Norwegian study. The existence of MS along the coast was rare (about 1 per 10,000 persons). In the mountains it was more common (about 9 per 10,000 persons).
Based on these and other figures, food consumption studies were done in these areas. In the mountains the rural families lived largely on meat, milk, eggs, and cheese, whereas along the coast, people consumed fish and other food sources found in the ocean.
The Norwegian study confirmed and amplified our previous impression and led to our low-fat diet study of MS.
By 1950 we had established the low-fat diet maximum of 10 to 15 grams of animal saturated fat daily, plus 20 to 40 grams of unsaturated fat (oils). Protein was largely obtained by eating seafood, plus skim milk. In addition, vegetables, fruits and grains were consumed.
In 1950 no one had developed a low-fat diet. The problem of developing a diet based on our results fell to Aagot Grimsgard and myself. She not only developed a very good diet, but she closely supervised the food consumption of our patients and saw to it that they closely recorded their food intake.
During the first five years in Montreal we saw and examined 250 patients with MS. 150 chose to follow the diet and were followed by Aagot, other dieticians, and myself. Once a year, we traveled to Montreal and spent one month examining patients and checking their diet. During the next 20 years they were also contacted every three months by phone and mail, in which they responded with a record of their diet.
All patients did not follow the diet carefully and records of their diet revealed this. In 1991 a record of progress was published in Nutrition. 70 of the 150 patients consumed an average of 17 grams of fat daily, 21% died. Those eating an average of 30 grams of fat daily, 75% died. And those eating an average of 42 grams of fat daily, 81% died.
In the fall of 2000, I traveled to Canada to see the last 14 patients who we are still in contact with from the study that began in Montreal in 1950. Two were unable to walk, but otherwise their body function and mental and communicative abilities were normal. The remaining 12 were ambulant. Two were weak yet able to walk and care for themselves and lived alone. The remaining ten patients were normal physically, mentally, neurologically and very active and normal in appearance. Their ages varied from 72 to 82 years. We will see two others this year.
Dr. Swank comments about MS patients in general and how they fare on his diet. In the beginning, most MS patients are tense, active, hard workers and “must always be on the job.” They are good workers and usually do well in school; however, most tend to suffer periodically from fatigue and general weakness, and they may often be kept home from school for several weeks because of fatigue.
Physicians usually fail to clarify the problem, and the patient slowly recovers to become active and energetic again. During this period, they may experience mild sensory and motor (muscular) symptoms, which are not marked enough to be recognized by the physician. Spontaneous recovery leads to no diagnosis and to confusion. When the neurological complaints become severe enough to be recognized by the physician, x-ray and blood examinations may appear to be normal. MS patients, when properly diagnosed and placed on the Swank low-saturated fat diet, respond variably, depending on how long the disease has been present and the degree of disability which is present.
If the diet is closely followed and daily rest is taken, the cases with very little neurological disability will shortly improve, and almost all will make a very satisfactory recovery. They will remain ambulant, energetic and agreeable, and in a period measured by months or years, will think clearly and be able to enjoy and enter into activities with friends. Usually in a relatively short time, patients will return to activities and work full or part-time.
In a matter of a few years, they will feel cured of their disease but still tend to tire and need more rest. For this reason, they are told at onset of treatment that they will have to have a midday rest of one to two hours daily to keep the fatigue under control.
If the disease is not diagnosed early and the patient has suffered from definite disability but is still able to get around and care for himself, recovery is slower and will not, as a rule, be as complete as it is for patients who had only a slight disability when first diagnosed and placed on the low-fat diet. Their progress will, nevertheless, be one of improvement toward recovery.
Our experience has shown us that patients on low-fat-diet treatment usually recover and that their recovery slowly improves during the entire period of 35-50 years or longer as long as they follow diet and rest.
Frequently, patients who have done very well for as long as 20 years or more, have been normal physically and mentally and able to work part or full-time will have what we call “ghost symptoms” that appear and are worrisome. We have learned that fatigue from working too hard, lack of the daily one-hour rest, or severe stress and continuous worry will often result in the reappearance of mild symptoms and findings reminiscent of the very beginning or original symptoms of the disease.
These “ghost symptoms” are real, not imaginary, but they are readily reduced or obliterated by increased rest, solution of problems causing worry, and dealing with stressful situations followed by clearing the mind. The workload must be reduced, a vacation taken if possible, and the afternoon naps reinstated. It is often necessary to restart the relaxing medications at this time as well. The diet must also be checked. It is often advisable to reduce saturated fat intake to no more than 5 grams.
In the past, I advised diazepam, 2 mg taken 3 times a day and 5 mg at bedtime. This drug is very good, but physicians now prefer new ones. The drugs advised now are known as tranquilizers. Stimulating drugs, in other words drugs for depression, should be avoided. Several months of increased rest and mental calming will remove the “ghost” symptoms, but it is important to remember that the disease is still with you, and these symptoms may appear again if the patient works too hard, worries too much, and is too concerned about routine problems.
If one fails to follow the diet and rest, old symptoms, followed by new ones, will occur. It is absolutely necessary that you continue both, or the disease will again become active.
Dr. Swank reports on the progress of some of his original patients. Many of you know about the early studies I began in Canada in 1950 treating MS patients with a low-fat diet containing only 10-15 gm of saturated fat.
During the autumn of 2000, Mrs. Swank and I traveled to Canada to see the remaining patients from the original group of 144. I am still continuing to pursue others of that original group. However, it is a difficult process trying to contact these patients, and in 2001 Leeanna and I drove to Edmonton, Alberta Canada to see another female patient, who had been a part of the original group. She is doing extremely well and had a very demanding career until her retirement.
I also was visited by a man from California, who was in the initial group as well. He also had a very demanding career as a civil engineer and worked until full retirement age. He has been on the diet for 47 years and at 71 still walks 18 holes of golf and walks four-plus miles a day in cool weather.
Prior to initiation of my studies in 1948, the prognosis for MS patient survival was not good. It was commonly held that 20 percent would die within 25 years, and all would be dead within 35 years. Our study revealed that 80 percent of MS patients on the Swank Low-Fat Diet were still living after 35 years. It is not difficult to see a correlation here between diet and survival.
I have not seen similar studies with the ABC drugs, but I have seen a number of patients on them, both on the low-fat diet and without the diet. The patients I have talked with have all found the ABC drugs to cause pain and worsen their MS symptoms, and many have quit the drugs because of this. I have yet to see patients who have been on the drugs for more than a year and who acknowledge that the drugs improved their condition.
The only statement by a drug house has been that on the drug, patients have experienced a 30 percent reduction in MS attacks. On the Swank Low-Fat Diet, when carefully followed, the exacerbations or attacks are reduced greatly.
Are you, or have you been, on the ABC drugs? Dr. Swank would like to hear from you. It has never been my way to speak negatively of those who disagree with my work. All that I can do is refer you back to the last 50 years of my research and its results, described in my books and previous newsletters.
It was and is my experience in communicating with patients that those who try the drugs have negative experiences and often serious exacerbations follow. I realize, however, that I may not hear from those who do well on the medications (although I doubt that).
I would like those of you who have tried the ABC drugs to write of your experiences, good or bad, so that we can use your input to educate others.
I wish you each well on your journey as you learn to live effectively with MS.
Consult with a physician before embarking on this or any other diet.
Every patient is different. Information on this site does not constitute medical advice or treatment. This site does not constitute a doctor-patient relationship.
© 2002 by The Swank MS Foundation. All Rights Reserved.