What Is the Swank Diet for Multiple Sclerosis?

Learn the science behind the Swank Diet and its basic food guidelines

Plate of fish with zucchini
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There is no doubt that many of you have heard about the Swank Diet for multiple sclerosis (MS). It's one of the more common dietary and complementary approaches to managing your disease. The Swank Diet for Multiple Sclerosis is a very low-fat diet that emphasizes whole grains, fruit, vegetables, and very lean proteins.

As far as eating plans go, the Swank Diet is pretty simple to understand. Instead of a "diet," you can really think of it more as a "lifestyle," meaning that you are not having to measure your portions or eat special food.

Instead, you will basically be cutting out lots of fat and cutting way back on meat.

Origin of the Swank Diet

Dr. Roy Swank was a neurologist who started considering that diet might play a role in MS after considering the geography and epidemiology of MS. For instance, multiple sclerosis is far more prevalent in the United States, Europe, Canada, and Australia than in other parts of the world, such as Asia or Africa. In these places with high MS prevalence, the people's diets tend to be high in fat, especially saturated fat.

In addition, Dr. Swank noticed that in Norway, people who lived in fishing communities (where fish is the main part of their diet) were 8 times less likely to develop MS than those who lived in the mountains (where meat is the main dietary component)

Also, Dr. Swank noted that after eating a high-fat meal, a person's blood cells would clump together and be able to block circulation in capillaries.

He hypothesized that these clumps were blocking the tiny blood vessels in the blood-brain barrier and leading to inflammation and lesions in the central nervous system.

His theory was that if you cut out the fat (saturated fat), you eliminate the clumps of blood cells. No more clumps means no more blockages and no more inflammation.

This would mean (theoretically) that MS lesions would stop occurring.

The Science Behind the Swank Diet

Dr. Swank started his research in the mid-1950s by putting 25 people with MS on a very low-fat diet. Six of these people dropped out of the study and five of them died. The 19 people who remained on the diet did not have any disability progression.

He repeated that research and followed a group of 144 people with MS for 34 years to find pretty much the same results. Ninety-five percent of those who stayed on a diet of 20 or less grams of saturated fat a day did not experience disability progression. After 34 years, they had a death rate of 31 percent, compared to the group following a more typical high-fat diet, which had a death rate of over 80 percent. The diet was not only protecting people from MS progression and death from MS-related causes, it was preventing other lifestyle diseases, as well.

The Basic Rules of the Swank Diet

Here are some basic rules for following the Swank Diet. As you will notice, they pretty much all focus on fat intake.

Oils: Limit your oils (unsaturated fat) to between 20 and 50 grams per day.

Saturated Fat: Do not consume more than 15 grams of saturated fat each day.

Red Meat: Do not eat any red meat the first year. After the first year, you may have 3 ounces of red meat per week. This rule applies to pork and wild game.

Dairy: Any dairy products cannot contain more than 1% butterfat. Clearly, this leaves out butter itself. Any dairy products with any saturated fat should be limited to 2 servings per day. However, fat-free dairy products are allowed in any amount. Artificial "dairy" products, such as margarine or shortening, are not allowed.

Processed Foods: Do not eat any processed foods containing saturated fat.

Supplements: Do take a daily multivitamin and mineral supplement, along with a capsule containing the equivalent of 1 tsp of cod liver oil.

Other Considerations for the Swank Diet

Don't Wait: Dr. Swank's data showed that the people who did the best (in terms of delayed/no disability progression and/or improvement) on the Swank diet were those who started eating this way early in their disease, ideally immediately following diagnosis.

Don’t Cheat: For the diet to have the amazing results demonstrated in the study, it was shown that people have to be very strict in adhering to the guidelines. In fact, Dr. Swank believed that an increase of even 8 grams of saturated fat a day increases the risk of death from MS-related causes three-fold.

What Can You Eat? You might be wondering what is allowed on the Swank Diet. There are misconceptions out there that the diet is vegetarian or even vegan. This is not the case. Here is a list of foods that you can eat:

  • Grains: Grains and cereals are allowed, with 4 servings encouraged; watch for hidden fats in baked goods and in granola.
  • Eggs: Eggs are allowed, but don't forget to count the 5 grams of saturated fat in the yolks.
  • Pasta and rice: These are allowed in any amount, but whole grain pasta and brown rice are preferred.
  • Poultry: White meat of chicken or turkey is allowed, as long as it has no skin or visible fat.
  • Fruits: People should eat least 2 servings a day of fruit. However, avocados and olives should be limited, due to their fat content.
  • Vegetables: At least 2 servings of vegetables a day are part of the Swank Diet (1 serving = 1 cup). You can have unlimited servings.
  • Fish: All whitefish and shellfish are allowed in unlimited amounts; fatty fish must be counted in daily fat allowance
  • Coffee: No more than 3 cups per day of any caffeine-containing beverage are allowed.
  • Nuts: Nuts and seeds are fine, but must be counted towards daily oil allowance.

What the Medical Community Says About the Swank Diet

The Swank diet has been disputed by the neurology community, as Swank's study was small and flawed. 

That being said, current research on the role of diet in MS is a hot topic. Now, experts are studying gut bacteria in the MS disease process. They have found that a high-fat, meat-laden Western diet contributes to inflammatory diseases (like MS) by promoting the growth of certain gut bacteria. On the other hand, people who eat a low-fat, plant-based diet have a completely different profile of gut bacteria, which is anti-inflammatory.

Clearly, there is still much to learn about the role of diet in MS. The big picture here is that diet is one way in which you can take an active role in your MS health. While there are no specific guidelines recommending the Swank diet or another dietary strategy for people with MS, adopting a healthy diet, (one that is at least low in fat and high in fiber) will benefit your overall health, and hopefully your MS health too. 

Sources:

Swank R. Effect of low saturated fat diet in early and late cases of multiple sclerosis. Lancet. 1990 Jul 7;336(8706):37-9.

Swank, Roy Laver and Dugan, Barbara Brewer. The Multiple Sclerosis Diet Book: A Low-Fat Diet for the Treatment of MS. New York: Doubleday, 1987.

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