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Evidence suggests that specific dietary modifications may be beneficial in MS. The Swank diet advocates a low intake of saturated fat of less than 15 g per day and relatively high intake of polyunsaturated oil. Other recommendations of the diet are an unsaturated fat intake of 20-50 g per day; abstention from red meat including pork for the first year, followed by a maximum 3 oz of red meat per week thereafter; consumption of dairy products having no fat or less than 1% butterfat; no use of processed food containing saturated fat; an unlimited intake of fruits and vegetables; and supplementation with cod liver oil at 1 tsp daily.51 Butter, margarine, lard, shortening, cocoa butter, coconut oil, hydrogenated oil, palm oil, and imitation dairy products must be avoided.

Swank followed a group of patients for 34 years and demonstrated relative success with his low-fat diet. His study showed that patients who adhered to the recommendation of 20 g of fat per day or less experienced significantly less deterioration and had much lower death rates than subjects who consumed greater fat than this per day. Persons with minimum disability at the beginning of the trial experienced the greatest benefit.52

A study compared a diet with 15% fat and fish oil supplementation with a diet of 30% fat and olive oil supplementation in individuals with relapsing-remitting MS. The patients had moderate clinical improvements with the former as compared with the latter regimen as measured with the Physical Components Summary Scale and the Short Health Status Questionnaire. The relapse rate in both groups was decreased.31 A further study found that consumption of liquid cow's milk was significantly associated with an increased prevalence of MS worldwide, with a weaker correlation for consumption of butter and cream.53

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