Never underestimate the power of real food as medicine. Terry L. Wahls, MD, is the senior author on two 2017 clinical studies that looked at the use of lifestyle measures on multiple sclerosis (MS).1,2 Dr. Wahls used a similar program to heal herself after secondary progressive MS resulted in her needing a scooter to ambulate. She credits diet, which she describes in YouTube and TEDx videos, as being the primary therapy that allowed her to regain the ability to walk without assistance.
In these clinical studies, the research team tested the effect of a multimodal program, consisting of a modified Paleolithic diet, an individualized exercise program for stretching and strengthening the trunk and leg muscles, neuromuscular electrical stimulation (EStim) of the trunk and leg muscles, and stress management (meditation and self-massage). The study followed 21 people with diagnosed progressive MS (mean 13.6 ± 7.5 yrs). All participants were able to adhere to the diet and exercise aspects.
The paleolithic diet
The modified Paleolithic diet excluded gluten-containing grains, dairy foods, and eggs (which are common allergens). Green leafy vegetables, sulfur-rich vegetable, and intensely colored fruits or vegetables were recommended (ideally 3 cups of cooked or 6 cups raw of each category per day). Can you imagine eating that much live, whole food in one day?
In addition to the vegetables and fruits, daily intake of omega 3 oils (2 T), animal protein (4 or more ounces), plant protein (4 or more ounces), nutritional yeast (1 T), kelp (1/4 tsp), algae (1/4 – 1 tsp), and nut milks were encouraged. Dr. Wahls taught the diet to participants and supportive family members and provided recipes and menus.
After one year on the program, participants showed a direct correlation between their participation in the intervention and improved mood and cognitive function and reduction in fatigue. Diet was credited for these improvements, particularly, for fatigue reduction. Participants adhered to the food guidelines 94.5% to 98% of days during the 12-month period, accord to patients’ daily home logs.
“Mood and cognitive improvements were more closely related to a higher intake of the modified Paleolithic diet than to exercise and stress management dosage,” say the authors. However, increased exercise dosage did correspond to greater improvement in anxiety and depression scores.
While gait and balance did not show statistically significant improvement overall by the end of the year, walking speed did increase. One woman, in particular, showed impressive improvement. She started with a very poor walking speed at baseline (6.1 cm/sec) and displayed a speed of 24.4 cm/sec at 12 months. The authors note that this person had good family support and adhered to the diet 100 percent throughout the study.
This research is a pilot study; the researchers wanted to find out if it was possible to conduct a year-long study that followed the effects of a diet/lifestyle program. So much of our current knowledge about the effect of diet on health comes from epidemiological studies that look for correlations between food choices and the incidence of disease.
Conducting an actual clinical trial that investigates a particular diet over an extended period has been viewed as problematic—in large part because it relies on participant adherence. The benefit of having less fatigue and the support of family kept diet compliance very high in these people with MS. Have researchers conducted other long-term clinical trials that show the effects of diet on select populations?
1. Lee JE, et al. A Multimodal, Nonpharmacologic Intervention Improves Mood and Cognitive Function in People with Multiple Sclerosis. Journal of the American College of Nutrition. 2017;36(3):150-168.
2. Bisht B, et al Effects of a multimodal intervention on gait and balance of subjects with progressive multiple sclerosis: a prospective longitudinal pilot study. Degenerative Neurological and Neuromuscular Disease. 2017;7:79-93.
