Abstract

Multiple sclerosis (MS) is an incurable degenerative disease that attacks the central nervous system. Roy Swank proposed a low saturated fat diet to treat MS around 1950 and showed delayed disease progression in his patients. However, there is insufficient evidence to recommend this diet for MS and default dietary recommendations are the Dietary Guidelines for Americans (DGA). This study assessed the nutritional adequacy of seven-day menus developed by Swank and their compliance with the DGA; menus were modeled for comparison with the DGA Healthy US-Style Eating Pattern (HEP) for males and females 31–50 years. Swank recommended dietary supplements corrected menu shortfalls in vitamins D, E, calcium, folate and iron but not dietary fiber, potassium and choline. Healthy Eating Index-2015 score for Swank menus (93.2/100) indicated good compliance with the DGA. Nutritional adequacy of the Swank modeled diet was similar to HEP for 17 vitamins and minerals (Mean Adequacy Ratios ≥94%) with similar shortfall nutrients except magnesium (HEP males) and dietary fiber (Swank males). Alternate Healthy Eating Index-2010 scores for Swank male (90/110) and female (88/110) model diets were similar to HEP. Swank menus have similar nutritional adequacy as HEP. Inclusion of foods high in dietary fiber, potassium and choline may be advised as well as selection of foods to reduce sodium below the Tolerable Upper Intake Level.

Highlights

  • Multiple sclerosis (MS) is an incurable immune-mediated, inflammatory disease that attacks the central nervous system

  • Nutritional adequacy and HEI-2015 scores for the Healthy United States (US)-Style Eating Pattern (HEP) were obtained from published data [70,71]; AHEI-2010 scores were calculated using publicly available food and nutrient data used to develop the HEP [69,70,72]

  • Nutrient composition of the Swank seven-day menus was modeled using United States Department of Agriculture (USDA) nutrient profiles to allow for comparison with the nutritional adequacy of the 2015–2020 Dietary Guidelines for Americans (DGA) HEP and calculation of the AHEI-2010

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Summary

Introduction

Multiple sclerosis (MS) is an incurable immune-mediated, inflammatory disease that attacks the central nervous system. Persons with MS (pwMS) may experience visual disturbances, cognitive and emotional changes, movement and balance difficulties, bowel and bladder dysfunction, pain and fatigue. The symptoms can wax and wane over time as myelin and axons are damaged and partially repaired. The accumulated damage may lead to greater disability, but the disease course is unpredictable [1,2]. That MS as a distinct condition, separate from diseases such as Parkinson’s disease, emerged [3,5]. By 1950 MS was the most common neurological disease in the United States (US) [5] but there were no effective treatments [4]

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