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36
Momentum 
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Fall.2008
Healthy
Living
DieT
Is there an MS diet?
by Judi Hasson
 T
here are low-cal diets and low-carb diets, liquiddiets, vegan diets, diets that claim to ghtaging, arthritis, autism, and anxiety—and that’sonly the “A”s.For people with MS, many doctors recommend a traditionallow-cal, low-at diet; others pro-mote strict limits on certain oodgroups. Or they emphasize certainoods such as atty sh, apples,blueberries, broccoli or almonds.The varied recommendations and the lack o adistinct game plan can leave people with MS justplain conused.“While it is unlikely that a simple diet will betherapeutic in MS, recent data regarding the roleso vitamins such as vitamin D and niacinin maintaining a healthy immune andnervous system suggest that we shouldpay more attention to nutrition,” said Dr.Peter Calabresi, who heads the MultipleSclerosis Center at Johns HopkinsHospital in Baltimore.“No one is completely sure what works and what doesn’t,” said Dr.Heidi Crayton, director o the MSCenter o Greater Washington,DC. “There are guidelines orsmart eating, but there isno ail-sae plan. I tell my patients with MS thatit’s really important tohave a healthy diet.
What do experts say aboutthe thicket of claims?Can a diet moderate MS?
That includes two liters o water and 30 grams o ber every day, a palate with bright, colorul oods,and oods that have high nutritional value. Decreaseats and rened sugar,” Dr. Crayton added.Some doctors who look to a more aggressive eat-ing plan to deal with MS support the Swank Diet, astringent low-at diet developed by Dr. Roy Swank more than 30 years ago. It bans all dairy products,glutens (ound in wheat), legumes(meaning beans and peas) andvirtually all saturated at romanimal sources. It stresses sh andsh oils.Dr. Swank reported that 95%o patients who adopted this very low-at diet ollowing an early diagnosis o MS hada remarkably good chance o remaining ree romurther disability.“They have to ollow the diet strictly becauseeven small amounts o at make a big dierence,”Dr. Swank said. He asserted that patients who had adaily intake o eight grams o saturated at(one hamburger or two ounces o cheddarcheese) signicantly increased their risks.Dr. Swank published his study in the Britishmedical periodical
The
 
Lancet 
in 1990.“Most people in this country expectto be cured by a pill, and to have a curethat is almost instantaneous. With thelow-at diet, people actually have to work to get better,” Dr. Swank told Dr. John A. McDougall,ounder and medical directoro the McDougall Program, which promotes this very low-at approach.The problem isother researchers
 
37
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Fall.2008
nationalmssociety.org/magazine
have not duplicated Dr. Swank’s results, and thereis no generally accepted proo that the Swank dietreally controls MS. There is anecdotal evidencerom people with MS who say this diet makes themeel better.Dr. Vijayshree Yadav, a neurologist at the Ore-gon Health & Science University MS Center inPortland, Oregon, said there is little current researchon the Swank diet. In act, “diet has not been paidthat much attention,” she said. “But diet can makea dierence.”She advises her MS patients to go low-at: “It’shealthy. And it’s such a low-risk intervention that Idon’t see any reason not to recommend it.” She alsosaid a new study is expected to get underway nextyear at the Oregon acility to take a hard clinicallook at the impact o diet on MS.“Diets have been used or MS rom timeimmemorial. I they worked, we wouldn’t be stilltalking about them,” said Dr. Randall T. Schapiro,the director o the Schapiro Center or MultipleSclerosis in Minneapolis. Like many otherMS specialists, Dr. Schapiro recommendsa healthy diet that is low in saturated at.Other than that, he said no specic diet hasshown any long-term benet. According to Dr. Allen Bowling,director o the Complementary and Alternative Medicine Program at theRocky Mountain MS Center inEnglewood, Colo., it may be rea-sonable or some people withMS to take a sh oil supple-ment that includes one totwo grams o EPA plusDHA. He also notesthat it’s wise to bewareo overstated claimseither or or against specic oods or supplements.He agrees with Dr. Yadav that research on MS anddiet is very limited. All these doctors agree that while there is no con-crete evidence that a specic diet controls MS, thereis every good reason to eat a healthy diet and avoidthings that are known to be bad or everybody. So while there is no true consensus, an MS plan mightlook like this:
•
Cut back on saturated at. That means avoid-ing highly marbled red meat, butter, cheese andother ull-at dairy products.
•
Use oils rom vegetables, seeds, and sh. Try butter substitutes, such as sot or tub margarine,but use sparingly and look or “0 trans ats” on thelabel.
•
Eat sh regularly, especially salmon, herring,mackerel, tuna, sardines and lake trout.
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Eat skinless chicken or turkey, lean meatstrimmed o visible at, or go meatless with vegetableproteins rom beans, lentils, soy or nuts.
•
Consume ve servings o ruits andvegetables a day, choosing the brightly colored ber-rich varieties.
•
Eat three to our servings o whole-grainproducts daily. There is no concrete evi-dence that gluten has any impact on MS.
•
Exercise to stretch muscles aectedby MS, stay in shape, manage mood,ght atigue, promote bone health,and maintain a healthy weight.
•
Be cautious with caeineand alcohol.
Judi Hasson is a Washing-ton, DC-based journalistwho was diagnosedwith MS in 2007.
 
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Fall.2008
Healthy
Living
important components o myelin and other centralnervous system tissues. They include both
monoun-saturated ats
—ound in olive, canola and peanutoils, avocados, and nuts includingalmonds, hazelnuts, and peanuts,and
polyunsaturated ats
—ound in other vegetable oils suchas safower, sunfower seed, cornand soybean oils, seeds, and nutsincluding walnuts and Brazil nuts. When these ats replace saturatedats in the diet they can help tolower cholesterol and the risk o heart disease.There is some limited research showing thatcertain types o polyunsaturated ats—specically 
omega-3 atty acids
and
omega-6atty acids
—couldactually have abenecial eect onMS. In the context o alow-at diet, they showed atendency to decrease the severity and duration o MS attacks. Additionally,the omega-3s may improve mood and memory.Omega-3s can be ound in atty sh like mackerel,herring, sardines, albacore tuna and salmon. Thesesh contain two omega-3s—EPA (eicosapentaenoicacid) and DHA (docosahexaenoic acid). For spe-cic amounts in sh go to
n.cs.purdue.edu/sh4health/NutritionalContentoFish/omega3.pd 
. Plant sources such as soybeans, canola oil, walnuts or faxseeds contain ALA (alpha-linolenicacid), a less potent orm o omega-3.Omega-6
 
ats are in safower, sunfower, andsesame seed oils, in other seeds and nuts, and inleay vegetables and grains.
Fitting in the fat
 While at is an important part o a healthy diet,moderation is key. Leading health agencies recom-mend that less that 30% o total daily calories comerom ats and that unhealthy saturated and transats be limited to no more than 7% o the total.
W
hen I’m asked, “Is there anMS diet?” I say “Yes,” eventhough I know no diet has yetbeen proved to be an eectivetreatment. I say that because it’sthe best answer to the hiddenquestion, “Can diet make my MS better?” Yes! Good nutrition has a positive impact onsome MS symptoms and also lowers the risk o other diseases and disorders. The goal is optimalhealth throughout a lietime. A diet that can makeMS easier to live with begins with a look at ats.
About those unhealthy fats
Saturated ats
have long been associated with high blood pressure, heart disease,stroke and some cancers. These ats are usu-ally solid at room temperature and can be
Yes, says our columnist.Good nutrition promotesoptimal health—and helpsmanage some troublesomeMS symptoms.
DieT
Is there a diet that helpspeople with MS?
by Denise Nowack, RD
 where a liquid at like corn oil is made into a moresolid orm, like margarine or shortening.
About those healthy fats
Unsaturated ats
play a very important role indiet, supporting many essential unctions. They areound in highly marbled meats, the skin on poultry,rich, creamy cheeses, butter and whole milk dairy products. There are saturated ats in coconut,palm and palm kernel oils (oten calledtropical oils), and cocoa butter, too.
Trans ats
act just like satu-rated ats in the body andare typically ound inshortening, margarine,cookies, crackers, snack oods and ried oods. Mosttrans ats are manmade through aprocess called hydrogenation—
of 00

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