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The Modified Swank Lo-fat Diet

There are several theories that try to explain how and why the Lo-fat diet is the best control over the severity of many of the symptoms of this disease that we call Multiple Sclerosis. Nobody knows which theory, nor even if any of the current theories, is correct. But the bottom line is that people who really do follow the Swank type of Lo-hard fat diet live longer, work longer and walk longer than MS patients who do not carefully follow this kind of diet.

As Dr. Swank outlined the diet, it limits all fats severely. Over the years I have modified the diet for myself in two ways. #1 - I do not limit the amount of oil or "soft fat" I use. Of course I am not foolish in using more that I need to use on a daily basis either. I use oil in salad dressing and in lightly sautéing vegetables plus I take many oil capsule food supplements. Four or five times a week for salads and now and then for tossing pasta we use a teaspoon or two of extra virgin olive oil. (Mono saturated olive oil [omega 9 fatty acids]  Olive oil is probably about 20% of the oil we use.) Most of the time I use no oil at all on salad. I sprinkle my twice-a-day, (WE MS patients tend to have constipation problems without lots of roughage in our diets) fresh green salad with salt, pepper and herbs. Then I either squeeze fresh lemon over it or use mildly pickled three-bean salad over the greens as a dressing.  A tablespoon of emulsified orange flavored cod liver oil (Omega 3 fatty acids) is also a necessary part of my daily intake of soft fats (oils).

For cooking oil, we use di-saturated Sunflower or Safflower oil. (They are both high in Linolenic acid [omega 6 fatty acid family] and low in saturated fat.) We never fry anything. But, using these oils, we lightly sauté onions, green pepper, celery and mushrooms at relatively low heat as a basic part of our cooking for many of the meals we prepare. High temperature frying breaks down part of the molecular structure of some fats and changes or destroys many fatty acids that are essential to our body’s health.

Always read labels for the fat content and type. Avoid Oleic acid (rendered tallow), the Trans-fatty acids (man made fats) and any saturated (hard) fat. Now that is not to say you will not get plenty of those fats accidentally anyway. But if you never use any pre-prepared mix or restaurant or fried food, the amount of fat you get in whole grain bread, beans and legumes, trimmed fish and white meat poultry will be low enough for you to not to need to worry about. It is the high hard-fat content of beef, gravy, cheese, sauces and desert type baked goods that we have to worry about and that will cause us MS problems.

Where, in his diet rules, Dr. Swank allowed three teaspoons (15 grams) of hard fat per day and 4 teaspoons (20 grams) of oils per day I try to allow myself zero hard fat (an impossible number) and oil only as needed. I realize that zero saturated (hard fat) is an unreachable goal, but I believe it is my attitude rather than my belly and cravings that makes a difference.

I find that many, if not most, MS patients starting the Lo-fat diet begin by trying to figure out what is the maximum hard fat they can eat under those guidelines.  They almost always exceed Swank’s rules. After all, we are used to eating meat, cheese and fried foods. By just ignoring those foods and totally eliminating those things right from the beginning I found it easier to break old habits and tastes. By sticking to only filleted white fish or white meat poultry as my protein foods and only fixing them baked, broiled or steamed, at least for the first year of the diet, I was able to break my traditional eating habits.

Of course it was hard to do! I liken it to quitting smoking or overcoming alcoholism. First you must really want to change. Then you must reach down and grab yourself by your own bootstraps, pull yourself up and force yourself to do what you need to do. Following the diet is a matter of sheer will power for the first days, weeks and months.

Many people cannot, or will not, self discipline themselves enough to stay with the diet long enough for it to start showing the desired results. And what are the results? Less frequent and less severe exacerbations. But, how does a person know the diet is really working and responsible for improvements in symptoms? They never do really know for sure. But, if a diagnosed MS’er on the diet has a few very mild or no new MS attacks, either he has a benign case or the diet works. It is called faith!

# 2 – I use absolutely no milk products! Dr. Swank says we can use skim milk. No other milk, just skim milk. I tried that. Skim cow’s milk is much worse than no milk! It tastes and looks like blue-water. Yuck!!! But skim milk is all that is allowed on the diet, not 1% or 2%: SKIM. That includes yogurt, ice cream (milk) and cheese as well as drinking milk. I don’t even think yogurt or iced milk can be made with skim milk unless they add synthetic fat and in over 30 years I found 100% skim milk cheese twice and it was absolutely tasteless.

It is easier to make up your mind to do without any milk products at all than it is to feel cheated and sigh and moon over and long for the taste of milk.  And then try to find substitutes for cow’s milk. Soy milk? Rice milk? No thanks; I’ll use fruit juice.  However, I did get a big side bonus by doing without milk. No sinus trouble!

In my younger years I was literally a snotty nosed kid. My nose ran all the time and I had to have my sinuses drained every year. The doctors could never find an allergy that was causing my sinus trouble; they ran every test available in the 1930’s, 40’s and 50’s without finding anything. But from the day I stopped using milk through today I have never had any sinus problem. Who needs milk anyway? Calves? Not me; I was weaned.

The medical community always says not to bother with any special diet to help mitigate MS symptoms. Their reason is always; "A Lo-fat diet has never been proved to be helpful in controlling MS." That is absolutely true. Dr. Swank has used the Lo-fat diet with his patients and recommended the same Lo-fat diet to all MS’ers since 1948. His research clearly shows that on average, seventy-five per cent of the patients who faithfully remain on the Lo-fat diet are still walking and working twenty-five years after diagnosis. But, the NMSS likes to point out, that is not proof!

Proof would be a controlled, double blind study done over twenty-five years. However, there is only one group that I know of with the resources and the expertise to do that kind of a study and have the findings accepted as proof. The National Multiple Sclerosis Society itself! But, for over fifty years the NMSS has refused to do such a study. Why? Just what do you think that proving that the Lo-fat diet is the most successful thing in controlling MS symptoms would do to the NMSS ability to solicit donations and pay themselves nice big salaries? Not to mention the bottom lines of the drug companies which produce the ABC’s.

Greed for money is the most pervasive sin in the world. I'm sorry to say that I do not believe that the people who run the NMSS are without the sin of greed.

Be prepared for the Lo-fat Diet side effects!

Not bad side effects, good ones.  You will lose weight on this diet.  In fact, after you're a couple years into the diet you may be struggling to keep enough weight on so that you don't look like "skinny Mini".

Not to worry.  A human's body weight is a mechanical function of calories consumed vs. calories burned by your living activities.

One of the main reasons for the human race becoming more and more obese is that our calorie count has gone way up during the nineteenth and twentieth century.  

In the United States two hundred years ago it's estimated that the average American consumed 60 grams of fat per day (540 calories of an estimated 3,500) By 1909, the first official records, the intake of fat was up to 125 grams (4 ounces) which translates to 1,125 calories from fat.  By 1948 it was measured at 141 grams (1,269 calories)

Now with the addition of "burger joints" and pizza parlors on every corner the estimates run as high as 200 grams of fat calories daily.  (That's as high as 1800 calories per day just from fat!)

So, if we aim for zero calories from hard fat and limit our soft fat calories to around 30 to 40 grams, we are back down in the range of 270 to 360 fat calories a day.

Even if an MS'er is wheelchair bound and sedentary; reducing fat calories that dramatically will result in a weight loss.  If you start the Lo-fat Diet and at the end of three months you have not lost a significant amount of weight, you are not doing something correctly on the diet! 

The steps every household needs to take in order to successfully live and follow the Swank Lo-hard-fat Diet.

The whole purpose of the Lo-fat diet is to severely limit the amount of fat that reaches your stomach and is then processed through the digestive process.

We accomplish this goal in three ways.  First we reduce the type and amount of hard fat foods we consume.  At the same time we increase the type and amount of non or lower hard fat foods we eat.

Second we change from using utensils and methods of cooking that encourage large amounts of cooking fats to be added to the food preparation.  And instead we learn to cook with a minimal amount of added fat while naturally reducing the amount of fat that our food started with.

Third we learn to add flavor to our meals with herbs and spices rather than the American standard seasoning of salt, catsup and fat.  Every meal should be an adventure of exciting flavors bursting on your taste buds.

The Lo-fat Diet is the most successful for MS'ers when it is started as soon after diagnosis as possible.  Even if a person does not have an confirmed diagnosis of MS, if a physician says possible or probable MS, then you almost certainly do have MS.

At that point your symptoms are usually relatively mild.  The action of the diet is to keep your symptoms just that way.  Mild and infrequent.  However, delaying the start of the diet allows your disease to become more severe and that makes turning it around and controlling your symptoms that much more difficult.

And, there is no reason to delay.  The diet is fun and the food you will eat will probably make you the envy of your friends.  Of course making food this way takes longer and is more challenging.  But, done right, the results are spectacular.  The Mickey D crowd will always think you are weird, but then they have no taste anyway or they wouldn't be the fast food crowd.  However, your friends with discerning taste buds will look at you with envy!

Actually the hardest time to follow the strict Lo-fat diet is about three years after you start.  By then your MS is usually in remission.  You look good, you feel good and even your doctor is just shaking his head about how well you are doing.  You start remembering pizza, grilled cheese sandwiches and banana splits with a fondness that is never really justified.  At that point it isn't too hard to convince yourself that this whole MS thing was all a mistake.  You never did really have MS, your doctors were wrong and they misdiagnosed you.

First stop, pizza and ice cream.  Second stop the local drive through for a couple of those "99 cent heart attacks in a bag".  The third stop (about six to eight weeks later) is your local hospital emergency room for IV Steroids to stop the exacerbation you have caused yourself while a little voice in the back of your head says, "You dummy!  You had MS under control and you blew it over a pizza!"

Forth stop is back to the Lo-fat diet.  

The Lo-fat attitude

Of course, there are always the people who will not follow the diet.  If you read My MS Story on this web site you know that I was like that at first.  But you see, I had an advantage that you don't have.  I had both the depressing sights and sounds of the standard NMSS meeting and the smiling, upbeat sights and sounds of the Swank MS society meetings.  The obvious difference convinced me that the Swank way was the right way.

I'm one of those people of stubborn German heritage and once my mind is made up, short of a major catastrophe, there is no changing it.  Once I had committed to the diet I lived by it.  No question, that was simply the way I ate.

Once an MS patient commits to the Lo-fat diet then it is just a matter of learning how to cook more delicious food than they are used to, and cook it in a different way.  I like to call my cuisine "Lo-fat Gourmet" 

The Lo-fat diet hardware

First the pans.  Buy good quality Non-stick pans for sautéing, sauces and baking.  Old fashioned iron or copper bottomed aluminum pans require added fat for successful cooking.  Our main goal is less fat.

The oven on your stove is your single most useful tool for Lo-fat cooking.  Have an expert repairman come in and make sure that your oven is in top notch shape.  No heat loss.  No variation in temperature.

Oh, I can here some of you moaning now.  "The oven!  I only use that once a year on Christmas!"  Not any more you don't.  It's back to Grandma's style of cooking now.  Frying is not allowed on the Lo-fat diet.  Every main dish must be broiled, baked, roasted, rotisserie cooked or steamed.  So the oven will be one of your main cooking utensils.

Broiling can be done in the oven or on a barbeque.  So the third tool is a good quality barbeque.  I personally don't like the gas grills.  To me half the fun and the main reason for using a barbeque is to impart the flavors of the various woods into the fish or chicken I'm cooking.  I have on hand oak, cherry, maple, mesquite, pine, cedar and even a few pieces of very old, waterlogged driftwood that has a little seaweed tang in its smoke.  Lo-fat gourmet!

A rotisserie is almost a must in this type of cooking.  We have a couple of different styles of rotisserie in our house, but the Showtime Rotisserie by Ronco that we bought from a TV Infomercial is the very best for cooking.  Too bad it is so hard to clean.  Oh well, the bad with the good.

Even after that first year on the diet when you can re-introduce some red meat into your diet, a well trimmed lean pork or beef roast, done on the rotisserie, will be even much less fat than one roasted in the oven.

The last two "must haves" are a food processor and a crock pot or slow cooker.  Of course we also have a vegetable juicer, a hand meat grinder and a microwave.  But none of them are absolutely necessary for our kind of cooking.  The last thing that's necessary is a willingness to dedicate the necessary time and energy as well as a full speed ahead and damn the torpedoes, "can do" attitude. 

The do's and don'ts of the Lo-fat Diet

To really be successful on this diet an MS patient must decide that walking and working are more important than fitting in socially and eating the way most of his/her friends eat.  The old saying, "You are what you eat" is true. 

Our basic problem is that we are no longer on an even playing field with our friends.  It's like if your home town high school basketball team was playing the best wheelchair basketball team in the world.  No mater how good the wheelchair guys are, they can never compete with five athletic guys running, jumping and blocking shots in the air.

Your friends can get away with pizza, ice cream, hot dogs and cheeseburgers (at least until they get obese and need bypasses) you and I can't.  Please don't ask me for any absolute, set in concrete reasons.  I don't know and neither does anyone else.  But I can give you an unproved theory that makes sense to me.  It's not provable, nor is it disprovable at this point.  There's that word "Faith" again.

Medicine has determined that MS is an Auto-immune disease.  They know that the damage to our myelin is caused by T-cells that our own bodies produce.  The reason that the A&B drugs work is that they reduce the ability of our systems to produce the "bad guy" T-cells.  In other words instead of finding out what causes our bodies to make these "bad guy" T-cells in the first place, medicine has found a way to reduce them my making our immune systems non functional!

My idea is simple.  We have an allergy (sensitivity) to hard fat.  How would anybody even be tested for that?  We all know that any time we run up against an allergy our immune system goes into action.  (if it's not suppressed by drugs)  The term Auto-immune has the connotation of an allergy to yourself, but an allergy none-the-less. Why is allergy to hard fat so inconceivable? 

Where do the "bad guy" T-cells come from?  For every allergy our immune system sets up an allergy counter measure.  Sneezing and watery eyes to wash the pollen out of your system.  An ugly, itchy red rash to keep you out of the poison oak or the strawberry patch if that is your sensitivity.  Why not "bad guy" T-cells to attack and destroy the hard fat that is giving our digestive system and liver a bad time?

But, the ingested fat is being broken down into it's chemical parts in order to be used as is or reassembled into fatty tissue in our bodies.  Of course those "bad guy" T-cells don't know what fatty tissue belongs and which fat is allergy!  So they attack and destroy.  And guess what the most hard fat fatty tissue in our body is.  Can you say MYELIN?

The Interferon drugs work by shutting down the natural function of the immune system.  And they do work about 40% of the time.  The diet works by lowering the intake of hard fat to below the immune response threshold.  And it works too, but about 75% of the time!

Choices: I have chosen the Lo-fat Diet course.  First of all it saves me personally thousands of dollars every year in food costs and does not cost everybody around me a lot of money.  Second, looked at in the proper context, the diet is not a burden.  It is fun and darn good eating!  Third, drugs promote side effects that decrease a persons quality of life.  The Swank diet is the most healthy one ever devised.  It promotes good health and an enhanced quality of life.

Don't take my word for it alone.  Spend some time in the privacy of your bathroom conversing the pros and cons of diet and drugs with the person looking back at you from the mirror.  Have a discussion and come to a consensus conclusion.  The person in the mirror won't steer you wrong and won't let you lie to yourself about what you can do or not do.  What do you have to lose?