My Big Hairy Audacious Goal: Changing the Standard of Care
My big hairy audacious goal is to change the standard of care. I want all patients newly diagnosed with MS, autoimmune condition, or a complex chronic health problem that includes neurological or psychological symptoms to be immediately told to improve their diet, manage their stress, and continue to exercise. I want them to know that these changes will improve their disease course and health outcomes.
It is not an easy journey. Those with a new paradigm for understanding or treating disease often run into a brick wall. Their proposals and ideas are ridiculed. Or condemned. They struggle to get funding to test their ideas, struggle to get their first experiments approved, and then struggle to get their first papers about this new paradigm published.
In 1982 Barry Marshall was convinced that the bacteria Helicobacter pylori was the cause of stomach ulcers. He and his ideas were ridiculed. He struggled to get funding to test his theory and to publish his findings. But in 2005, Dr. Marshall was awarded the Nobel Prize in medicine for discovering the bacterial cause of stomach ulcers. He’d changed the standard of care.
That is my mission: to change the standard of care for people with multiple sclerosis.
I began this journey 15 years ago, when, in 2008, I stunned my family, my physicians, and myself with my remarkable reversal of profound disability.
As I began telling my story of recovery from profound disability, some people were inspired. Others were deeply skeptical and considered my ideas dangerous. I was banned as a speaker by the National Multiple Sclerosis Society because they believed I was offering “false hope.” Many in the neurology and multiple sclerosis community condemned me and my message.
However, the chair of internal medicine at the University of Iowa, Dr. Rothman, was a rheumatologist. He had watched my descent into profound disability and remarkable recovery. He’d told me that a single case report has the power to change everything. He directed me to work with my treating neurologist and physical therapist to write a case report detailing my protocol and my recovery. Then he directed me to begin doing clinical trials, testing my protocols in others with progressive multiple sclerosis (MS), and helped me get mentors to support my research.
It took a year to get approval to do the first study, and two years to get the first paper published. We continued our work, doing more trials, writing papers, and building a body of research that supports this new paradigm, that a better diet and exercise are key to good outcomes for those with MS. We have done 7 clinical trials, published dozens of papers related to diet and multiple sclerosis[1-28], and our work has been cited over 1,700 times by other scientists.
A recent network meta-analysis completed by Dr. Snetselaar that examined all of the diet studies conducted in the setting of multiple sclerosis with fatigue or quality of life as an outcome found that the diet that was most effective for reducing fatigue and improving quality of life was the modified paleolithic diet. Furthermore, the paleolithic diet was twice as effective as the Mediterranean diet. The meta-analysis was published with an accompanying editorial that stated there is now good evidence that diet influences disease course and that all patients should be referred to a nutrition professional to improve their diet. These two papers were published in Neurology, one of the highest impact journals in my field that is widely read by the physicians who care for MS patients. Now my ideas are not so crazy. This is progress.
But diet, exercise, and stress management are not yet the standard of care for treating MS. For that to happen, we need more high-quality research that investigates diet and lifestyle in the setting of MS, other autoimmune conditions, and complex chronic disease states. We need research that is randomized, with a control or usual care arm. And we need research that includes some mechanism or biomarker data.
I am committed to conducting those studies, collecting that data, and writing up the results in manuscripts that I will submit to the highest impact peer-reviewed scientific journals, such as Neurology, The New England Journal of Medicine, Science, and Nature. I want my postdoctoral fellows to gain the skill and confidence to create their own research teams that also investigate how diet and lifestyle impact health and cellular mechanisms in those with multiple sclerosis, neuroimmune conditions, and complex chronic disease.
I am creating a research portfolio whose mission is to study the diet and lifestyle interventions that consistently help people achieve clinically meaningful improvements in quality of life and clinical function, in short, the restoration of health and vitality. I am committed to conducting studies with basic science collaborators to investigate the molecular mechanisms of how these interventions improve the health and vitality of multiple sclerosis, neuroimmune, and chronic complex disease patients.
It is a big vision. But we can do it. It takes 30 years to change the standard of care, and we are halfway there. We can and will change the standard of care so more people can live healthier, happier lives. But we need your help.
If you want to help me change the standard of care, I invite you to support our research. Contributing to the Wahls Research Fund means contributing to more innovative research, more published papers, and more awareness that diet and lifestyle can help patients have a higher quality of life. Increased funding would allow the Wahls Lab to do more of the following activities.
Obtain preliminary biomarker data for our grant proposals
$25,000 to $100,000
Having preliminary biomarker data makes our grant proposals stronger and more likely to be funded. We already have frozen biospecimens from study participants that we want to analyze for changes in markers of neurodegeneration (serum Neurofilament light chain and other markers of neurological damage), oxidative stress, mitochondrial function, and inflammation. These funds will allow us to conduct analyses and generate preliminary data that can help explain the molecular mechanisms by which changes in diet and lifestyle lead to reduced symptoms and better function. This kind of data makes grant applications much stronger and more likely to be funded.
Fund postdoctoral research scholars in the lab
Hiring postdoctoral scholars increases the Wahls lab’s ability to write more research papers and apply for more grants. Postdoctoral scholars help conduct biomarker analyses and learn how to conduct clinical trials that investigate diet and lifestyle in the setting of complex chronic disease states. Having additional postdoctoral scholars in the lab will increase the Wahls lab’s impact on the field of diet and lifestyle research in the setting of MS, other autoimmune conditions, and complex chronic disease states.
Fund small single arm pilot studies in new disease states
$250,000 to $300,000
Starting investigations in new disease states is challenging without preliminary data. Having the funds to conduct a small single arm pilot study in a new disease state will allow us to obtain preliminary data we can use to add more disease states to our research portfolio.
Contact the University of Iowa Center for Advancement Development team to learn more about Dr. Wahls’ innovative research by reaching out to Hayden Bevelacqua Hayden.Bevelacqua@foriowa.org Office: 319-467-3382,
Implications Of Our Studies:
We think everyone should be using a therapeutic diet and lifestyle as part of their treatment of multiple sclerosis, other autoimmune conditions, and complex chronic disease states. Right now, when most people see the specialist who manages their disease, they are told to start disease-modifying drug treatment right away. They are not told that diet and lifestyle are important factors in disease course and health outcomes.
I don’t know of any other researcher who has a big hairy audacious goal of changing the standard of care so that all patients with MS, other autoimmune conditions, and complex chronic diseases are told as soon as they are diagnosed that it is vital to also address diet and lifestyle, regardless of whether they start disease-modifying drug treatments.
We are committed to doing the research that is needed to change the standard of care. Join the team and help make it happen!
By donating, you become part of a team doing research that is changing lives and improving the future.