Roy Laver Swank - The Multiple Sclerosis Diet Book: A Low-Fat Diet for the Treatment of M.S., Revised and Expanded Edition

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T HE M ULTIPLE S CLEROSIS D IET B OOK is an extensively revised edition of The Swank Low-Fat Diet, published in 1972 by Willamette Publishers, Beaverton, Oregon.

Library of Congress Cataloging-in-Publication Data
Swank, Roy L. (Roy Laver), 1909
The multiple sclerosis diet book.
Bibliography: .
1. Multiple sclerosisDiet therapyRecipes.
2. Low-fat dietRecipes. I. Dugan, Barbara Brewer.
II. Title. [DNLM: 1. Cookery. 2. Dietary Fats
administration & dosage. 3. Multiple Sclerosisdiet
therapy. WL 360 S972m]
RC377.S94 1987 616.8340654 86-16819

eISBN: 978-0-307-79740-7
Copyright 1977, 1987 by Roy L. Swank
Copyright 1972 by Willamette Publishers
Portions of this book, reprinted by permission,
Copyright 1959 by The University of Oregon Press
ALL RIGHTS RESERVED

v3.1

To Eulalia Swank, my wife
To Patricia Brewer, my sister

It has been thirty-six years since our investigations of multiple sclerosis (M.S.) were undertaken. The early history of the development of the low-fat diet therapy was described in the Introduction to the 1977 edition, which is included in this book following this introduction.

During this period, Dr. Roy Laver Swank has interrogated and examined about thirty-five hundred M.S. patients and maintained contact with approximately two thousand of them for ten to thirty-six years. Since his retirement as head of neurology in 1974 and the publication of the 1977 edition, research has continued. Studies of cerebral blood flow, a series of papers on the red-cell mobility test for diagnosis of M.S., papers describing abnormality of blood plasma in M.S., and a paper concerning the benefits derived by patients from infusion of normal blood plasma have been published. In addition, the statistical analysis of the Montreal patients who have been on the Swank low-fat diet for up to thirty-six years was completed. This new material has been integrated with the older material and is presented here in a manner we hope will be of help to both patients and their physicians.

This book describes methods by which patients with multiple sclerosis can take the best possible care of themselves. By following the precepts developed over the years, the great majority of patients can expect to remain free of disability for up to thirty-six years if these methods are initiated before disability has developed and are faithfully adhered to. If the treatment is started late, marked reduction in the frequency of exacerbations, increased stability, and slowing of deterioration can be expected.

It has been said that patients on the Swank low-fat diet prosper because it is basically a healthy diet. It is the opinion of the authors, however, that the very close relationship of the progress of the disease to the amount of fat intake, and the marked intolerance of the disease to animal and butterfat, argue for a direct relationship of the fat intake not only to the clinical course but also to the basic mechanism of the disease.

In this edition, we explore the early symptomatology of the disease, and we examine additional factors that influence the course of the disease and advise the treatment for them. The diet instructions have been made easier to master, new recipes have been added, and others have been removed. We offer suggestions for adhering to the diet while traveling abroad, as well as while eating in restaurants or at other peoples houses. There are new sections on condiments and helpful cooking aids for disabled patients. And we explore the relationship of traumatic and psychological stress to multiple sclerosis and recommend treatment for this.

A chapter on the use of the Swank low-fat diet in the treatment of heart disease and stroke was included in the 1977 edition. Although it has been deleted from this edition to focus attention on our main interest, M.S., we still advise the diet for treatment of these vascular diseases. The diet is easy to learn and is well tolerated. In addition, it reduces blood cholesterol concentrations, in most patients to very low levels () it increases circulation.

Roy Laver Swank, M.D., Ph.D.
Barbara Brewer Dugan

Numbers in parentheses throughout this book, both in the text and in the figure captions, refer to the Bibliography.

To immerse oneself completely in research of a single disease is unusual, but in August 1948 Dr. Wilder Penfield, then director of the Montreal Neurological Institute, invited me to Montreal to undertake studies of multiple sclerosis. My knowledge of multiple sclerosis changed rapidly as I interviewed and examined many patients at the clinic and spent hours in the library. Three useful clues to the disease came to light. First, in many cases relapses occurred quite suddenly, suggesting a vascular cause. Second, the neurological literature suggested that the frequency of the condition varied geographically. Third, postWorld War II nutritional studies revealed a marked variation in fat consumption in different parts of the world, suggesting a possible correlation between high-fat intake and a high frequency of multiple sclerosis.

We began to place patients with multiple sclerosis at the institute on the low-fat diet in December 1948. The diet was closely supervised until 1954, when I moved to the University of Oregon Medical School in Portland. The Montreal patients were then checked frequently by mail and by a yearly visit to Canada until October 1974. Communications continued to remain open, but the patients did so well that only occasionally did one need help. This was taken care of by telephone or letter. Since moving to Portland, I have seen and treated many new patients, but they have not been added to the original study group in Montreal, now under observation for twenty-nine years.

). Other studies of nutrition and blood viscosity were carried out later in Tokyo, Japan; Mesina, Italy; and Israel; as well as in Portland, Oregon.

In the laboratory it was shown that high-fat meals caused the blood cells to aggregate or clump ().

Because of the observation that fat meals lead to the clumping of red cells in animals and man, and that similar clumping occurs in patients with multiple sclerosis, an instrument known as the screen filtration pressure machine was developed for measuring the presence in the blood of aggregated blood elements. By accident, this led to the discovery of aggregated platelets and leukocytes in blood that had been stored for transfusion, and to aggregates composed of the same blood elements during very low blood pressure that resulted from rapid bleeding (). These studies were done first on animals but were later confirmed elsewhere on humans at the time of the Vietnam war. These aggregates were sufficiently large and numerous to obstruct the smaller blood vessels and cause pathological and physiological abnormalities.

By chance, it was found that these aggregates could be removed by passing blood through a layer of polyester wool (tested on both animals and humans; the results of these tests indicate that removal of the aggregates from circulating blood tends to normalize the blood flow, allow maintenance of normal oxygen and carbon dioxide contents in blood, and minimize tissue damage. Needless to say, many patients have benefited.