By Prof. George Jelinek
The OMS program provides dietary guidelines from findings in scientific research, incorporating principles important in managing MS and preventing its progression. The program builds on Dr Swank’s prior work 1-3, taking into account modern data on fats as well as additional evidence on other dietary factors 4.
The OMS plan is a whole foods plant-based diet that includes seafood if desired. It aims to significantly reduce saturated fat intake while increasing the intake of omega-3 fatty acids. It recommends getting a variety of fruits and vegetables; omitting all processed foods, eggs, meat, dairy, and saturated fats; and taking 20-40 ml of flaxseed oil daily. In addition to diet, regular exercise and meditation are encouraged.
The plan is based on research conducted by Dr. Jelinek and colleagues demonstrating important associations. For example, a study involving nearly 2500 RRMS patients showed a significant link between dietary factors (fat, fruit and vegetable intake, dairy, and meat consumption), and health-related quality of life, disability, and relapse rate 5. A later one-year randomized controlled trial of a low-fat, plant-based diet found a statistically significant association with the mental health composite of health-related quality of life 6. Nutritional principles of the diet portion were evaluated in 1346 participants from the Health Outcomes and Lifestyle In a Sample of people with Multiple sclerosis (HOLISM) study over a period of two-and-a-half years. Greater diet quality according to OMS criteria was significantly associated with less severe disability, fatigue, and depression risk 7.
Foods to Favor
· Vegetables: All, with special attention to cruciferous
· Fruits: All but coconut, due to its high saturated fat content
· Herbs and spices: All
· Grains and cereals: It is noted that some people choose to eliminate gluten from their diet, a decision that should be made based on personal sensitivity.
· Beans and legumes: All except peanuts, which are not recommended due to their higher saturated fat content
· Seafood: Lean white fish (e.g., bass, bream, cod, haddock, halibut, monkfish, mullet, perch, pike, plaice, snapper, sole, tilapia)
· Dairy/milk alternatives: All except coconut milk and its products and those made with unhealthy vegetables oils (read labels carefully)
· Eggs: Egg whites can be eaten but egg yolks should be avoided due to the saturated fat content
Foods for Moderation
· Because they are high in important omega-3s, fatty fish (e.g., herring, mackerel, salmon, sardines, swordfish, trout, tuna) are encouraged to be consumed three times per week in servings of 120 g each (before cooking). Shellfish, squid, and octopus are also allowed in moderation.
· Nuts and seeds: Whole and their butters, with the exception of peanuts, which are high in saturated fat
· Fatty fruits: Avocado, olive, and their oils are high in beneficial monounsaturated fat. Of note, avocados are also relatively high in saturated fat and olives are high in sodium, which is why moderation is important. These oils ideally should be cold-pressed and unrefined (sometimes
referred to as “extra-virgin”).
Foods to Forgo
· Red meat, pork, poultry, and their products
· Dairy
· Egg yolks
· Tropical oils such as palm and coconut
· Margarine, mayonnaise, and unnamed “vegetable”
oils
· Baked foods, unless fat-free
· Commercial baked goods
· Other sweets, including candy
· Snack foods, including chips, crackers,
chocolate, snack bars, oil-popped popcorn
· Fried and deep-fried foods
· Fast food
References
1. Swank RL. Multiple sclerosis: fat-oil relationship. Nutrition. Sep-Oct 1991;7(5):368-76.
2. Swank RL, Goodwin J. Review of MS patient survival on a Swank low saturated fat diet. Nutrition. Feb 2003;19(2):161-2. doi:10.1016/s0899-9007(02)00851-1
3. Swank RL, Goodwin JW. How saturated fats may be a causative factor in multiple sclerosis and other diseases. Nutrition. May 2003;19(5):478. doi:10.1016/s0899-9007(02)01099-7
4. Jelinek GA, Hadgkiss EJ, Weiland TJ, Pereira NG, Marck CH, van der Meer DM. Association of fish consumption and Omega 3 supplementation with quality of life, disability and disease activity in an international cohort of people with multiple sclerosis. Int J Neurosci. Nov 2013;123(11):792-800. doi:10.3109/00207454.2013.803104
5. Hadgkiss EJ, Jelinek GA, Weiland TJ, Pereira NG, Marck CH, van der Meer DM. The association of diet with quality of life, disability, and relapse rate in an international sample of people with multiple sclerosis. Nutr Neurosci. Apr 2015;18(3):125-36. doi:10.1179/1476830514Y.0000000117
6. Leong TI, Weiland TJ, Jelinek GA, et al. Longitudinal Associations of the Healthy Lifestyle Index Score With Quality of Life in People With Multiple Sclerosis: A Prospective Cohort Study. Front Neurol. 2018;9:874. doi:10.3389/fneur.2018.00874
7. Simpson-Yap S, Nag N, Probst Y, Jelinek G, Neate S. Higher-quality diet and non-consumption of meat are associated with less self-determined disability progression in people with multiple sclerosis: A longitudinal cohort study. Eur J Neurol. Jan 2022;29(1):225-236. doi:10.1111/ene.15066