Managing Multiple Sclerosis: A Dietary Approach

By Véronique Gauthier

The first book I read after being diagnosed with MS thirteen years ago was called “The Healing Code”. Written by Dermot O’Connor, it claims to “heal, transform and revitalise” the life of people with MS.  That sounded pretty good to me but I must admit that I was very dubious and although I read it, I didn’t follow the steps advocated by its author.

The first three years after my diagnosis were pretty gloomy.  Learning to cope with what is often referred to as a “debilitating” or an “incurable” disease takes time. But the worst was to deal with the immune modifying treatment I was prescribed. Against my neurologist’s advice, I decided to stop the treatment and get my life back. At this stage, I remembered “The Healing Code” and started to investigate alternative ways of managing MS. Over the past 10 years, the books, articles and personal accounts I read recommended reducing stress, practicing yoga or chi kung. Five authors also stressed the importance of diet.

The following table summarises the main points of these MS diets:

• Cooking

• Dairy

• Fat

• Gluten

• Daily supplements

  Kousmine (1983)

• (acid-base balance) below 110°C 

• 1-2 tbsp cold pressed oil (sunflower, linseed or wheatgerm)

• Reduce animal fat

• Reduce gluten

• Only virgin oil

• Vitamins and minerals

• “Budwig cream” 

• No alcohol, no tobacco

  Dr Swank (1991)

• No dairy with 1% butter fat or more

• Max 15 grams of saturated fat daily

• 20 - 50 grams  unsaturated fat 

• 1 tsp  cod liver 

• multivitamin

• No red meat for 1st year, then 3 ounces per week allowed

D. O’Connor (2006) (based on Swank)

• No dairy with 1% butter fat or more

• Replace saturated fat with unsaturated fat

• Spirulina 

• Vitamin A,B,C, E, Zinc, Selenium, Coenzyme Q10, MSM

• No refined carbohydrates.

• No red and dark meat.

• No coffee. 

• Limited alcohol intake

Prof. Jelinek (2010) (based on Swank)

• below 110°C 

• No dairy

• No saturated fat

• Avoid only if proven gluten sensitivity

• 20 g Omega 3 fatty acid

• 5000IUVit D 

• Optional B12

• Plant-based, wholemeal, plus seafood

Dr Wahls (Paleo principles)

• No dairy

• Omega 3 for salad dressing lard or coconut oil for cooking

• No grain, no legumes, no potatoes

• Vitamins and minerals

Dairy and Fats

Despite some differences, these five MS diets all recommend to avoid dairy products and reduce saturated and processed fats while increasing unsaturated ones. 

I am not a dietician but my understanding is that saturated fats are harmful to people with MS for two reasons. First, if our diet is high in saturated fats, then the cells’ membranes become hard and inflexible, and so do tissues and organs. This leads to a variety of health problems. 

But fats also play another crucial role since they form the basic building blocks of the immune system chemicals. As Professor Jelinek explains, “A diet high in monounsaturated fats is essentially neutral for the immune system. One high in omega-6s results in immune chemicals which promote the inflammatory response, and one high in omega-3s results in chemicals which suppress the inflammatory response.”

For any autoimmune disease, it is thus crucial to increase the intake of omega 3 too.

The Swank diet results:

The study most often quoted is Dr Swank’s study of 144 patients over a period of 35 years. Among these patients, 72 patients were good dieters, in other words they were able to stick to the MS diet and consumed less than 20g/day of saturated fat. The other 72 could not keep fat consumption below 20g/day.

Dr Swank used a neurological disability scale, which went from 0 (nearly symptom free) to 6 (deceased). Patients who needed a wheelchair were at point 4 and those confined to bed and chair at point 5. 

The main finding was that regardless of their level of disability at the start of the research project, good dieters did not deteriorate significantly. The results were best for those who started with minimum disability, with 95 per cent surviving and still physically active 34 years later, excluding those who died from non-MS diseases. But even people with significant disability benefited from the diet as the progression of the disease was slowed down. 

On the contrary, people who couldn’t follow the diet didn’t do very well. Even those who started with minimum disability ended with average grade of 5.3, that is wheelchair and bed bound after the 35 years period. Only 7 per cent of the “poor dieters” remained active. The death rate amongst them was extremely high. 58 of the 72 were dead by 34 years, 45 from MS-related causes. 

If the results are so impressive, why isn’t every MS patients following a low saturated fat diet? First, health has become such an industry that many people wouldn’t necessarily approve of a cheap way to manage a disease that is worth billions of dollars. There is no real effort to promote lifestyle changes in general. Second, even for those who - like me - believe that food is medicine, being a “good dieter” requires a lot of discipline and support. 

Gluten and vitamin D

Kousmine and Wahls advocate a reduction in gluten while Jelinek also deems it necessary to avoid gluten in case of personal gluten sensitivity. In 2002, in The New England Journal of Medicine, Farrell and Kelly listed 55 diseases they believed were actually caused by this protein found in wheat, barley, rye, spelt, kamut, and oats. MS is one of them. The reason being that gluten creates an inflammation throughout the body, including the brain. I must say that I do feel much better and less tired when I avoid gluten. Whether this has an influence on the progression of my MS symptoms, I don’t know

Personally,  I opted for Prof Jelinek’s diet, which is based on Swank’s findings, but also includes vitamin D. The vitamin D theory proposed by Goldberg in the seventies has been refined recently and researchers found that vitamin D is involved both in the immune system function and in the brain function. It can protect and also change the immune system function. 

Another reason I chose to follow Prof Jelinek’s advice is that it incorporates lifestyle factors. For instance, his “Overcoming Multiple Sclerosis” program recommends 20 minutes of meditation daily and 20 to 30 minutes of exercise per week. Another considerable advantage is that he created a “community”, encourages exchanges via a blog, organises retreats, etc. This support is crucial. I have to confess that I am still fighting to be a “good dieter” even though I am fully convinced of the benefits of a low saturated fat diet. Too often, I find I have to “defend” myself for not eating like others and it is very tempting to just do like the others and enjoy the nice forbidden food! 

So, although I am not a dietician, I have no doubt that diet is crucial in managing MS symptoms. The evidence in favour of a low saturated fat diet is too strong to be ignored. But I also believe that a holistic approach is needed. I started practising yoga in 2000 and later qualified as a Vinyasa Yoga teacher before doing an advanced training in Yoga Therapy. For me, coping with MS means adopting a life style that includes diet, sunshine or vitamin D, yoga, meditation,and lots of relaxing moments!

Véronique Gauthier

References:
Kousmine, Catherine, La sclérose en plaques est guérissable, Éditions Delachaux et Niestlé, 1983
Swank Roy, The Multiple Sclerosis Diet Book, Doubleday editions, 1987
O’Conner Dermot, The Healing Code, Hodder Headline Ireland, 2006
Jelinek George, Overcoming Multiple Sclerosis, Gazelle edition, 2010
Wahls Terry, The Wahls Protocol, forthcoming.
Farrell RJ, Kelly CP. “Celiac sprue”. New England Journal of Medicine, 2002 Jan 17; 346 (3):180-8.