Profound New Research on Improving MS with Diet - with Dr. Wahls | The Empowering Neurologist EP.149

that that was the moment when i understood that the current understanding of ms is incomplete and that who knew just how much recovery might be possible uh because up until then i had learned to take each day simply as it unfolded and i didn't know what any of it had meant but when i rode my bike around the block what i understood was who knew what might be possible [Music] [Applause] [Music] hello everyone welcome again to the empowering neurologist i'm dr david promoter today on the program we're going to talk about multiple sclerosis it's a an autoimmune condition we're seeing more and more of that condition in terms of its incidents and noting that it is like other auto immune conditions in general more common in women uh generally people get diagnosed with ms there are a variety of drugs that are chosen to treat them to try to tamp down the immune system but you know for many years lifestyle factors have been recognized as playing an important role primarily diet you know years ago we used to do what was called the swank diet we're going to be talking about that today but there's a better diet out there and it's been developed by our guest today dr terry walls she's been on the program before dr walls is the author of a terrific book called the walls protocol i'll read it to you a radical new way to treat all chronic autoimmune conditions using paleo principles we'll discuss what paleo principles is all about let me tell you a little bit more about dr terry walls she is professor at iowa university of iowa where she conducts clinical trials testing the efficacy of diet lifestyle to treat multiple sclerosis and certainly her protocols have been extended to other autoimmune conditions we're going to jump right in and look at a very recent study that she just published and i'm very much looking forward to reconnecting with dr terry walls well hello dr walls how are you doing uh hi david so glad to see you i'm glad to see you too um we're going to talk about your new study which compares a number of results that you evaluated based upon comparing your protocol versus the the the swank diet which is you know the only thing we had for so many years as related to an autoimmune condition multiple sclerosis but let's first take a step back a little bit and let me ask you what why did you become interested in ms well i became interested when i was diagnosed in 2000 there you go and when you were diagnosed you uh were offered up i guess the standard of treatment how did that play out for you and yeah you know where i want to take it is how did we get to a place now where you're not just thinking about lifestyle issues but actually putting them to the test yeah you know so i was diagnosed i i did some research sought out uh one of the best ms centers in the country which is the cleveland clinic and saw the best person uh took the newest drugs and continued to decline now at that time i had trigeminal neuralgia i had weakness in my left leg uh 13 years earlier at i'd had an episode of dim vision in my left eye that they decided was probably optic neuritis and at that time you know i was following the low fat diet you know swank diet was all that was out there and so i was uh very carefully uh low-fat and is also a vegetarian so it's probably more like the mcdougall diet in many ways so in retrospect you'd say that your diet would be with what you know now might have been sort of making the wrong choices being vegetarian risking being low in vitamin d low in vitamin b12 and actually not leveraging the notion of how fats can reduce inflammation and balance immunity well you know at the time uh you know i had really accepted the cholesterol hypothesis for heart disease and you know swank was all that we had so i thought i was being as aggressive as i could be for managing my disease uh it is you know it's interesting uh that in 2002 i i'd clearly had lost a lot of ground i couldn't run anymore walking was more difficult sitting up was more difficult fatigue was a bigger problem in my physicians told me about the work of lauren curdain and suggested i look into adopting a paleo diet and then that was a big decision um which i did do so i slowly reintroduced meat i gave up grain i gave up dairy gave up legumes so it was a very big change in my diet so what does that mean a paleo diet why is it why do they call it a paleo diet and and why might that be valuable for someone with an autoimmune condition well the theory and lauren curdain was the fellow who advocated this he said that uh the foods that were introduced when we became farmers were introducing new protein compounds that were unfamiliar to our species and that they would have more lectins in them and those are proteins with the sugar chi chain and depending on the individual you may have an abnormal immune response to that so we advocated for a lower lectin diet he advocated for meat vegetables eggs he suggested removing grains legumes in dairy and and so it took me several months to make that change i did that but unfortunately for me i continue to decline and yet um you know you did implement some pretty powerful lifestyle changes there and and really trying to target your genome with different signaling i mean what you mentioned is that uh suddenly when we adopted agriculture that was a huge shift for human physiology to try to you know to try to adjust to these lectins these grains these these proteins to which for to any significant degree our our physiology had never really been exposed correct now you know one of the things that i did do that was um really very very helpful i'd been an athlete before becoming a physician i and once i was diagnosed with ms i i've sort of felt relieved to understand why mathletic performance had declined so much but i knew i had to keep exercising as much as i could so i would stay as functional as i could for as long as possible so i was committed and i continued to do a workout every day although i kept getting smaller and smaller and smaller of course uh and then uh was impossible to jog and that of course that happened very quickly and walking was getting difficult uh very quickly uh and i was sorting out you know should i put in a pool i and i was fussing over how expensive it was going to be my mom sat me down very wisely said terry for heaven's sakes if this is what keeps you mobile it's the best money you'll ever spent in your life put in the pool uh and um you know i did and any specific tricks on the temperature of that pool that you thought about um i kept it cool i kept it very cold uh and so you know and i wouldn't heat the pool so during the winter it would get very cold i was swimming uh in you know 72 then 68 it'd get as cold as 55 degrees and so that is a cold swim well our our friend uh wim hof would be very proud of of hearing that you know it was many many years ago probably perhaps a century ago when uh the diagnosis of ms would be made by putting people in the hot bath called the utah phenomena where their ms situation would deteriorate so i think there's some wisdom there though from you and that is that ms patients should be thinking about you know the the possible issues related to getting too hot or overheated versus the benefits of a cold how bad did you get with your ms um bad really bad so we're going to take this on uh two realms one is uh the fatigue and the motor function uh within three years i am having difficulty walking my physicians suggest a tilt recline wheelchair which i adopt and by 2007 i cannot sit up in a regular chair as i am now i have a zero gravity chair which i recline back with my knees higher than my nose i and i'm spending more time fully reclined or in bed uh an another problem that i have is the trigeminal neuralgia which is becoming more frequent more severe much more difficult to turn off back then uh back then um so i was on uh gabapentin uh first i would take it just intermittently when these episodes would come on then i was placed on maintenance dose then i was on maximal dose then i was going to the pain clinic when these would turn on up for injections then i was going to the pain clinic plus i was taking cellular then i was going to the pain clinic plus i was now taking five days of salumetral to get it turned off so steroid yeah so in the summer of 07 uh you know it's very clear to me that i'm headed towards becoming bedridden i'm beginning to have brain fog so i'm headed towards cognitive decline possibly dementia and that my trigeminal neuralgia is likely to turn permanently on and be unable to turn it off and once it was turned on uh david i i was you know a breeze in my face would trigger the pain light would trigger the pain sound would trigger the pain uh talking would trigger the pain swallowing would trigger the pain so you know the pain would go out would get turned on i'd grow the pain clinic i'd get get my injections get my cellular my my kids would go stay with someone else uh as would our dog so things would be very quiet i'd be in a dark room uh and uh drooling because i i wasn't willing to swallow and i wasn't willing to talk uh and so um i you know i was coming to terms with bedridden demented i'd and my presumption would be if i got if my pain turned on where it was that permanently on the agreement would be there would be no feeding tube that's quite a story i mean i i i've heard you lecture many times and i've heard the part about the wheelchair and losing ambulation and the fatigue and and the cognitive issues but i think you know it's really helpful to describe this uh ticdolaroo the trigeminal neuralgia that you were experiencing and how you know many people suffer from that and it's it can be devastating in terms of the pain and sometimes it can't be remediated no matter what happens but i think the the point i'd like to make is that this can be seen in multiple sclerosis so for people mostly women who are having that issue it's worth a diagnostic exploration that are there other issues that could have in the past been related in your case probably the optic neuritis or what does the mri of the brain look like so that's actually very valuable so here you are you can't basically can't do much you're afraid to swallow because of your facial pain keeping in out of the light can interact probably with people can't walk and uh things are looking pretty pretty grim things looking grim you know unfortunately fifth day of salumetra pain stopped and so that's where i am in 2007 uh and of course that looks like a very grim future because what was clear i've been having those pains for 27 years and for 27 years they've been getting more more frequent more severe and relentlessly more difficult to turn off so you know i could unfortunately imagine that i would quite possibly find myself in a circumstance where the saudi mud say metro would not turn it off and i'd be left with continuous relentless electrical pain across my face and just for the viewer solumental is a an injectable steroid very powerful steroid designed to turn down inflammation and it sounds as if you did re receive some benefit from it were these rhizotomies that you were getting or what were the injections that you're talking about well those were injections uh on my scalp and along my c-spine uh of uh lidocaine and decadron uh and here so i was getting multiple ejections across my scalp and my neck that would turn the pain off for about six hours then they they would come back and i'm waiting for the effect of the cellular so i'd go in for injections every day and you know eventually the cellular would kick in the pain would stop i would not have to go back to the pain clinic and then i would wait for when was it going to happen again next you know it's one thing for a physician to have experiences with patients and write a book about it and and help people but you know this is first person you know you're you're uh ultimately dealing with ms patients but look where you are right now uh in 2007 in you know in the in terms of suffering from the very condition that you've made your life made into your life work so what happened then when did things start to improve you know um so when i hit the wheelchair in 2003 uh that's when i said you know am i really doing everything that i can so i went back to reading the basic science and at that time nobody was talking about mitochondria as being a player for ms i and my my take in the literature was that i had a couple of relapses but most of my course was this slow relentless decline so biologically i thought i had much more in common with progressive ms and so that was the literature that i was reading and i was reading about nerd degeneration which then got me into reading mitochondria so my first aha was okay so what supplements could help the mitochondria work more effectively so i'm adding those and what i can tell is that is slowing my decline you know actually it's sort of funny i had taken this supplement cocktail for about six months decided it hadn't done anything for me so i stopped it and could not function at all and then three days later my wife jackie brings it in and says you know honey i think you ought to take all your supplements again i took them and i could get up and go back to work so i was very excited a couple weeks later i did the same experiment stopped all my supplements was completely exhausted could not function waited three days resumed them and could function so my conclusion was the supplements were slowing my decline they were doing more for me than my disease modifying drugs at that time i and it got me much more excited about reading the basic science and experimenting on myself and then uh in the summer of 07 i discovered um because i was on the institutional review board a study that used electrical stimulation of muscles uh in people's spinal cord injury so i thought well that's pretty interesting i and convinced my physical therapist to give me a test session and to let me try that i and the test session by the way was quite painful but on the other hand on the other side of it i felt great the best i'd felt in years i and so i began adding e-stem to my physical therapy and i would gradually increase uh the dose of the e-stem and then uh at about that same time i discovered the institute for functional medicine and took their course on neuroprotection and as katherine wilner uh and uh uh jay um lombard uh that i listened to so i had a longer list of supplements and it felt much more empowered that yes there are things i could be doing and so i added these supplements and then a couple months later i had another really big aha moment is what if i redesign my paleo diet based on the nutrients that science said were really critical for my brain so instead of being focused on what not what to avoid i focus more on what i needed to be sure that i was eating and you know that the first time that i started that was december 26 of 2007 after christmas the day after christmas you know and i had been assigned uh to to join the traumatic brain injury clinic i wouldn't have any residents uh and and i know my chief of staff that assigned me there basically to force me to face medical retirement because he knew was a job i probably no way i could do that physically so in january i go to this new clinic the first couple weeks i just watched what's what what's happening from my wheelchair and then on the third week it's time for you to get up and start you know interacting with patients and seeing these vets and at the end of that week i realized you know that wasn't too bad at the end of the next week it's like i can do this and my energy is better and you know my face hasn't bothered me at all i and two more months later i um this is a sort of a stunning uh uh day i had a letter to mail and it was going to be down the hall about 200 yards and i decided you know i wonder if i could walk there so i i had walking sticks in my office i put the letter in my pocket grabbed my walking sticks and i walked down to mail that letter and people are stopping me saying oh my god dr walls you're walking what what what happened uh because it had been four years since people had seen me uh walk that's breathtaking you know that's really breathtaking because what we're hearing right now is the development of a story of somebody who didn't succumb i'm going to say succumb to the status quo recommendations you know it's pretty much in mainstream neurology you have ms these are the handful of drugs that are currently being used hope for the best and you know you uh you out of necessity you challenge that you know that whole paradigm and you walk down the hall and mailed that letter i mean this is a screenplay for a movie in my opinion love to see it so you began to recognize that uh what you were doing was effective uh with the premise that you were trying to enhance mitochondrial functionality understanding then that the bioenergetics of brain cells seems and immune cells in the brain might be what you are targeting in terms of their regulation that immune functionality and immune balance is an energy dependent event throughout the body and certainly in the brain so you adopt this diet you're taking these supplements maybe later on we could talk what they may be and uh with time things seem to get better for you you know it and about that time my physical therapist is like yep you're definitely getting stronger he has me starting to lift weights now mind you at first these are really tiny weights uh one pound uh little weights but you know we advance my exercise routines he's advancing the amount of e stim that i'm taking i in uh that spring i i'm now walking around the block i have it in my head that i'd like to try biking again because it's been six years since i've biked it used to be a big part of uh our family life in my life and that mother's day weekend we have an emergency family meeting uh and we decide that i can try biking so my kids are gonna jog along on either side jackie's coming up behind and i push off and i bike around the block oh my gosh so my kids are crying jackie's crying i'm crying yeah and as i talk about it you know i i cry again because that that was the moment when i understood that the current understanding of ms is incomplete and that who knew just how much recovery might be possible uh because up until then i had learned to take each day simply as it unfolded and i didn't know what any of it had meant but when i rode my bike around the block what i understood was who knew what might be possible i think the challenge though you just articulated is that we're up against a dogma that is so entrenched and and pervasive that what is purported to be the only approved treatment plan taking a drug is the only way to go and you know god bless dr swank for for trying something i mean i think you're going to tell us in a little while how that approach a nutritional approach how there were some upsides to swank diet no question but that you know by and large nutrition and an autoimmune condition come on what you know we don't we have drugs for that especially these days you know with all the monoclonal monoclonal antibodies that are advertised on television left right and center you know it it similar for for me in neurodegenerative conditions like um that are cognitive alzheimer's we've seen the brilliant work of dr dale bredesen the end of alzheimer's i mean it's bold but that is uh that's so iconoclastic and that that's a compliment i mean we were told that that's a one-way street and perhaps there could be drugs that could slow the course but the idea of reversing that decline and allowing people to regain cognitive function is still very very much uh looked upon as being you know blasphemy basically and yet we see it happen and here you are telling us in ms that you've had this nice last recovery fortunately the chair of medicine had watched me go from athletic to wheelchair to biking again and he called me in told me first to get a case report written up which we did then he called me back and said do a safety and feasibility study test your protocol in others with progressive ms see if they could do what you did and uh what happens so we we did that we published that and then he was instrumental in helping us get some small pilot studies going showing once again that yes people could implement this diet this program in that we could have remarkable improvements in quality of life reduction fatigue in motor gains well those are big parameters we're going to talk about them through the lens of the new study that you just completed the you were diagnosed with having chronic progressive ms correct so originally it was relapsing remitting ms but within three years i converted to secondary progressive ms i and you know my neurologist uh you know sat me down and said okay at this phase uh the the whole focus is to slow decline so he recommended i take novantrone and said there's a two percent uh risk of converting to leukemia each time you take the drug and there's a significant risk to your heart each time you take the drug but i was thrilled to take the drug because i already knew how disabled i was and so i know i i took the drug continued to decline uh then they said look this is not helping you but we have this new drug tysabri it's really quite miraculous i'm sure that will help so i did several cycles of tysabri uh that did not help i continued uh again to relentlessly decline so we've got um your work you've been publishing these uh studies showing that dietary intervention has a role to play a very powerful role to play who knew please so uh the new study i'm going to just read the title that we'll be talking about it's and we'll have to unpack this impact of the swank and walls elimination dietary interventions on fatigue and quality of life and relapsing remitting multiple sclerosis so um we've talked about the swank diet popularized in late 1940s from university of colorado or oregon i think colorado and dr swank made some observations about ms being the differences in in incidents in various uh areas was it norway yeah of people that were living near the coast ate a lot of fish versus those who were inland and eating a lot more of the foods that you ended up avoiding grains etc and therefore implemented a study i think the main thing that that his study did was really was very reduced in saturated fat and i think that's a big take-home message but um you then used the standard uh swank diet in a group of people and another group of people put them on your protocol which would be more along the lines of paleo certainly nurturing the gut bacteria which we should probably talk about if we have time today but the the protocol basically that you've refined although i hate that word because it sounds like refined carbohydrate that you've refined or you've tested on yourself and then obviously on so many other people over the years and i'm not sure when this study was published it says july 31st 2021. so let's talk about this study i i think it involved 87 people 12 and 24 weeks and uh walk us through first of all uh the differences in the interventions so uh i want to step back just a little bit further we had an observation period so that we could let everyone be compared to themselves uh as a control and that we could document stability of the fatigue of the quality of life of walking so that we'd have a comparison within and between the dietary programs we also and this was a big debate in our team we improved the swank diet uh swank as he originally described the diet focused entirely on saturated fat he did not restrict sugars he wasn't restricted refined grain vegetables were sort of a free food that you could take although he did not have any prescription as to how many vegetables so we re changed that to have uh we continued with the less than 15 grams of saturated fat four servings of grain preferably whole grain in four servings and vegetables on the wall side we add six to 12 ounces of meat or fish no grain uh no legumes uh no night shades for the first 12 weeks although we let people bring nightshades back after 12 weeks uh and six to nine servings of vegetables according to gender and size and the vegetables were divided between green leafy vegetables uh sulfur rich in the cabbage onion mushroom family vegetables and in the deeply pigmented vegetables things like uh carrots beets berries we also encouraged organ meat and we encourage fermented foods nutritional yeast and just a little bit of seaweed so it so the the walls side had a much more clearly delineated dietary plan and then uh you apply various evaluations to these individuals at the outset uh ultimately at several time points along the course and we actually from the the study we're going to look at some of these graphs let's take a look at that first graph if we can sure so pull that up yeah our editing people right now are going to insert this this is the fss number uh letter a in your study so uh we'll gonna go back on um okay so we're we're looking at the first study this uh fss which means what so that's fatigue severity scale score uh and that was our primary outcome it's a very short very easy questionnaire nine questions and it's used across many different disease states you rate your agreement with how fatigue impacts various aspects of your life and the score ranges from seven total fatigue in every aspect of your life to one no fatigue in any aspect of your life so this is a subjective uh a patient-centered uh expression of basically how they're doing with fatigue being uh really what what were you really focused on and it looks like uh again back to the graph that uh in the the swank group which is in the gray column they actually seem to have uh they they drop a little bit in the in their level of uh on the scale versus a a far more dramatic decline that we see at the 12 week versus the 24 week in your protocol well um in the graph you'll see there is a line that indicates clinical significance so a change of 0.45 is clinically significant so both walls and swank hit clinical significance and we have to acknowledge that in terms of statistical difference between walls and swank for the fatigue severity scale they were not different at either 12 or 24 weeks so but comparing them to the level of fatigue they had at run in when they first came in and they were eating their usual diet there was a large reduction fatigue experienced by both by the time you got to 24 weeks walls certainly had a greater fatigue reduction but statistically not different between the two so for our primary outcome we didn't hit our goal because we we had predicted that the walls would have a statistically and clinically greater fatigue reduction than swank from a public health standpoint you know it's great to show that both walls and swank improved now is part of the reason that we didn't see the difference that we improved the swank diet well maybe yeah so so again uh you in a sense you put the swank diet to the test too and it looks as if there's efficacy and as we'll see later on in the rest of the of the data um they're pl there are places though where you pull ahead of the pack i mean yeah let's look at a graph b which is mfis can we can we unpack that one a little bit yeah so that's the modified fatigue impact scale that's a more uh sensitive examination of fatigue it's a longer questionnaire and there the clinical significant number is four and what you see there is that again both groups have clinically meaningful reduction fatigue compared to the run-in period at both 12 and 24 weeks however the walls group has clinically and statistically greater reductions in fatigue than swank at both 12 and 24 weeks so then we're going to look at the mental quality of life that's this now looking at this chart c and one sees looking at this graph this looks pretty dramatic in terms of what what the walls protocol is able to accomplish with these individuals so let me explain uh the quality of life measures uh so this is based on the short form 36 quality of life measures they've added some additional questions that are more ms specific and broken it down to physical health and mental health uh and uh again what you'll see is the walls and the clinical significance difference is five points and so within 12 weeks there is a fairly robust and you've got the graft in front of you uh there i think it was a 14 to 17 points at 12 weeks and at 24 weeks so uh in the papers we don't we don't get to use the terms large clinical significance that's always in the uh eye of the reader so you can use that term dave but i i don't say it all i want so so there is a robust difference from the run-in for the walls group that is larger for the walls group than for the swank group and that again that is statistically different and clinically very different so there's a robust again it's a patient reported outcome but certainly very very meaningful and then as we get to the next graph d this is the physical quality of life scale and and i want to point out that uh these are looked at at 12 and 24. so this is really uh the change from from the run-in that's correct correct okay so go ahead again this is uh built on the short form 36 plus those additional questions that are ms specific it's a great way of looking at your ability to do the tasks of daily life and again five is the clinical significant difference the swank group does have changes uh uh that are just barely present at 12 more noticeable at 24. and again if you look at the walls group again it's 14 to 17 points at 12 and 24. uh so uh in the paper we don't get to call those large but david i'll let you make your judgments as to how significant why do you think you're on the program today i i looked at i read the study multiple times uh and i've been you know working with ms patients for more than three and a half decades and um you know i was around for the walls for the swank protocol i was limiting a total fat and saturated fat so you know i'm a veteran of all this stuff and when i see your diet that targets the microbiome for example and all you know in our understanding of how that's immunoregulatory uh it's thrilling so um let's get to the last graph though uh graph uh e and this is uh gmwt and i think this looks pretty uh okay so well so this is the six minute walk test uh and this is a measure of endurance now because this is a dietary study we asked people to not add new exercise programs during the nine months they were working with us unless their physical their medical team sent them to a physical therapist and we put an actograph on them so we know in fact they did not add any new physical activity so they followed that direction so it's not surprising at 12 weeks there was no change in endurance because you wouldn't expect that and neither walls or swank had any meaningful difference and then at 24 weeks which is really interesting is the walls group did walk farther so we had greater endurance it's clinically significant in terms of statistical difference it's a p-value of 0.08 so not statistically significant but clinically significant improvements in endurance because we improved people's diet i think that's pretty cool more than that so why what's going on here um you know we've had dr gundry on the program talking about lectins and how pro-inflammatory they are how disruptive they are for mucosal linings and barriers uh we've had dr fasano on talking about gluten and what that does in terms of zonulin and again barrier disruption we certainly have talked about the microbiome for many years now and its role in immune regulation and inflammation how do you encapsulate what's going on here with this diet and why it's seemingly so effective not just for you but for ms patients in general well because it is a system that lets us get to multiple biochemical pathways in the body we're improving enough kappa b we're improving intracellular anti-oxidant response element we are improving the myelin we're improving cell membranes we are feeding the microbiome we we also as part of the protocol corrected vitamin d deficiency when we found that so if we're going to restore health we're not going to ever be able to do that by a single molecular pathway programs that address multiple pathways through addressing dietary patterns and ideally also including meditation stress reduction sleep exercise are going to be the ones that will be most effective what i what i think that is so interesting is that even though all we did was focused on dietary pattern we still improved endurance had i been able to do a multimodal program that included diet stress reduction attention to sleep and exercise the impact of course would have been far more magnified you know and you could double click on any of those things and describe biochemically why they are good choices why exercise via stimulation of amp kinase and its role in metabolism up regulating bdnf production so that's a trophic hormone that the neurons love how this the organ meat part of the story for example the vitamin b12 that might be available through that meditation reducing cortisol cortisol disrupted to the gut lining threatening neurons specifically high levels of cortisol so it all comes together and i'm thinking right now and i i would bet that many of our viewers are thinking back to the dr bredesen most recent uh time on the program where he he basically said exactly the same thing that we aren't going to fix pardon me you want to do it all yeah we we live in a world of uh monotherapy and are seemingly uh convinced that there is a magic pill for our ills and what you're describing is attacking this problem through you know multiple inroads jumping on that carousel at multiple stops to realize an improvement which is it the end-all perhaps not i mean is there a place for medication perhaps so but for to do one to the exclusion of the other i think isn't fair to uh doesn't serve patients well when i first started doing my uh research that very first uh program the reason i was able to get it through the irb was that my chair of medicine had become the dean of the college of medicine and behind the scenes he helped get that protocol approved because people said if it worked you wouldn't know the mechanisms i and uh fortunately uh paul rothman said the first question is will people do it and could it work then you could begin to do studies to look at the mechanisms we we have a a study right now in newly diagnosed ms patients where we are back to my multimodal roots diet meditation exercise in a cohort of people david who said newly diagnosed i'm declining drugs i'm going to do diet and lifestyle we're following them along with another cohort of folks who are doing drugs and most of them are also doing diet and lifestyle and we're following their clinical course uh and how many people i have progression i have improvement have relapses uh we'll have our last person through that study in july of 2022 we'll be analyzing the data and hopefully we can come back and talk with you when we get that paper uh published well we will count on that and let me just uh revisit something you just said about you know we live in a world where mechanisms kind of lead where that's the horse before the cart that we have to understand a mechanism whereby this drug targets a certain receptor and lowers blood pressure then we'll try it on animals then we'll do a human trial because we know the mechanism and lo and behold then there'll be an approved treatment but is it really always necessary to have the mechanism understood to lead the way in situations where there's no downside i mean i you can understand risk benefit ratio as it relates to a drug but when you're talking about the things that you are doing there is no downside and if people are improving then why is it so fundamental that we delineate every aspect of the mechanism you know and some might say this is placebo effect and i would say okay who cares the patients are getting better you can call it whatever you like when i first started doing my research and talking about my experience many neurologists certainly uh not people like you condemned what i was doing creating false hope i condemned my research i was severely criticized nationally somewhat criticized here at the university but now that we've had more success with our studies now slowly we are seeing more multimodal studies that are focused on creating health through diet lifestyle mechanisms i so i i think the early work that we did and published was key to that success the other thing that's been key is because my protocol has been so successful with helping people who have resources who then have contacted the university of iowa to say we believe in what walls is doing we want to support her lab and we're happy to write a check so i've been able to do these remarkably innovative studies not because of the nih but because of philanthropy from grateful patients that says it all doesn't it i mean that is really ultimately that's what you aspire to so i want to let our viewers know that your book is called the walls protocol and it talks about what we've talked about today and i have to say that it remains on the top of the list of of amazon books that are dedicated to neurological disease and i'm so happy about that because it your work is so good and i'm just encouraging our viewers to read that book and i'll make a promise to everybody that we'll have you back on the program with your next study and keep doing it as your studies come out thank you thank you you know we have a another study that we will be launching uh probably the next two or three months comparing the modified paleo diet a ketogenic diet dietary guidelines we'll follow people for two years and we will have mris at the baseline at the end of the study and we'll be getting neurofilaments along the way so if you want to be aware of that study you can look for that announcement at walls.uiowa.edu and through the magic of video that is going to appear on the bottom of your screen as we speak and uh having said that you you uh sent me a link to an interesting article uh about neurofilament uh this uh several days ago uh tell us what that that talked about why that's gonna be a really important tool so um we've been searching for some time for uh blood biomarkers that we could use as a way of monitoring changes in the brain and the leading biomarker right now is this neofilament light chain that has been correlating very well with a number of enhancing lesions the volume of enhancing lesions and the rate of brain atrophy uh and this paper that i sent to you looked at a study that had been done in germany comparing in 60 folks 30 that followed the usual german diet 30 that followed a calorie-restricted diet for a week and then switched over to a mediterranean diet and probably was 20 in each group and 20 that followed a ketogenic diet and then they measured the neurofilament levels at baseline three months and at six months what i found exciting was that the ketogenic diet group demonstrated favorable changes in the neurofilament levels at six months so that we could begin to use a neurofilament marker as a measure of what kind of damage is occurring in the brain because if there's more damage that neural filament marker level goes up if there's less damage the neurofilament marker goes down and what makes me excited is i have a freezer of specimens from my prior studies so we've just submitted a grant proposal to investigate our freezer looking for neurofilament levels now why the interest in ketogenic diet well the ketogenic diet uh we have a long history or a longer history that that's been very helpful in seizure disorders uh and uh that became quite popular in the 1960s i believe charlie was the little boy who had seizure disorder and some neurodevelopmental issues who remarkably improved on a ketogenic diet and there's been a great deal of interest in ketogenic diets in the seizure disorders uh in cognitive decline in some alzheimer's studies it's a little more difficult for the mental health studies because of compliance it's also being investigated for insulin resistance disorders i have investigated it for ms i followed ketogenic diets for many years myself although i'm doing more of a intermittent fasting program presently i there are a couple of studies using ketogenic diets for ms with favorable outcomes i and our grateful patient has had tremendous success with the ketogenic diet and so i said we would love to do a longer study of the ketogenic diet dietary guidelines and a modified paleo diet well i think it speaks back to your original observation or conclusion that perhaps mitochondrial upregulation may be fundamental here in immune balance and in just brain energetics in general uh that's the so-called bioenergetic theory of ms and so i'll be interested to hear how that comes out we've as you mentioned seen really nice work by dr matthew phillips in new zealand in both parkinson's and now a new paper in alzheimer's you know the use of this diet as it relates to type 2 diabetes we had dr sarah hallberg on the program talking about you know not just getting blood sugars down but turning the diabetes off i mean what drugs do we have today that actually cure diabetes you know the ma the sulfonureas metformin etc they get the blood sugar down sure but you're stuck on the drug and you know she she's demonstrated how powerfully effective that can be and you know this uh these metabolic issues certainly play into our immune dysfunction issues autoimmune issues as well so it might well be why another reason why we're certainly seeing a powerful uptick a significant uptick in autoimmunity these days you know i think the decline in uh in our the dietary quality that we're seeing around the world you know is probably front and center um you know as we now see such dramatic changes in the microbiome increase in inflammatory markers higher uric acid you know across the board so i want to thank you and a good standing invitation for the the next study when it's completed be delighted to have you back and uh again for our viewers the book is the walls protocol we're going to put a link to this incredible study on the website and dr wallace thank you so much for your time great and i'll get you the links for our upcoming study that'd be great talk to you soon well that really was a very very interesting uh discussion of her latest research again i'll read to you the title of the study impact of the swank and walls elimination dietary interventions we talked about both of those things today on fatigue and quality of life in relapsing remitting multiple sclerosis what a breath of fresh air to recognize that here is a protocol based upon lifestyle change that has such an effect on some of the big issues that relate to ms patients again dr terry walls we're very grateful that we've had her on the program always a terrific guest great information i'll be back soon this is the empowering neurologist and we'll see you [Music] [Applause] [Music] you

Channel: DavidPerlmutterMD

Views: 14,076

Keywords: david perlmutter, dr. david perlmutter, grain brain, dr. perlmutter, brain maker, ms, multiple sclerosis, treatment, recovery, miracle, doctor, science, breakthough, research, patient, diet, nutrition, terry wahls, cure, health

Id: UJaTYfx-uSY

Length: 55min 36sec (3336 seconds)

Published: Mon Apr 25 2022