August 2016    
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A Tribute to Roy Swank, MD
Founder of the Low-fat Dietary Treatment of Multiple Sclerosis


Dr. Roy Laver Swank (1909–2008), Neurologist and Professor Emeritus at the Oregon Health &Science University (OHSU) was a personal friend of mine, one of my most important mentors, and a precious colleague. We worked together for almost two decades. He ran two multiple sclerosis (MS)-dedicated programs with me at my live-in clinic at St. Helena Hospital in Napa Valley, California in the 1990s. Fortunately, I shot a homemade movie of some of our time together.


In September of 2002 Dr. Swank and I entered into a legal agreement allowing me, in his name, to make as many people as possible, who were suffering with multiple sclerosis, aware of the benefits of the low-fat diet for the treatment of this deadly disease. My obligation also included making this treatment available and accessible going forward. One way that I have done this is to offer free resources on MS and diet on Dr. McDougall's Health & Medical Center website. I also have written and continue to write articles that are published on the Internet, in newspapers, magazines, and medical journals, and I speak nationally through radio, TV, my webinars, videos, and YouTube.


The Swank MS Foundation has given me permission to share their professional video, "Conversations with Roy L. Swank," with you. Please take the time to get to know one of the true medical geniuses of the twentieth century.


Conversations with Roy Swank, MD


Making Treatment Accessible and Available


On Tuesday, January 16, 2008 I contacted Dr. Swank's former department of Neurology at Oregon Health & Science University with a proposal to carry out a study of the highest quality in order to demonstrate the value of the low-fat diet for people suffering with MS. OHSU was the obvious university to work with since Dr. Swank served as the leader of the Division of Neurology in the Department of Medicine for 23 years.


My Proposal for a Diet MS Study
  1. We (The McDougall Program) will provide the entire initial and follow-up education of the participants on the intervention side of the study. We will also provide the funding for this initial study.
  2. You (OHSU) will gather, analyze, and report the results. You will be the first authors of any papers published. However, I expect that the methods reported in all papers will clearly describe the diet used and identify The McDougall Program in Santa Rosa, California. Roy Swank, MD will also be given proper credit for his pioneering work in all publications.


The McDougall Research and Education Foundation (a tax-free 501c3 entity) raised nearly three-quarters of a million dollars (with many generous contributions from you, our newsletter subscribers) to fund this pilot project. Enrollment began in July 2009 and the last subject completed the study in March 2013. Unfortunately, it took another three years to write the study and find a reputable journal to publish the results.


I am happy to announce that the study appears in the September 16, 2016 journal Multiple Sclerosis and Related Disorders (released early on the Internet). Through extra financial contributions made by OHSU, the article was immediately made "open access" so that anyone is able to view our entire effort without charge.


Low-fat, plant-based diet in multiple sclerosis: A randomized controlled trial

Read Full Documentation >>>


The research paper reported excellent adherence to the McDougall Diet with those following the program reducing their fat intake from 40% of calories to 15% of calories, and maintaining this reduction for a year. Body weight, total cholesterol, LDL cholesterol, and insulin levels were significantly reduced for one year compared to the control group. Fatigue is a very debilitating problem for people with MS. Those following the McDougall Diet experienced remarkable improvement in their energy levels.


Notably, 85% (22/26) of the diet group subjects were diet adherent during the 12-month study. Therefore, those who doubt the power of food in curing major diseases can no longer claim that "even though the diet improves patients' health, no one can follow it." The study subjects could and did. These findings are as good, or better, than those for adherence to medications used in treating MS.


Unfortunately, the study was unable to demonstrate important benefits such as brain MRI outcomes, number of MS relapses, or disability at 12 months. I believe a larger study with more participants over a longer period of time would demonstrate these benefits. Dr. Swank's multiple observational studies published in major medical journals, which included many of the 5,000 patients he cared for over 50 years, showed dramatic reductions in relapses and disability progression from dietary changes.


So, why were we unable to confirm Dr. Swank's positive relapse and disability findings? I believe the answer to this question lies in the fact that the diet group was far more ill with their disease than the control group. The diet group was more fatigued, had 4 times as many MS brain lesions, with 4 times more disease activity, and suffered from more disability than the control group. Thus, the randomization process (chance distribution to the control or diet group) resulted in a serious bias against demonstrating improvements from a healthier diet. (A much larger study, say of 600 rather than 60 people, would have avoided this problem.) Although these results were not reported as significant, the diet group had fewer relapses: 7 for 32 people, compared to 9 for 29 people in the control group. The fact that most people were on medications known to suppress the formation of new lesions and reduce relapses also made it difficult to show if a healthier diet made a differences between the groups for these two endpoints.


The Impact of Individual Patients Was Profound


One of the principal investigators of the study, Dennis Bourdette, MD, current chair of the Department of Neurology at OHSU, told me that he could not remember a patient ever thanking him for prescribing one of the typical MS medications (such as Interferon Beta or Copaxone). However, he went on to tell me about patients who cried tears of joy and gratitude for the opportunity to learn about the low-fat diet for the treatment of their disease, and the dramatic improvements in their health. Reading the story of Karen Cooper or Deb Tasic will help you understand how much joy the physicians involved in this study experienced from caring for our study patients.


Supporters and critics of our work must agree that if they accept the study to be well executed and valid with the disappointments, then they must also accept the undeniable benefits we discovered and reported, including outstanding adherence, weight loss, cholesterol reduction, insulin level decreases, and fatigue relief. All maintained for a year, indicating permanent dietary changes and improvements.


Will We Repeat the Study?


The amount of money spent to treat just one MS patient for 10 years is more than the $700,000 we spent on this entire study. (The cost of a typical MS medication alone is $75,000 annually for one patient.) Give me $7 million and what we have learned from this project, and I bet OHSU and the McDougall Program could confirm all of Dr. Swank's findings and more.

One thing is for sure, and that is we have opened the eyes of patients, physicians, and researchers worldwide to the importance of diet in the prevention and treatment of multiple sclerosis. This study was made possible with a tremendous amount of effort from many dedicated people (and a tiny bit of money), with most of the credit going to our principal investigator at OHSU, Vijayshree Yadav, MD.


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