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Old 09-25-2014, 11:44 AM
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Default 2014 MS Diet Study Report: Swank Diet helps w/fatigue, fails to influence progression

The findings from the most recent study of the Swank diet are unsurprising: you'll lose a lot of weight (hooray!), you'll experience less fatigue (you aren't lugging around all those extra pounds), and you'll feel better mentally (heck, you are looking sharp). But researchers in this small study—too small to make any firm conclusions—found no connection between the low-fat diet and disease progression (lesions, disability, relapses). Article and abstract are below. - Dave


Low-Saturated-Fat Diet

[A diet] study presented here [at ECTRIMS] by Dr. Yadav and colleagues, looking at a low-saturated-fat diet in MS, was inspired by the work of Dr. Roy Swank in the 1950s. Dr. Swank suggested that individuals who consumed high amounts of saturated fat were at higher risk for MS.

The study evaluated a plant-based diet very low in saturated fat known as the McDougall diet. The composition of the diet is estimated at 10% fat, 14% protein, and 76% carbohydrate, with a focus on starches such as potatoes, corn, rice, beans, oats, fruits, and vegetables. Meat, fish, and dairy are not recommended.

For the study, 61 participants were randomly assigned to this diet or to a control group. The diet group underwent dietary training in a 10-day residential program and then completed monthly food-frequency questionnaires for 1 year.

Results showed no discernible effect on the MS disease process, with no significant changes in the number of active lesions, relapse rate, or Extended Disability Status Scale scores. But the researchers say the study was probably too small and had too short a follow-up to detect such changes.

They did find, however, significant improvement in fatigue measured by an almost 50% reduction in the Modified Fatigue Impact Scale score in the diet group.

Patients in the diet group also lost an average of 20 pounds in weight and had improved cholesterol and mental health scores.


V Yadav1,2, G Maracci1,2, E Kim1,2, R Spain1,2, M Cameron1,2, S Overs3, A Lewis1, J McDougall4, J Lovera5,6, C Murchison1, DN Bourdette1,2

1Oregon Health & Science University, Neurology, Portland, OR, United States, 2Portland Veterans' Affairs Medical Center, Neurology, Portland, OR, United States, 3Novant Medical Group, Charlotte, OR, United States, 4McDougall Research and Education Foundation, Santa Rosa, CA, United States, 5Louisiana State University, Neurology, New Orleans, LA, United States, 6Lsu, Neurology, Neurology, LA, United States

Background: Despite use of disease modifying therapies, poor quality of life in MS patients can be a significant management issue. Fatigue remains one of the most disabling symptoms of MS and effective treatment options remain limited.

Objectives: To assess the effects of a very low-fat, plant-food-based diet (< 10% of calories from fat) on fatigue and quality of life measures in relapsing remitting multiple sclerosis (MS) patients.

Methods: We conducted a randomized-controlled, rater-blinded, 1-year duration, study with subjects assigned to a very low-fat, plant-food-diet (diet) or wait-listed (control) group. Study outcomes: changes over one year in fatigue as measured by Fatigue Severity Score (FSS) and short version of Modified Fatigue Impact Score (MFIS) and quality of life by the SF-36 Score. Medications were unchanged during the trial.

Changes in blood lipids by nuclear magnetic resonance spectroscopy, blood insulin, C- reactive protein and 25 hydroxy vitamin D levels were assessed.

Results: 61 subjects with relapsing remitting MS [diet -32 (including 6 drop outs); control - 29 (including 2 drop outs)]; median age 41 (range 24-55), mean disease duration 5.3 (range 0.8-14.7), and mean EDSS 2.5 (range 0-4.5) were randomized. Linear regression indicated significant improvement in the diet group over the control group in the monthly change of fatigue as measured by FSS (monthly change compared to controls: -0.572 points/month; t=-2.40, p=0.017) and abbreviated MFIS (monthly change compared to controls: -0.277; t=-3.45, p< 0.001). There was a trend of improvement in the SF- 36 Mental score with the diet group showing an monthly score increase of 0.223 compared to controls (1.79 t-stat, p=0.075). Benefits on the fatigue measurements were observed within a month of beginning the intervention diet and were sustained at the same improved level throughout the year. Compliance based on monthly Food Frequency Questionnaire was excellent: Total fat intake of ~15% of calories in diet vs. ~ 40% in control. Results of changes in the fasting blood lipids, blood insulin and 25 hydroxy vitamin D levels will be presented.

Conclusions: A very-low fat, plant-food-based diet demonstrated significant improvement in fatigue and showed trends for improvement in mental health quality of life in the subjects over one year duration compared to controls. Studies with a larger sample size and longer follow-up are needed.
Dave Bexfield
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