Unlock the Ultimate Multiple Sclerosis Diet: Expert Tips for Better Health and Energy!

Multiple sclerosis (MS) is an autoimmune disease where the immune system mistakenly attacks myelin, a protective substance surrounding nerve fibers in the brain and spinal cord. This attack disrupts communication between the brain and the rest of the body, leading to a range of symptoms. While there is currently no cure for MS, various medications and lifestyle changes, including dietary adjustments, can help manage the condition and improve the quality of life for those affected.

Understanding Multiple Sclerosis

Multiple sclerosis (MS) is an autoimmune disorder that gradually destroys the protective coverings called myelin sheaths that wrap around your nerve fibers. Over time, this disease can permanently damage your nerves, affecting nerve communication in the brain and spinal cord. Living with multiple sclerosis (MS) means paying close attention to how everyday choices, like what you eat, can affect your well-being.

Symptoms of MS include:

Fatigue
Tingling
Bladder dysfunction
Movement difficulties and spasticity
Impaired vision
Brain fog

MS is highly complex, and the way the disease progresses varies from person to person. Recent research has linked infection with the Epstein-Barr virus as a contributing trigger of MS, but a cure remains to be found.

The Role of Diet in Managing MS

Although diet cannot cure MS, some research suggests that making dietary changes can help improve health and reduce inflammation. A balanced diet can make you stronger and healthier, reducing the effects of MS. Diet may help with MS in several ways, including: preventing or controlling its progression and reducing flare-ups.

Read also: Managing Weight Loss with MS

Professor George Jelinek pointed out the amazing statement in Neurology, the journal of the American Academy of Neurology, at the end of 2022: there is sufficient evidence to recommend a healthy diet as an adjunct intervention in MS.

General Dietary Guidelines for MS

Currently, there are no official dietary guidelines, or evidence of any specific diet or dietary pattern, for people with MS.

That’s why any dietary guidelines and recommendations for people with MS should aim to improve overall health. Ideally, an MS-friendly diet is:

High in antioxidants to curb inflammation
High in fiber to aid bowel movements
Adequate in calcium and vitamin D to address osteoporosis
High in vitamins and minerals to relieve fatigue and promote wellness

Foods to Include in an MS-Friendly Diet

In short, the guidelines for an MS-friendly diet are similar to an overall nutrient-rich, well-balanced diet.

Here is a list of foods to include in an MS-friendly diet:

Read also: MS and Nutrition

Fruits and vegetables: all fresh fruits and vegetables. They’re also higher in compounds that function as antioxidants, which are molecules that help defend your cells against free radical damage and inflammation. These compounds may help fight inflammation and potentially slow MS progression.
Grains: all grains, such as oats, rice, and quinoa. That’s because plant-based foods and grains are higher in fiber, vitamins, minerals, and fluid, which can help with MS symptoms, such as constipation.
Nuts and seeds: all nuts and seeds.
Fish: all fish, especially fresh fish and fatty oily fish, such as salmon and mackerel, as they’re high in omega-3 fatty acids and vitamin D. Fatty fish such as salmon and mackerel may be beneficial for MS. They are high in omega-3 fatty acids, which reduce the relapsing rate and inflammatory markers in MS. They’re also high in vitamin D, which can help keep your bones strong when combined with calcium. People with MS also have a higher likelihood of vitamin D deficiency.
Meats: all fresh meats, such as beef, chicken, lamb, and more, especially beef liver, which is particularly high in vitamin D and biotin.
Eggs: good source of biotin, vitamin D, and other important nutrients.
Dairy products: such as milk, cheese, yogurt, and butter. Dairy products also show mixed results. In some studies, dairy products were linked to disease activity. However, they’re a good source of calcium, vitamin D, vitamin A, and potassium, so you can try including them in moderation in an MS-friendly diet. Talk with your doctor if you believe dairy products are worsening your MS symptoms.
Fats: healthy fats, such as olive, flax seed, coconut, and avocado oils. This includes foods containing monounsaturated and polyunsaturated fats such as avocados, seeds, nuts and oily fish.
Probiotic-rich foods: such as yogurt, kefir, sauerkraut, and kimchi.
Beverages: water, herbal teas.
Herbs and spices: all fresh herbs and spices.

Foods to Limit or Avoid

An MS-friendly diet limits foods that have been linked to chronic inflammation and other negative health effects, or those that simply make day-to-day activities more difficult for someone with MS. For example, avoiding ultra-processed foods is recommended, as they are known to cause disease in general.

While an MS-friendly diet allows plenty of options, there are still some food groups you can limit or avoid to help manage MS symptoms.

Most of these foods are linked to chronic inflammation. They include processed meats, refined carbs, trans fats, and sugar-sweetened beverages, just to name a few.

Here’s a list of foods to consider limiting or avoiding if you have MS:

Processed meats: sausages, bacon, canned meats, and meats that are salted, smoked, or cured.
Refined carbs: white bread, pasta, biscuits, and flour tortillas.
Fried foods: french fries, fried chicken, mozzarella sticks, and doughnuts.
Highly processed foods: fast food, potato chips, and convenience and frozen meals.
Trans fats: margarine, shortening, and partially hydrogenated vegetable oils.
Sugar-sweetened beverages: energy and sports drinks, soda, and sweet tea.
Alcohol: limit consumption of all alcoholic beverages as much as possible.

Popular Diets for MS

Several diets specifically aim to help slow progression and prevent flare-ups of MS. They include the Swank diet and variations of the Wahls diet. These diets are popular within the MS community.

Before starting any diet, especially ones that restrict food groups, talk with your doctor. Your doctor can help you decide whether starting a diet is right for you and can make sure that you are getting the nutrients you need.

Swank Diet

The Swank diet for MS is a low fat, low saturated fat eating pattern that neurologist Dr. Roy Swank, MD, PhD, developed in 1948. Its recommendations include:

avoid processed foods that contain saturated fat or hydrogenated oils
limit saturated fat to 15 grams per day; consume no more than 20 to 50 grams per day of unsaturated fats
avoid red meat for 1 year, then limit red meat to 3 ounces per week
avoid dark meat poultry and limit fatty fish to 50 grams per day
choose only dairy with 1% fat or less
avoid egg yolks
consume as many fruits and vegetables as you want
enjoy whole grain breads, rice, and pastas
snack on nuts and seeds daily
consume 1 teaspoon of cod liver oil and a multivitamin and mineral supplement daily

However, a 2019 review on the effectiveness of the Swank diet is limited to a series of reports Dr. Swank published. Those who adhered to the diet (consumed 20 grams of fat or less) had fewer and less severe MS-related exacerbations than those who consumed greater than 20 grams of fat. Individuals with lower performance status at the start of the observation period or who were in the progressive phase of MS were likely to experience continued decline, even if they complied with the Swank diet.

While Swank’s studies had a long follow-up duration and large cohort size, they were not randomized controlled trials and were subject to several forms of bias. Larger, better-designed studies are needed to determine whether the Swank diet can help improve symptoms or delay the progression of MS.

Wahls Diet

Dr. Terry Wahls developed the modified paleolithic Wahls diet for managing MS in 2008.

Some evidence suggests that a modified paleolithic diet and taking supplements may help improve perceived fatigue in people with MS.

The Wahls diet is a version of the paleolithic (paleo) diet. The paleo diet promotes eating:

meat
fish
eggs
vegetables
fruits
nuts
seeds
herbs
spices
healthy fats
oils

On the other hand, the paleo diet avoids:

processed foods
sugar
grains
most dairy products
legumes
artificial sweeteners
vegetable oils
margarine
trans fats

The modified paleo Wahls diet makes the following recommendations beyond the general paleo diet:

eat 9 or more cups of fruits and vegetables daily (3 cups each of green leafy vegetables, sulfur-rich vegetables, and intensely colored fruits or vegetables)
emphasize consumption of seaweed, algae, and nutritional yeast
consume limited servings of gluten-free grains and legumes
avoid eggs
consume lower meat and fish intake than the paleo diet

According to a 2021 analysis, the diet is effective in reducing symptoms of fatigue and improving quality of life in MS.

Dr. Wahls developed the Wahls elimination diet in 2015. It recommends avoiding all grains (including gluten-free ones), legumes, and nightshades (including tomatoes, white potatoes, eggplant, peppers, and seed spices) to reduce lectin in the diet.

It also recommends avoiding all dairy and allows for unlimited consumption of saturated fat. Like the modified paleo Wahls diet, the Wahls elimination diet recommends at least 9 cups of fruits and vegetables daily as well as seaweed, nutritional yeast, and fermented foods.

A 2021 study with 77 people with relapsing-remitting MS found that the Wahls elimination diet was associated with an increased quality of life and decreased fatigue. Another analysis of that study found that the diet improved anxiety and depression scores in participants.

However, much of the existing research, including the studies linked here, on the effectiveness of the Wahls diet involves Dr. Wahls. More research without the potential for bias is needed to explore this diet for MS.

It’s also important to note that diets that exclude whole food groups (like grains and dairy in the Wahls elimination diet) increase the chance of nutritional insufficiency. Taking supplements under a doctor’s supervision when on these diets can help reduce the risk of nutritional deficiency.

Ketogenic Diet

A 2022 study examining whether ketogenic diets may help improve symptoms in people with MS did not have promising results. However, this research is ongoing, and scientists need to further investigate the role of diet in MS.

The ketogenic diet is considered in MS research because it’s high in fat and low in carbohydrates. Since myelin is a lipid-based (fat) substance, some research has focused on whether a high fat diet could help restore myelin. However, current results are not reflecting this prediction.

And since it is restrictive, a ketogenic diet can be difficult to follow. Moreover, it restricts food groups that are recommended in an overall balanced diet.

Clinical trials investigating the effects of ketogenic diets and intermittent fasting on MS are currently underway.

Fast-Mimicking Diets

A 2022 meta-analysis found that fast-mimicking diets, or a dietary pattern that involves periodic cycles of low calorie intake, and ketogenic diets have not shown effects on relapsing-remitting MS.

Still, researchers suggest that more large, prospective clinical studies are needed.

In a 2019 study, researchers gave people with MS a ketogenic diet that restricted carbohydrate intake to fewer than 20 grams per day for 6 months. They found that the diet helped improve fatigue and depression, promoted fat loss, and reduced inflammatory markers.

However, this study included 19 people, and only 15 remained in the study for the full 6 months. Thus, more large studies are needed.

Practical Tips for Managing MS Through Diet

In addition to the diet guidelines in this article, people with MS may want to consider the following food tips to help manage their symptoms.

Make sure you eat enough food: Eating too few calories can cause fatigue.
Prep your meals in advance: If you have time, batch-making meals can help you save energy later. If you’re often fatigued, this can be especially helpful.
Rearrange your kitchen: Place food, utensils, and other equipment in areas that are close by and easy for you to clean up. This will help you save energy.
Try “ready-to-use” items: Buying precut fruits and veggies can help you shave minutes off cooking time and make cooking simpler.
Make thicker drinks: If you have difficulty swallowing, preparing thicker beverages like a nutrient-rich smoothie may be easier to manage. Choose soft, moist foods: If you have difficulty swallowing, make smoothies with Greek yogurt, protein powder, berries, nut butters, flaxseeds, and anything else you enjoy.
Soft foods may help: If chewing too much is making you fatigued, try choosing softer foods like baked fish, bananas, avocado, and cooked veggies.
Limit crumbly foods: If you have difficulty swallowing or find yourself choking on food often, consider limiting foods that crumble, such as toast and crackers.
Reach out for help: Even if you do not like asking for help, having members of your support network help with small tasks, like preparing meals, cleaning, or setting the table, can help ease your fatigue. Ask for help: Family and friends often want to help. But they can’t know what you need unless you tell them. Get help with groceries: If fees for grocery delivery aren’t in your budget, ask family members or friends to shop for you.
Stay active: Although exercise can make a person with MS feel fatigued, it’s especially important for helping achieve and manage optimal health and a moderate weight. It’s also important for preventing osteoporosis, which is more common among people with MS. “Staying active can help prevent flares of symptoms,” she says. “Do exercises at home. Do physical therapy. Walk regularly, at least three times a week. Many MS patients are intolerant of heat, which makes it hard to get out and stay active, especially in the summer. Look for everyday opportunities to move your body, Mangan says. “Walking, gardening, dancing, bicycling.
Be a smart shopper: Use a heart-healthy grocery list to guide shopping decisions and avoid impulse buys.
Don’t overlook canned products: You can add lots of things to canned soup, says Oliveira. If you don’t like low- or no-sodium versions, buy regular canned soup and dilute it (4 cups of water to 1 regular can of soup).
Make every bite count: If you don’t have much appetite, or you need to put on a few pounds, nibble on nutrient dense foods with healthy fats in small amounts throughout the day.
Meal prep once a week: Cut up fruits and vegetables to have throughout the week.
Shop the frozen foods section: Frozen fruits and vegetables (without added salt or sugar) have similar nutrients as fresh produce.
It’s helpful to have a registered dietitian on your care team: “A dietitian can make recommendations based on your food preferences and issues like difficulty swallowing or loss of appetite,” says Oliveira. When discussing a healthy diet, in some cases it’s frustrating for people,” says UNC Health registered dietitian Margaret Mangan. Research also has looked at increasing biotin, a form of vitamin B, increasing omega-3 fatty acids, reducing salt, and eliminating gluten or dairy products from the MS patient’s diet. “While there is no answer to which dietary approach is better, it usually comes down to what the patient wants to do, what is most feasible,” says UNC Health neurologist Irena Dujmovic Basuroski, MD. Financial and cultural issues need to be considered, too. “People usually cannot make large dietary changes all of a sudden, so small but consistent changes over time are recommended,” Dr. Dr. Dujmovic Basuroski says she and other UNC neurologists who treat MS patients often recommend the Mediterranean diet. It’s largely plant-based and limits saturated fats and sugar while emphasizing anti-inflammatory foods such as fruits, leafy green vegetables and olive oil. Obesity can cause inflammation in the body, including the central nervous system, Dr. Dujmovic Basuroski says. “When we talk to patients who really want to address inflammation, we talk about the Mediterranean or DASH or MIND diets. More fruits and vegetables. If you’re going to eat bread, go with a whole-grain option. If you get protein from meat, choose a lean meat. Dr. People should enjoy the foods they eat, Mangan says. Healthy foods can become comfort foods, depending on how you cook and season them. “People tend to consider healthy food as boring,” she says. Vegetables and salads are great examples. There are many resources at your local library and online that provide education and techniques for making healthy meals you will love eating. “You want to fill your body with goodness,” Mangan says.

Additional Lifestyle Changes to Benefit MS

Beyond diet and exercise, other habits and routines, like those around stress and sleep, can affect MS symptoms.

“Often, people living with MS say that their symptoms increase with stress,” Castillo says. “Increasing stress resiliency is something that can help manage stress.”

If you’re living with MS, Castillo recommends reframing the way you view stressful situations and practicing mindfulness. Some of her stress management tips include the following:

Adopt an attitude of gratitude. This means consciously expressing thanks for the good things in your life that you may sometimes take for granted. They can be small, like having running water in your home, or large, like having great relationships. This will help you focus on the positive rather than dwelling on the stressful.
Treat each problem as a learning process. Think of how much you’ve learned by solving or coping with problems in the past. Perhaps you had the opportunity to try something new or broaden your perspective. Maybe the problem you encounter now could be a chance to gain wisdom, empathy or new skills.
Nurture a positive view of yourself. Avoid comparing yourself to others, and grant yourself patience and kindness. Try to eliminate negative self-talk. Instead, do some positive affirmations. Notice the things you like about yourself. Set achievable goals, and celebrate yourself when you reach them, whether they are big or small.
Find a healthy go-to stress management technique. Castillo suggests putting your hand over your heart and taking three slow, deep breaths when stress starts to overwhelm you. You can also try a few moments of mindful meditation, getting some fresh air outside or doing some light exercise. Stick to whatever works for you.

Castillo also recommends paying attention to your sleep habits.

“The long-term effects of sleep deprivation are significant,” she says. “It can impair a person’s mental ability, lower their quality of life and may place their physical health at risk.”

People 17 or older need about seven to nine hours of sleep per day. Tips Castillo recommends for MS patients to improve their sleep habits include the following:

Put down screens at least 90 minutes before bedtime.
Exercise daily.
Control caffeine intake.
Reduce or avoid alcohol consumption.
Avoid nicotine.
Sleep when you need to, even if that means an early bedtime.
Get comfortable.

tags: #multiple #sclerosis #diet #recommendations