Unlock the Secrets to Beating Multiple Sclerosis with Proven Diet Tips!

Multiple sclerosis (MS) is an autoimmune disease affecting the central nervous system, characterized by the demyelination of nerve cells. This chronic inflammatory process leads to gradual neuronal damage and is often considered a neurodegenerative disease. While there is currently no cure, effective management strategies are crucial. Alongside pharmacotherapy, nutritional prevention and diet therapy hold significant promise for patients, potentially delaying the onset of the disease, reducing relapses, and alleviating symptoms. Lifestyle habits, including diet and exercise, are known to affect the chances of developing MS and influence how the disease progresses over time. While diet cannot replace treatment with MS disease-modifying therapies, studies suggest eating a balanced diet that provides for all nutritional needs may help patients better manage and control MS. Diet also can help to ease some symptoms of the disease.

The Role of Diet in Managing MS

Diet plays a wide range of roles in an individual’s health, impacting weight and altering the risk of heart disease, bone problems, and other health issues. There is no evidence that any one dietary strategy is best for people with MS. However, studies suggest that a balanced diet that provides for all nutritional needs may help patients better manage and control MS and ease some symptoms of the disease. Being obese or overweight is linked with worse severity of some MS symptoms, such as fatigue and pain. It’s recommended the diet for individuals with MS should be varied and well-balanced to provide all the nutrients the body needs to function.

Key Nutrients for MS Management

Vitamin B12: This vitamin is used to make myelin, the fatty wrapping around nerve fibers that becomes damaged in MS.
Vitamin D: Affecting a number of biological functions, this vitamin is known to impact immune activity. A deficiency in vitamin D has been linked with an increased risk of MS, and patients commonly have lower-than-normal levels of this vitamin.
Calcium: This mineral is needed to maintain healthy bones.
Essential fatty acids (EFAs): EFAs are a class of polyunsaturated fats that cannot be synthesized in the body and must be acquired through diet. They are needed to repair damaged nerve cells and to produce certain signaling molecules that control inflammation.
Antioxidants: Oxidative stress is a type of cell damage that contributes to inflammation in MS. Antioxidants, as their name suggests, are molecules that can lessen oxidative stress, thereby helping to reduce inflammation and neuronal damage.

Fruits and vegetables are a good source of carbohydrates, vitamins, minerals, antioxidants, and fiber. Whole grains are a good source of complex carbohydrates and fiber. Skinless chicken, fish, and plant-based proteins such as beans, peas, lentils, and soy products, are different kinds of lean proteins. Unsaturated fats, particularly polyunsaturated fatty acids or PUFAs - which include EFAs - have been shown to have anti-inflammatory and nerve-protecting properties in animal studies. Another kind of unsaturated fat, monounsaturated fatty acids or MUFAs, are found in food like avocados, peanut butter, and vegetable oils. Considered unhealthy fats, saturated fats have been linked to an increased risk of heart disease; they also have pro-inflammatory effects. In animal models of MS, eating a diet high in saturated fat leads to more inflammation, and higher saturated fat intake has been linked with increased relapse risk and more disability among MS patients. Saturated fats are mainly found in animal-based foods such as whole milk, high-fat cheese, pastries, cured meats, and fatty cuts of meat. Trans fats are strongly associated with an increased risk of heart disease, so most experts recommend limiting the amount included in the diet.

The effects of a high-sugar diet - containing a lot of sweetened beverages and cereals, cookies, and cakes - have not been confirmed in studies of people with MS. But a high sugar intake can promote inflammation and lead to more aggressive disease in MS mouse models. A small study found that MS patients who drink more sugar-sweetened beverages like soda tend to have more severe disease. Evidence suggests the overall severity of MS is not affected by alcohol intake. However, especially in large quantities, alcohol’s effects on the body can cause worsening of numerous MS symptoms, including coordination difficulties, bladder problems, and depression. Alcohol also may interact with medications. It remains unclear whether consuming dairy products affects the course of MS. Some studies have found MS patients who consume more dairy tend to have more severe disease, but other studies have reported the exact opposite trend, with more dairy consumption linked to less severe MS. Full-fat dairy products are often high in saturated fats, but dairy also can be a good source of protein, calcium, and vitamin D. Some research has suggested a link between higher salt (sodium) intake and more severe MS, but other studies have shown no connection between salt consumption and MS severity. A few studies have explored whether gluten intake may influence MS, but there is not enough evidence to make any conclusions one way or another.

Popular Diets and Their Potential Impact on MS

There is no single diet universally recommended for people with MS. Some of these diets have been explored in clinical trials, but studies are generally small, lack comparison groups, and often have high dropout rates.

Read also: Managing Weight Loss with MS

The Best Bet Diet: The Best Bet diet is based on the idea that molecules in certain foods may leak out of the intestines and worsen the inflammatory attack that drives MS. It is a strict exclusion diet that recommends cutting out all dairy, grains, legumes, sugar-rich foods, and any foods that may cause an allergic reaction, such as eggs and yeast. Developed by Ashton Embry, a geologist whose son has MS, the diet consists mainly of fish and lean meats, lots of fruits and vegetables, and olive oil. While some people with MS report feeling better on this diet, there is no research showing benefit for MS patients.
Ketogenic Diet: A ketogenic or “keto” diet is one that is low in carbohydrates and high in fats, leading the body to use fats as its main energy source - a process called ketosis. A few small studies have indicated that following a keto diet may help to ease fatigue and depression, and improve quality of life in people with MS. However, the diet also may have negative effects, like vitamin deficiencies or digestive upset. A pilot study reported by Brenton et al. suggests that a modified ketogenic diet may benefit patients with MS. Despite a small study sample, it has been shown to alleviate fatigue and depressive symptoms, reduce body fat and pro-inflammatory adipokines. More recently, the results of a study by Brenton et al. were published in which 53 patients with relapsing-remitting MS (RRMS) completed a 6-month intervention involving a ketogenic diet. Significant improvements in the patients’ disability status, improved quality of life while on the diet, and reduced fatigue and body fat levels were reported. A pilot study by Benlloch et al. that analyzed the dietary habits of 27 MS patients showed that MS patients who followed a ketogenic, isocaloric diet based on the principles of the Mediterranean diet, rich in medium-chain triglycerides (MCTs), for 4 months showed an increase in lean body mass, an improvement in the patients’ metabolic profile (reduced inflammation) and an increase in satiety.
The McDougall Diet: The McDougall diet is a low-fat, plant-based diet rich in complex carbohydrates, whole grains, fruits, and vegetables. In studies, the McDougall diet has not shown any effect on measures of MS progression, such as relapse rates or inflammatory activity on MRI scans.
The Mediterranean Diet: As its name suggests, the Mediterranean diet is based on the foods that are commonly eaten in cultures surrounding the Mediterranean Sea. The diet includes plenty of fruits and veggies, whole grains, and olive oil, and recommends a moderate amount of low-fat dairy products, fish, poultry, and red wine. There is not much research specifically evaluating the Mediterranean diet in MS, though the plan is generally considered well-balanced and nutritionally complete.
The Overcoming MS (OMS) Diet: The overcoming MS (OMS) diet is a plant-based diet that also includes fish and seafood, but cuts out all processed foods, eggs, meat, dairy, and saturated fats. The diet usually includes daily supplements of flaxseed oil or fish oil. A few small studies have reported that this diet or lifestyle intervention is associated with increased mental and physical quality of life. The OMS diet program does not allow the consumption of meat, poultry, eggs, dairy, coconut oil or palm oil, but recommends a plant-based diet of whole foods and seafood.
Paleo Diet and Wahls Protocol: The paleolithic or Paleo diet involves eating foods that are thought to be similar to what ancient humans ate before the advent of farming and agriculture. The Wahls protocol is a lifestyle intervention that combines a Paleo-inspired diet with vitamins, meditation, and exercise. There is some evidence that a Paleo or Wahls diet can help to ease fatigue and improve quality of life in people with MS. According to some sources, modified Paleolithic diets carry the risk of nutritional deficiencies such as vitamin B, as a result of limited cereal consumption, and calcium and vitamin D deficiencies as a result of not consuming dairy [16]. A recently published study found that a paleo diet may be useful in the treatment of MS, reducing perceived fatigue, improving mental and physical quality of life, increasing exercise capacity, and improving arm and leg function [17]; however, some researchers have suggested this work as having a high risk of bias [18]. According to other researchers, similar dietary interventions can reduce fatigue and improve quality of life in patients with progressive MS [19, 20]. A study by Titcomb et al. evaluated the safety of a modified paleo diet as part of a 12-month intervention among people with progressive MS. The average kilocalorie intake was 1820 ± 506 kilocalories/day and consisted of approximately 38% carbohydrate, 18% protein and 44% fat. Micronutrient intake from food exceeded individual recommendations for most vitamins and minerals. However, vitamin D, choline and calcium were not consumed in sufficient amounts, indicating nutrients of concern. Many people did not meet individual recommendations for vitamin E (so far, it is not known what effect inadequate vitamin E intake may have on MS).
The Swank Diet: The Swank diet mainly advocates strictly limiting fat intake, emphasizing low-fat dairy products, whole-grain starches, fruits, and veggies, and cutting out red meats and oily fish. A study conducted by Swank more than 30 years ago suggested that people who followed the diet had lower risk of relapse, disability, and mortality than those who didn’t. But the study did not include a control group or a scoring system for MS disability, so the meaningfulness of these results is debatable.
Calorie Restriction and Intermittent Fasting: Calorie restriction, as the term suggests, is a dietary strategy that involves limiting the amount of calories (units of energy derived from food) one consumes. Research has indicated that a low-calorie diet can help to reduce markers of inflammation, and some small studies reported MS patients have better emotional health (e.g., better well-being and less severe depression) after following these diets. However, this type of diet may not meet all of a person’s nutritional needs so it can lead to substantial weight loss. It does not provide medical advice, diagnosis, or treatment. Intermittent fasting puts strict limits on calories some of the time, with the usual calories allowed the rest of the time. For example, it could mean cutting what you eat to just 500 calories for 2 days every week. Calorie restriction diets are associated with lower levels of inflammation and oxidative stress, maintaining a healthy weight, and with cardiovascular health.

Practical Dietary Recommendations for Managing MS

Given the complexities of MS and the varying results of dietary studies, here are some practical recommendations to consider:

Focus on a Plant-Based Diet: Emphasize fruits, vegetables, whole grains, and legumes. These foods are rich in nutrients, fiber, and antioxidants.
Incorporate Anti-Inflammatory Foods: Include leafy greens, berries, and fatty fish like salmon and sardines, which are rich in omega-3 fatty acids. Omega-3 fatty acids support brain function and may help protect nerve cells.
Limit Saturated and Trans Fats: Reduce consumption of red meat, processed foods, and high-fat dairy products. These fats can promote inflammation.
Avoid Processed Foods: Cut out all processed foods, eggs, meat, dairy, and saturated fats.
Minimize Refined Carbohydrates and Sugars: Limit white bread, pastries, sugary cereals, and sweetened beverages. These can cause blood sugar spikes and crashes, worsening fatigue.
Stay Hydrated: Drink plenty of water and incorporate herbal teas to maintain hydration and overall well-being.
Consider Supplements: Discuss with your healthcare provider whether supplements like vitamin D, vitamin B12, and omega-3 fatty acids are appropriate for you.
Personalize Your Diet: Work with a registered dietitian to develop a personalized meal plan that considers your individual needs, preferences, and symptoms.

Specific Food Recommendations and Considerations

Seafood: People with multiple sclerosis can eat any seafood. Fish, scallops, lobster, prawns, crab, calamari, mussels, oysters, clams, crayfish - they’re all OK.
Nuts and Nut Butters: Enjoy nut butters in small amounts; spread thinly on wholegrain toast for breakfast, or maybe as a snack on wholegrain crackers etc. Many peanut butters and nut butters contain added oils and sugars to improve their texture and taste. Enjoy other nuts instead - walnuts, almonds, pecans and pistachios. Brazil nuts, macadamias and cashew nuts contain more saturated fat than some other tree nuts.
Oils: High-quality extra virgin olive oil is higher in mono-unsaturated fats, contains anti-inflammatory polyphenols and is healthy in moderate amounts. If you see sunflower or rapeseed oils on an ingredient list and they feature only in small amounts in those shop-bought foods, then it is ok to include these produces in small amounts & less frequently for convenience. Avoid completely: palm oil and coconut oil, vegetable oil and highly processed oils (e.g. Don’t fry in oil even if it has a high ‘smoking point’.
Caffeine: There are no specific restrictions about caffeine included in the Overcoming MS Program.
Sugar: There is no compelling evidence linking added sugar to worsening MS symptoms, however through following a plant-based diet most people naturally reduce the amount of sugar they consume.
Coconut Products: Often hailed as a healthy oil in the media, coconut products actually contain a high percentage of saturated fat, which are excluded on the Overcoming MS program.
Dairy: Cow, goat and sheep milk all appear to contain the same offending protein, butyrophilin, which causes harm to the immune system.
Omega-3 Fatty Acids: If one is eating an ultra-low saturated fat diet, as with the Overcoming MS program, it doesn’t take much omega-3 to get a structural benefit; i.e. an improvement in the pliability and resilience of cell membranes. That is why the standard dose (often recommended by specialists) of 3g a day of fish oil is inadequate; it doesn’t really provide the immune system benefit. You can of course get refined fish oil where these constituents (the actual total omega-3s DHA and EPA) are concentrated, and so this dose needs to be adjusted accordingly.
Chicken: Although skinless chicken is low in saturated fat and allowed on the Swank Diet, it is not recommended on the Overcoming MS Program. The idea is to move away from eating animal products (as well as altered fats and so on) and to change your way of eating.

Additional Lifestyle Changes to Complement Dietary Modifications

In addition to diet, other lifestyle changes can significantly benefit individuals with MS:

Regular Exercise: Engage in moderate-intensity aerobic activity and strength training to improve walking, balance, cognition, and overall quality of life.
Stress Management: Practice mindfulness, gratitude, and relaxation techniques to reduce stress, which can exacerbate MS symptoms.
Adequate Sleep: Aim for seven to nine hours of sleep per night to support mental ability, emotional well-being, and physical health.

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