MSWA Bulletin Magazine Autumn 17

SPECIAL DIETS AND
MULTIPLE SCLEROSIS
DR LUCINDA BLACK, MSWA POSTDOCTORAL RESEARCH FELLOW,
SCHOOL OF PUBLIC HEALTH, CURTIN UNIVERSITY
People diagnosed with MS are often motivated to make
dietary changes in an effort to reduce disease progression. A
Google search of diet and MS reveals an excessive amount of
information about what foods to increase and avoid if you have
been diagnosed with MS. However, the advice available online
is not necessarily based on scientific evidence, and some
dietary changes may be costly and hard to implement, with
little or no benefit for people with MS. At worst, some dietary
changes may result in poor intake of important nutrients.
There are a number of special diets that are promoted for
people with MS, including (amongst others) the Swank diet,
the McDougall diet, the Paleo diet, and a gluten-free diet.
The Swank diet encourages people to substantially reduce
their saturated fat intake. Foods to avoid include processed
foods that are high in saturated fat and hydrogenated oils,
full-fat dairy, and red meat for the first year (1 serve per week
thereafter). Permitted foods include fruit and vegetables,
wholegrains, nuts and seeds, white-meat poultry, white fish,
oily fish (3 serves per week), and eggs (3 per week). The diet
suggests taking a cod liver oil and multivitamin-multimineral
supplement daily. Although many of these recommendations
are commendable, some aspects of the diet may be
unnecessarily restrictive, such as avoiding lean red meat
(a good source of protein, iron, vitamins and minerals),
limiting eggs (which contain valuable nutrients, including
protein, omega-3 fatty acids, antioxidants and vitamins), and
restricting certain dairy products (a good source of calcium).
The McDougall diet is a vegan diet based on starchy
vegetables, fresh or frozen fruits and vegetables, and
wholegrain products. Animal foods (including red meat,
poultry, dairy products, eggs, and fish) are excluded. By
excluding some important food groups, this diet could
potentially result in inadequate intakes of protein, iron, vitamin
B12, calcium, vitamin D and omega-3 fatty acids.
The Paleo diet is a modified version of the diet that would
have been consumed by our ancestors in a hunter-gatherer
lifestyle. Highly processed foods are avoided, and intakes
of game meats and plant-based foods (with the exception
of grains) are increased. Although the guidelines vary, most
Paleo diets advocate avoiding dairy, eggs and grains.
The Wahls protocol is a modified version of the Paleo diet,
and recommends green leafy vegetables, coloured fruits and
vegetables, sulfur-rich vegetables (eg broccoli, cabbage, kale,
garlic and onion), omega-3 supplements and animal protein.
Gluten-containing grains, dairy and eggs are excluded.
There are some benefits to the Paleo diet, including avoiding
processed foods and increasing fruit and vegetable intake;
however, the diet excludes some nutritious foods, including
wholegrains, dairy and eggs.
A Gluten-free diet is currently the only treatment for people
with coeliac disease – an autoimmune disease that causes
small bowel damage – and is sometimes promoted for
people with MS. The diet excludes all products derived from
gluten-containing grains, namely wheat, barley, rye and oats.
Gluten-free grains/seeds include corn, millet, rice, amaranth,
buckwheat and quinoa. Following a gluten-free diet is
challenging and can be costly if gluten-free substitutes are
purchased. Some gluten-free products are highly processed
and contain substantial amounts of salt, sugar and fat.
16 | MSWA BULLETIN AUTUMN 2017