The Swank Diet for Multiple Sclerosis

Some say limiting saturated fat helps symptoms from getting worse

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The Swank diet was created by an American neurologist in 1990 as a way to help manage multiple sclerosis (MS). The overlying premise of the diet is simple: Cutting out saturated fat and focusing on eating more fish might help prevent problems with blood flow that ostensibly could play a role in symptoms of MS.

There's little scientific evidence to support the effectiveness of the Swank diet, and so, as a therapy for MS, it's regarded as a form of complementary and alternative medicine (CAM). However, enough people with MS who've tried the diet have found it to be helpful enough to continue its use.

Basics of the Swank Diet for MS
Verywell / JR Bee

Origins

The doctor who developed the diet, Roy Swank, MD, PhD, was inspired by geographical and dietary differences in the epidemiology of MS, which caused him to theorize that diet could play an important role in the disease. Specifically, he saw that multiple sclerosis is more prevalent in areas where people eat considerably more fat (especially saturated fat), such as the United States, Europe, Canada, and Australia.

He also noticed that in Norway in particular, people who lived in fishing communities (where fish is the main part of the diet) were significantly less likely to develop MS than Norwegians who lived in the mountains (where meat is the main dietary component).

Also, Dr. Swank saw that after a high-fat meal is consumed, blood cells tend to clump together, blocking circulation in capillaries. He hypothesized that the clumps blocked the tiny blood vessels in the blood-brain barrier, leading to the inflammation and lesions in the central nervous system that are hallmarks of multiple sclerosis.

Based on his observations, Dr. Swank theorized that by cutting saturated fat from the diet and eating more fish, blood-cell clumping would not happen. As a result, he postulated, blockages and inflammation would be eliminated. This would mean (theoretically) that MS lesions would stop occurring.

Swank's Research

Dr. Swank started his research in the mid-1950s by putting 25 people with MS on a very low-fat diet. Six dropped out of the study and five died. None of the 19 remaining participants had worsening MS.

He repeated the research by following a group of 144 people with MS for 34 years. The results of that study, which was published in The Lancet in 1990, were similarly encouraging: 95 percent of those who stayed on a diet of 20 or fewer grams of saturated fat a day did not experience progression of their MS.

What's more, 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. It appeared the diet not only prevented multiple sclerosis from getting worse, it also was associated with longevity.

Should You Try the Swank Diet?

As exciting as his results were, Dr. Swank's research is viewed by neurological experts as flawed and too limited to support. Even so, the overall concept of limiting saturated fat and eating more of the healthy fats found in fish is regarded as a smart approach to eating and can have benefits for everyone—not only people with MS.

What's more, following the diet is straightforward: You don't need to measure portions or count calories. Simply steer clear of certain foods in order to keep total fat intake low and focus on eating other options.

This snapshot of the "rules" for following the Swank diet will give you an idea of what's involved. You can get more details on the Swank diet website or by reading Swank's book, "The Multiple Sclerosis Diet Book: A Low-fat Diet for the Treatment of M.S."

Limit/Avoid These

  • Oils: Limit those with unsaturated fat to between 20 and 50 grams per day.

  • Saturated fat: Limit to 15 grams each day.

  • Red meat: Exclude from your diet entirely for the first year (including pork and wild game); 3 ounces of red meat per week (if desired) thereafter.

  • Dairy: Avoid options with more than 1 percent butterfat; limit those with any amount of saturated fat to two servings per day. Artificial "dairy" products (e.g., margarine, shortening) not permitted; fat-free dairy products allowed in any amount.

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

Enjoy These

  • Grains: Four servings of whole grains and cereals per day (watch for hidden fats in baked goods and granola)

  • Eggs: Factor in the 5 grams of saturated fat in the yolks.

  • Pasta and rice: Whole grain pasta and brown rice

  • Poultry: White meat of chicken or turkey; remove skin and any visible fat

  • Fruits: At least two servings a day; limit avocados and olives

  • Vegetables: Unlimited, with a minimum of two 1-cup servings

  • Fish: All white fish and shellfish in unlimited amounts; count fatty fish in daily fat allowance

  • Coffee: Caffeinated beverages are OK, but drink no more than three cups per day.

  • Nuts and seeds: Include in daily oil allowance

  • Alcohol: A glass of wine or a cocktail with dinner is fine.

It's also advised that you take a daily multivitamin and mineral supplement, along with a capsule containing the equivalent of 1 teaspoon of cod liver oil.

For potentially getting the best results, it's suggested that you:

  • Don't wait: In Dr. Swank research, people who had the best results in terms of delayed/no disability progression and/or improvement were those who started eating this way early in their disease.
  • Don’t cheat: Dr. Swank found that an increase of even 8 grams of saturated fat a day increases the risk of death from MS-related causes three-fold.

Sample Swank Meal Plan

Following the Swank diet isn't about adhering to a strict meal plan but rather making food choices for meals and snacks that, over the course of a day, keep your total fat intake low. For example:

Breakfast:

  • Fruit smoothie made with 1/4 cup each frozen raspberries, blueberries, and pineapple, half a frozen banana, and 1 cup of skim, soy, almond, or rice milk
  • One cup of coffee or tea, black or with a splash of non-dairy milk or cream

Morning snack:

  • 1 cup non-fat yogurt topped with berries and roasted walnuts

Lunch:

  • Salad of dark leafy greens topped with one hard-boiled egg (one of three that are allowed during the course of a week), whatever mix of raw vegetables you enjoy (carrots, celery, cucumber, fennel, tomatoes), and 1/8 avocado
  • Whole grain crackers or a handful of baked tortilla chips

Afternoon snack:

  • Almond-butter-and-sliced-apple sandwich on whole-grain bread

Dinner:

  • 4-ounce skinless breast
  • Vegetables (cauliflower, Brussels sprouts, broccoli, or a combination) tossed with olive oil and fresh herbs and roasted on a sheet pan
  • Brown rice
  • Optional: One glass of wine

Dessert:

  • A slice of angel food cake
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