Multiple Sclerosis

There are many different drugs and diets attempting to reduce the odds of future Multiple Sclerosis (MS) exacerbations. For the patient it is vitally important to be able to judge the efficacy of these and how the choices impact their finances, lifestyle and most importantly vitality. This analysis attempts to shed light on such choices with pictures instead of a "mind numbing" list of numbers as done in clinical trials. Although the numbers to back up the pictures are provided and available for more details.

Diet considerations

So let's start with diet considerations. Start with an old Science and Engineering adage:

You can't manage what you don't measure

Unless you measure and track outcomes, you don't know if it is getting better or worse. You can't manage for improvement.

Dr. McDougall study results

This study relied upon only MRI lesion measurements as the primary measurement. So even if there was an exacerbation it was not recorded unless there was an associated lesion on the MRI. Also, there may be lesions without any outward physical signs of an attack. The MRI was to be the primary indicator.

Although the mean does show slight improvement with the diet, the tails of the confidence interval overlap. This implies either the sample size was too small, the study was too short of duration, the measurement result was not conclusive or there was no net effect.

Dr. Swank 50 year study

In this regard, a well seasoned Dr. Swank, MD tracked his patients for over 50 years by keeping good records using measured results. He wrote several papers over his career on his findings. One paper shows the results of tracking patients over 3 years before and 3 years after adopting a low-fat diet. Here is the chart of his results. In the chart it appears the wider the lines the more severe the attack. Notice how much narrower the lines were after starting the diet. One issue is the severity and the other is the quantity.

Then extract the pertinent exacerbation rate

data, we generate a spreadsheet that lists the exacerbation rates before and after the diet.

Then finally presenting this data as a confidence interval to get a picture of the improvement. Notice the tails of the confidence interval do not overlap.

This means, with fairly high confidence, these were very significant results. The improvement of the mean is nearly 3 times better. This indicates a significant improvement in the odds of reducing the exacerbation rate.

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