Abstract
The precise etiology of multiple sclerosis (MS) is unknown but epidemiologic evidence suggests this immune-mediated, neurodegenerative condition is the result of a complex interaction between genes and lifetime environmental exposures. Diet choices are modifiable environmental factors that may influence MS disease activity. Two diets promoted for MS, low saturated fat Swank and modified Paleolithic Wahls Elimination (WahlsElim), are currently being investigated for their effect on MS-related fatigue and quality of life (NCT02914964). Dr. Swank theorized restriction of saturated fat would reduce vascular dysfunction in the central nervous system (CNS). Dr. Wahls initially theorized that detailed guidance to increase intake of specific foodstuffs would facilitate increased intake of nutrients key to neuronal health (Wahls™ diet). Dr. Wahls further theorized restriction of lectins would reduce intestinal permeability and CNS inflammation (WahlsElim version). The purpose of this paper is to review the published research of the low saturated fat (Swank) and the modified Paleolithic (Wahls™) diets and the rationale for the structure of the Swank diet and low lectin version of the Wahls™ diet (WahlsElim) being investigated in the clinical trial.
Highlights
Multiple Sclerosis (MS) is a chronic, inflammatory, immune-mediated condition that damages nerve fibers and the myelin sheath and affects the brain, spinal cord and optic nerve [1]
The purpose of this paper is to provide an overview of the published research on the use of the Swank and WahlsTM diets and rationale for the structures of the Swank and WahlsElim diets being investigated in the Dietary Approaches to Treat Multiple Sclerosis Related Fatigue Study (NCT02914964) [45]
Nightshade foods may be re-introduced to the WahlsElim diet one ingredient at a time after three months; these foods may be consumed if no increase in neurological or medical symptoms is observed in the week following reintroduction
Summary
Multiple Sclerosis (MS) is a chronic, inflammatory, immune-mediated condition that damages nerve fibers and the myelin sheath and affects the brain, spinal cord and optic nerve [1]. To address the demand for research on the safety and efficacy of diets promoted for MS, a randomized clinical trial is currently underway [45,46] to compare the effect of two diets, Swank and Wahls Elimination (WahlsElim), on MS-related fatigue. These diets were selected for comparison because they were designed to treat MS and are popular within the MS community [40]. Was published; 3 quantity adjusted depending on appetite and energy needs; 4 Avocado and olives count towards daily oil allotment; 5 Includes cruciferous (e.g., broccoli, cauliflower) and allium vegetables (e.g., garlic and onions) as well as mushrooms; 6 Includes carrots, beets, sweet potatoes, cherries, berries and similar fruits/vegetables with color throughout; a variety of colors including red, blue/black/purple, green and yellow/orange are encouraged;
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