May 27, 2009
we are getting closer- one last committee has to give its approval - the VA research and development committee. If all goes well we will be able to begin recruitment this summer.
This is a from a physician colleague with MS who has noted the similarity between MS and other types of neuro-degenerative types of brain disorders. With his permission I've copied his correspondence below.
Re DIET and MS/ Other Neuro-degenerative Brain Diseases
Dear Dr. Wahls:
I was diagnosed with MS 14 years ago after having about 4 relapses over a 32 month period. These involved loss of sensation in my legs, forearms, hands, and the left side of my face. I also had patellar hyperreflexia, altered proprioception in my legs, and bladder spasticity. I was diagnosed by Dr. Doug Williams in Bristol, TN, after an MRI showed a lesion at T10 and an LP showed elevated monoclonal bands.
Doug told me about a friend’s father who had practiced OB/GYN until 65 years of age while having MS. Doug quoted him as saying “Stay away from doctors; they will kill you.” Doug said that he was very upset when his son became a neurologist. Doug told me that he was not very impressed with Beta-Seron and did not prescribe it for me. He said to stay away from steroids, since they seemed to worsen the long-term rate of relapses. He said to avoid getting overheated. Most important, he said to limit my total fat intake to 20 grams a day – he said that this treatment was recommended in England and France even though it was not recognized in the USA.
I have complied with his recommendation for a low-fat diet for the past 14 years. Initially I could find nothing in the adult neurology texts or the NMSS web site to support its use. I felt that this must be cutting edge research that had not had time to make it into the textbooks. I initially felt that it was unlikely that the diet would have much effect of the MS, but that at least it would be good for my heart, as shown by Dean Ornish, MD. After about 2 years without further relapses or progression I started searching for more information about dietary treatment of MS. I found a mention of using a low-fat diet in Menkes’ Textbook of Child Neurology, 2nd edition. It gave a reference for an article published in 1970 by Dr. Roy Swank “20 years on the low fat diet.”
This article reported on a group of patients who had been told to limit their saturated fat intake to less than 20 grams a day, starting in 1950. An initial attempt at having a control group failed because the patients would talk with each other about their results while in the waiting room waiting for appointments, and after less than a year all the patients had gone on the low-fat diet. Swank had to use historical controls – how the patients had been doing before starting the diet and how other MS patient typically progressed. He found that the relapse rate dropped from 1 a year to less than 0.1 yearly (a 90% reduction), and that the rate of progression slowed.
Swank continued his study until about 1984. Not all of his patients remained in compliance with the diet. Among those who had minimal disability at the start of the study, there was a 5% death rate from MS among those who remained compliant with the diet, while there was an 80% death rate among those who were noncompliant.
Studies that show a benefit from a low-fat diet include:
1. Swank, RL. Multiple Sclerosis: Fat-Oil Relationship. Nutrition 1991; 7:368-376
2. Nordvik, I, et al. Effect of dietary advice and n-3 supplementation in newly diagnosed MS patients. Acta Neurol Scand 2000; 102:143-149
3. Weinstock-Guttman, B, et al. Low fat dietary intervention with w-3 fatty acid supplementation in multiple sclerosis patients. J.plefa 2005; 73:397-404
Your results with diet and exercise are like those reported by Joan Seliger Sidney in J Clin Epidemiol 1994 47:953-954. She went from using a rolling walker to being able to cross country ski 15 km after strictly following the Kousmine Diet (virgin oils, organic wholegrains, fruit, vegetables, nuts).
Your diet is very similar to the one that I have been on for 14 years. Others who use a similar diet include Ann Romney and Montel Williams.
Other discussion of the diet for MS is given in The China Study by Colin Campbell, Diet for a New America by John Robbins, The McDougall Program by John McDougall MD, Taking Control of Multiple Sclerosis by George Jelinek MD, and The Multiple Sclerosis Diet Book by Roy Swank MD.
Web sites that include information about dietary therapy for MS include www.swankmsdiet.org, www.drmcdougall.com, and www.hacres.com.
Since starting a low fat diet for MS in 1995 I have had no further relapses or progression. I have not missed any work due to MS since I started the diet. I am a pediatrician in solo practice in Bristol, TN.
Good luck in getting your results publicized. The benefits of a low-fat diet have been hidden for way too long.
John Hovious, MD
John Hovious, MD
You are welcome to use this note on your blog.
Follow up message
I have included 3 articles from Swank; the 1991 article is the most complete report of his study, and the 2003 article gives a 50 year follow-up on several of his patients. The 2003 Weinstock-Guttman article is an early abstract of the article that came out in 2005; I think that it is easier to follow than the abstract in the 2005 article. The neuropsychology and the breakdown of the BBB articles both state that BBB breakdown occurs before demyelination, which goes against the autoimmune hypothesis. The adrenoleukodystrophy and the nervonic acid articles show some similarity between ALD and MS.