Send to

Choose Destination
Nutrients. 2019 Feb 7;11(2). pii: E352. doi: 10.3390/nu11020352.

Review of Two Popular Eating Plans within the Multiple Sclerosis Community: Low Saturated Fat and Modified Paleolithic.

Author information

Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA.
Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA.
Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA.


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.


Paleolithic diet; Swank diet; Wahls Elimination diet; Wahls diet; low saturated fat diet; modified Paleolithic diet; multiple sclerosis

Free full text

Conflict of interest statement

T.W. strongly advocates for a modified Paleolithic style diet in academic and business settings and follows variations of the Wahls Elimination diet and the various diet plans described in the Wahls Protocol® books and programs. She has copyrights for The Wahls Protocol Cooking for Life, The Wahls Protocol and Minding My Mitochondria, 2nd Edition and has trademarked Wahls™ Diet, Wahls Paleo™ Diet and Wahls Paleo Plus™ Diet. She has not trademarked Wahls Elimination Diet. T.W. has financial relationships with BioCeuticals; Genova Diagnostics; Institute for Health and Healing; Integrative Medicine for Mental Health; MCG Health Inc.; NCURA; Penguin Random House Inc.; Suttler Pacific and an equity interest in Terry Wahls, LLC; TZ Press, LLC; The Wahls Institute, PLC; and T.W. received funding from the National Multiple Sclerosis Society to conduct a randomized clinical trial comparing the effect of the Wahls Elimination and Swank diets on multiple sclerosis-related fatigue. The University of Iowa prepared a conflict of interest management plan for this clinical trial that TW follows to mitigate conflicts of interest. L.S. is a co-investigator on the clinical trial comparing Swank and Wahls Elimination diets and reports no other conflicts of interest; she does not follow a special diet. C.A.C. has been employed by T.W. since 2013, was paid to calculate the nutrient composition of the menus in The Wahls Protocol and was paid for the preparation of this manuscript; she does not follow any special diet. The funding sponsors had no role in the design of the study; in the collection, analyses or interpretation of data; in the writing of the manuscript and in the decision to publish the results.

Publication type

Publication type

Supplemental Content

Full text links

Icon for Multidisciplinary Digital Publishing Institute (MDPI)
Loading ...
Support Center