Guest post by Dr. Terry Wahls A decade ago, autoimmune specialists claimed that diet did not really matter and did not give dietary advice to their patients. However, in the last decade, the number of papers discussing the link between diet and autoimmune symptoms has steadily grown. Today, physicians can talk very clearly to patients and clients about how the quality of diet impacts symptoms and explain that it matters a great deal. I’ll briefly comment on the research about using a special diet to treat autoimmune problems and the various strategies that may benefit your clients. Working with clients to successfully implement a therapeutic diet is challenging. We do not have head to head studies that identify which diet is the most effective. At present, I think the Wahls Diet will be the most effective, but if clients are more interested in another eating plan, you should work with them to fully implement the therapeutic diet they choose. Later you can decide if that diet has produced the desired results. If not, that client should consider trying a different therapeutic diet. It is likely that we have different underlying genetics and microbiome populations and that those variations determine the effectiveness of different diets at reducing autoimmune symptoms and improving quality of life. Low saturated fat diet. Swank followed 144 patients with MS who were advised to eat very little saturated fat (<15 grams). The results were that patients who followed this diet were more likely to be still walking 50 years later than those who did not. Elemental diets. These are diets are based on amino acids, fats, and simple sugars. No food is consumed other than through elemental tube feeding. There are no proteins in the tube feeding — only amino acids. This dietary approach reduced leaky gut (according to lab measurements) and was the equivalent of taking prednisone for patients with Crohn’s disease or Rheumatoid Arthritis (RA). Exclusion diets. There are several small pilot studies that have eliminated specific proteins (gluten-free, raw vegan, gluten-free and vegan). These diets have been associated with reduced symptoms in the setting of RA and inflammatory bowel disease. Autoimmune Protocol (AIP). There is one pilot single arm study of patients with inflammatory bowel disease that demonstrated reduced symptoms and decreased severity of disease as observed via colonoscopy. Modified paleo diet (Wahls). I have several studies examining the modified Paleo diet in the setting of multiple sclerosis that have demonstrated improved energy, improved quality of life, and improved motor function. We have also studied the ketogenic version of the Wahls Diet and found an association with improved quality of life. There is currently a paper on these results under review. Fasting mimicking diet. This is very interesting work by Dr. Volter Longo. The animal model demonstrates many health benefits. Fasting changes some hormonal pathways and shifts resources away from reproduction towards repairing our cells. In animal models, fasting is very potent in terms of anti-aging effects. In animal models, fasting has shown to have repairing effects on heart disease, liver disease, and multiple sclerosis. It has also shown promise in reversing diabetes. This group has reported on a small study conducted in Europe that compared a fasting mimicking diet, ketogenic diet, and control and demonstrated that both fasting mimicking diet and ketogenic diets were associated with improved quality of life. Additional studies are being planned in the U.S. and we are hoping to be one of the study sites. Mediterranean diet. There is a case-control series that has demonstrated a Mediterranean diet was associated with improved quality of life. If you want to learn more about these therapeutic diets and how to use motivational interviewing and self-determination theory in your clinical practice, consider attending the 2019 Wahls Protocol® Seminar and taking the certification program to become a Wahls Protocol® Health Professional, I am waiving the application fee for NTA grads. Every year we see a greater demand for certified Wahls Protocol® Health Professionals to help people utilize the Wahls Protocol® in their journey to better health. Plus, the Seminar is approved for NTA continuing education credits. Visit https://terrywahls.com/ntagrad/ to read my latest research and view the remarkable gait videos from my research lab.   Learn more about Dr. Wahls’s research and the connection between autoimmunity and food during a NTA FB Live Interview.  Dr. Wahls will be interviewed on the NTA’s Facebook page Tuesday, November 20th at 11 am PST.  Register for the live event.       References • Review of MS patient survival on a Swank low saturated fat diet.Nutrition. 2003 Feb;19(2):161-2. Review. • Effect of low saturated fat diet in early and late cases of multiple sclerosis. Lancet. 1990 Jul 7;336(8706):37-9. • Multiple sclerosis: twenty years on low fat diet.Arch Neurol. 1970 Nov;23(5):460-74. • Low-fat, plant-based diet in multiple sclerosis: A randomized controlled trial Mult Scler Relat Disord. 2016 Sep;9:80-90. • Kjeldsen-Kragh J, Haugen M, Borchgrevink CF, Laerum E, Eek M, Mowinkel P, Hovi K, Førre O. Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. Lancet. 1991 Oct 12;338(8772):899-902. • Kjeldsen-Kragh J, Haugen M, Borchgrevink CF, Førre Vegetarian diet for patients with rheumatoid arthritis–status: two years after introduction of the diet. Clin Rheumatol. 1994 Sep;13(3):475-82 • McDougall J, Bruce B, Spiller G, et al, Effects of a very low-fat, vegan diet in subjects with rheumatoid arthritis. J Altern Complement Med. 2002 Feb;8(1):71-5 • Hafström I, Ringertz B, Spångberg A, et. al, A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Rheumatology (Oxford). 2001 Oct;40(10):1175-9. • Hagen KB, Byfuglien MG, Falzon L, et, al. Dietary interventions for rheumatoid arthritis. Cochrane Database Syst Rev. 2009 Jan 21;(1): • Smedslund G, Byfuglien MG, Olsen SU, et. al, Effectiveness and safety of dietary interventions for rheumatoid arthritis: a systematic review of randomized controlled trials. J Am Diet Assoc. 2010 May;110(5):727-35. • Konijeti GG1 Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease.Inflamm Bowel Dis. 2017 Aug 29. • Randomized control trial evaluation of a modified Paleolithic dietary intervention in the treatment of relapsing-remitting multiple sclerosis: a pilot study. Degener Neurol Neuromuscul Dis. 2017 Jan 4;7:1-18. • A multimodal intervention for patients with secondary progressive multiple sclerosis: feasibility and effect on fatigue. J Altern Complement Med. 2014 May;20(5):347-55. • A Multimodal, Nonpharmacologic Intervention Improves Mood and Cognitive Function in People with Multiple SclerosisJ Am Coll Nutr. 2017 Mar-Apr;36(3):150-168. • A Diet Mimicking Fasting Promotes Regeneration and Reduces Autoimmunity and Multiple Sclerosis Symptoms. Cell Rep. 2016 Jun 7; 15(10): 2136–2146.