Professor Roy Laver Swank was a pioneer in MS research. His successful treatment of 144 people with MS with a low saturated fat diet over 34 years was a breakthrough in MS management, and should have been acknowledged as such by his peers, and taken up by the profession. But on reading his ‘Multiple Sclerosis Diet Book’, a startling fact emerges. Swank appears to have predicted the work of Zamboni in his Chronic Cerebro-Spinal Venous Insufficiency (CCSVI) hypothesis of MS causation. Not only did he develop the treatment for the disease, but he may have found the cause as well.
On p81 of his book, Swank says: “…the frequent location of the pathological lesions (plaques, or areas of demyelination) in the brain and spinal cord surrounding small venous channels, suggest that the small blood vessels (microcirculation), which includes the arterioles, capillaries and venules, play a role in the genesis of this disease. This contention has been supported by the observations that small arterioles and venules of the brain and spinal cord are thickened, often tortuous, nodular, and alternately constricted and dilated….”
On p84 Swank states that “…Recent study of the cerebral blood flow (CBF)……revealed significant reduction of the flow in the MS patients. …In patients with MS, there was a progressive, generalized decrease in CBF….The rates of decrease were significantly greater than in normals, and they correlated directly with the speed of progress of the disease.”
But Swank took things further than Zamboni. He postulated a cause for these small blood vessel obstructions and decrease in blood flow: on p86 he says: “A search for a mechanism that could cause both an interference with, and slowing down of, the cerebral… blood flow, and breakdown of the blood-brain barrier in the central nervous system, leads to a consideration of the circulatory changes that have been observed in a number of species, including man, following large saturated fat meals.” And of course he followed this up with an intervention trial, where he gave people with MS a low saturated fat diet, with startling results.
It is extraordinary that we in the medical profession have ignored Swank’s work for so long. In hindsight, not only did he develop his theories from basic observational epidemiological studies, as we do today, but he did laboratory work to confirm the likely causes of circulatory problems in MS, and then actually showed that changing the diet from saturated to unsaturated fats stopped disease progression.
Today, we accept that saturated fat causes many of the circulatory diseases in Western society, including heart disease, peripheral vascular disease, stroke, and so on. These diseases are characterised by narrowing of vessels and reduced blood flow. Zamboni’s contribution has been to focus us again on this mechanism in MS, like the others, a typically Western disease. As with the other diseases, Zamboni’s work suggests that once the damage is done, opening up the narrowed vessels surgically provides temporary relief; but Swank’s lifelong research makes us realise that, in all probability, if we wish to make a real difference long term, dramatic dietary changes are necessary.
Once again, we in the MS community have reason to celebrate the amazing genius of Professor Roy Laver Swank.