Book Review 5.0 out of 5 stars, By Prof George Jelinek, January 1, 2011
5.0 out of 5 stars Recovery from progressive multiple sclerosis is possible, January 1, 2011
Dr Terry Wahls, Clinical Professor of Medicine at the University of Iowa, is an inspiration. She was diagnosed with relapsing-remitting multiple sclerosis (MS) in 2000, and within three years had become wheelchair dependent in the secondary progressive phase of the disease. Her rapid descent into disability was a strong motivation to begin to delve into the scientific literature around MS. Terry began to assemble literature around the health of mitochondria. These little (about 5micrometres diameter) structures live inside our cells and convert food into energy. It is quite likely that over evolution, these tiny particles originated as bacteria that learned how to live symbiotically in cells as organisms grew more and more complex. They play very important roles not only in energy production for cells, but in cell death and ageing. Terry became convinced after reviewing the literature that mitochondrial health was intimately tied up with MS, and set about devising a program to improve the health of her mitochondria. The nutritional program she produced has many similarities with other ultra-healthy diets that have been shown to produce marked improvements in other chronic western diseases. She also added electrical stimulation in an attempt to encourage muscles suffering from disuse to get accustomed to activity again.
The results were astonishing. Six months after starting the program, she attempted to ride a bicycle again, in a year she completed an 18 mile bicycle tour, and now she is fully mobile. Terry chose to spread the word rather than be content with her own improvement. Hence the second edition of her book `Minding My Mitochondria: How I overcame secondary progressive multiple sclerosis (MS) and got out of my wheelchair’, at the time of writing ranked number 8th best-selling MS book on Amazon, was released in April 2010.
Dr Wahls’ book is powerful, as is her story. One of the things that strikes you on reading the various accounts of people who have recovered from MS is the great similarity between their recommendations. Most firmly place optimal nutrition at the top of the list of important interventions. The rationale for Dr Wahls’ nutritional program, of essentially a plant-based diet with an emphasis on plenty of high-antioxidant vegetables and fruit, is to optimise mitochondrial function. But in fact, it is an ultra-healthy diet that also has wide-ranging benefits in the body through many different mechanisms, on lipid profile, endothelial health, the cardiovascular and central nervous systems, blood pressure, cognition, mood, and so on. Whether or not it operates particularly through its effect on mitochondria is actually not clear, but given its similarity to other well-studied nutritional approaches such as ultra-low saturated fat diets (the Swank approach in MS), and plant-based wholefood diets (the Colin Campbell and Dean Ornish approaches to health) in general, there is every reason to expect it would work in MS.
The scientific part of the book is actually quite short, with chapters about the function of mitochondria and cell metabolism, but actually not a lot of clinical evidence presented about a direct link between mitochondrial health and MS, and certainly not a lot of evidence showing the intervention works. That is to be expected given the heavy bias in medical research in general towards drugs. Most of the book is in fact made up of recipes. These can be very useful for people with MS just starting out on a healthy way of eating, who haven’t yet sourced much in the way of recipes for this approach. Most people who are trying to do everything possible to stay well after a diagnosis of MS will have already assembled a recipe bank for daily use from many other sources.
But Dr Wahls is a physician and an MS survivor, and her real strength is not in cooking but in medicine and healing. That it is possible to recover from secondary progressive MS is the real story here. Professor Roy Swank showed in his landmark but often overlooked study that regardless of level of disability at entry, people with MS adhering to his diet had not deteriorated much over the 34 years of study. By implication, given that some with progressive disease got worse and some died from MS, some must have got better and some recovered. But their individual details have never been published. One of the great values of Dr Wahls’ book is that it shows that recovery from secondary progressive MS is possible. It only has to happen once to make it possible, and there can be no doubt she has recovered significantly.
Some may dispute the exact details of the diet, as different commentators often do about any dietary approach to MS, such as Dr Wahls’ recommendation to eat meat (I must admit I cannot reconcile this recommendation with my own review of the literature on diet in MS), or the omission of some key components of optimal health, like meditation, adequate sun exposure, and so on. Others may be critical that there is no direct evidence provided of a link between mitochondrial health and MS, or the suggested diet and the health of mitochondria. Was the diet successful in her case because of its effect on mitochondria, or through some other mechanism? In fact this is largely unimportant. The important thing is that Dr Terry Wahls recovered. Dr Wahls’ story and her book make inspiring reading for anyone affected by MS, particularly those with progressive MS. People with MS, their relatives and their healthcare professionals should take the time to read this book, realise what is possible, and not give up hope even if they have profound disability.