September 29, 2016

This is a layperson’s review of the academic paper Review of Multiple Sclerosis Patient Survival on a Swank Low Saturated Fat Diet by Swank, R.L., and Goodwin, J. from 2003.

My first though on being diagnosed with multiple sclerosis was - will I die?

Second was about my quality of life. How long do I have left of being an active mum, wife? Do I plan retirement now or can I last the distance? Can I/Should I buy those pretty high-heeled shoes or start saving for the wheelchair? Drama queen, admittedly so. But it got me researching.

MS survival
No drugs and their side effects
MS diet

graphic that shows difference in disability progression over 34 years between good and poor dieters

The 2003 paper by Dr Swank follows his papers published in 1953, 1955, 1970, 1988 and 1990. That gave me confidence that (a) he knew what he was talking about, and (b) whatever he is selling, isn’t a short term fix.

His paper starts with an introduction of inexpensive saturated fat (margarine) in 1900, which led to increase in daily fat consumption which was a shock:

60 grams / day - circa 1750
100 grams / day - 1860
125 grams / day - 1930
145 grams / day - World War II

Surely not! So I went off on a side track …

An 1960 paper Fat consumption in the United States by Frederick Epstein analysed saturated and unsaturated fat consumption, finding that while consumption varied across four regions of the United States and by urban/rural non-farm/rural farm, that consumption was indeed around 150 grams / day.
The National Centre for Health Statistics was less helpful, in their paper Trends in High LDL Cholesterol, Cholesterol-lowering Medication Use, and Dietary Saturated-fat Intake: United States, 1976-2010 just defines the ATP guidelines as consuming less than 10 per cent of total kilocalories from saturated fat.
The Australian Heart Foundation recommends only 7 per cent of total energy intake be saturated fat - giving the example average adult intake of 8700 kilojoules, 7 per cent is 16 grams of saturated fat (but they acknowledge that the average is 28 grams).

In 1945-48, studies in rural Norway first linked consumption of saturated animal fat to the frequency of multiple sclerosis. Almost 70 years ago!

In 1951, Swank commenced a ‘long-term study of the effect of a very low saturated fat diet by multiple sclerosis patients’.

The study concludes that having observed patients over 50 years ‘in all probability, multiple sclerosis is caused largely by consumption of animal fat’. Based on his research, he states that patient survival is greatest at 10-15 grams of saturated fat per day.

I got confused (foggy brain), so laid it out on the graph above. After 34 years, 67% of people who had followed Swank’s diet were still alive. And of the 23 deaths, only 14 were due to MS. Given they started at aged 30-42 years, that would put them around 65-76 years old. Not bad.

But after 50 years (now 72-84 years old), of the 15 people who responded to the request for interview, 13 were still ambulant. That is, walking around and functioning! That is some statistic I can work with.

What is not obvious until you look for it, is that even the ‘poor dieters’ were still averaging 38 grams of saturated fat per day. That is still well below WWII consumption and consistent with US and Australian health guidelines. So if you want to stick to those guidelines, you have a 21 per cent survival rate. Not bad, but I’ll take the 67 per cent.

Would have, could have, should have …

Growing up, my cheap and filling meals were processed meats, chips, gravy. Hamburgers, battered fish and other fried foods. Cheap, filling, comforting.

Did these contribute to my MS? I dont know. But they were not helping me to be a health weight either.

Going gluten free in 2005, I felt deprived of bread and pasta and cakes. So I admit to eating fried chips and packets of corn chips as my consolation prize. Unfortunately, it appears fat was replacing gluten for my taste spuds. Any benefit my future MS DX was receiving from gluten free, was being eroded by high saturated fat comfort eating.

Now.

As explained on other blogs, I was desperate in January 2016. Three years formally dx and symptoms were not going away. And the question I asked myself are yours to ask and answer for you.

What is the worse that following Swank can do?

Just be careful that you dont lose too much weight. If you have iron deficiency, keep up the blood tests and iron supplements and green veggies. Be careful of where your fish is sourced from and that no additional hormones are added to your chicken.

These days, you can get lower saturated fat products - eggs, yogurt and cheeses come to mind. Venison and kangaroo are high in protein, iron and really low in fat.

This is just a summary of Dr Swank’s years of work itself summarised into a short paper available from the publisher.

For more information and support, check out the Swank MS Foundation, Swank MS Diet and Lifestyle public facebook and if you have been diagnosed, ask to join the closed Swank MS Diet and Lifestyle facebook group.