October 1, 2016

Where are you now on the Disability Scale … and where do you want to be?

table demonstrating swank survival across disability

This is a layperson’s review of the paper Effect of low saturated fat diet in early and late cases of multiple sclerosis by Swank, R.L. and Dugan, B.B. as published in Lancet in 1990.

Good dieters starting at EDSS 0-1 have average 0.9 increase - Bad dieters increased 4.3

Okay, my previous post and tweet resulted in a ‘little bit’ of personal tweets and emails.  That’s as it should be.  We should all question what is the best way of fighting back on this stupid disease.

So, I thought I’d go back to only of the first papers I read when researching ‘MS diet’.  Building on his previous work, in this paper, Dr Swank looked at the category of disability that his patients had when they commenced his low saturated fat diet, and then at 34 years.  The following paragraph was originally my conclusion, but I thought you might not notice so …

At the end of the day, if you start with minimal disability you have 95% chance of surviving 34 years as a good dieter and an 80% chance of death if you are a poor dieter.  

No matter what level of disability you start with, a good dieter is unlikely to progress even two stages over 34 years, with the study mean maxing at 3.6 grade.  BUT, poor dieters ended up well into Grade 5 disability after 34 years.

Good dieters starting at EDSS 2 have an average increase of 1.6 - Bad dieters increased 3.4

Back to Swank, he found

the greatest benefit was seen in those with minimal disability at the start of the trial.  

Excluding those who died from non-multiple sclerosis diseases, 95% survived and remained physically active.

Results from studies are often difficult to read.  So I have gone through his paper, mapping his original disability categories (1-3) against current Kurtzke disability model (0-6) and comparing Swanks ‘Good Dieters’ and ‘Poor Dieters’.

Good dieters starting at EDSS 3-5 had average increase of 0.8 - Bad dieters increased 2.4

Some highlights from his study that you should think about:

  • You cant just stop the diet and think that you will keep good health.  His study showed that increasing saturated fat will make the incidence of relapse and progression come back.
  • Limiting unsaturated fat without control of of fat intact will decrease the incident of relapses.  There are good oils / fats out there - embrace them! (But continue to count them).
  • He also addressed the concerns that this was not a controlled randomised study - basically that would have been impractical due to the long term nature of the study.  I guess, the current study comparing Swank and Wahls diet is only planned for 36 weeks - well short of Swank’s 50 years.

In my own conclusion:

Even ‘poor dieters’ ate less fat than the average 2016 modern individual.  

There is no ‘cure’ for MS - but progression can be slowed and we have control.

The sooner you start - the better the result.

There is no quitting**.  

Your MS is not cured, but diet can keep the MonSter at bay.