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What’s The Best Diet for MS?

Managing MS

December 06, 2023

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Photography by Aya Brackett

Photography by Aya Brackett

by Jillian Kubala, MS, RD

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Medically Reviewed by:

Amy Richter, RD

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by Jillian Kubala, MS, RD

•••••

Medically Reviewed by:

Amy Richter, RD

•••••

•••••

Some evidence suggests that people with MS whose diets are rich in anti-inflammatory foods have fewer symptoms and a better quality of life.

When you’re living with multiple sclerosis (MS), taking care of your health is vital. Getting plenty of rest, managing your stress, and regularly visiting a doctor can help manage MS-related symptoms and improve your quality of life.

But what about diet? Dietary choices can significantly influence overall health and disease risk, but can dietary changes improve MS symptoms and slow disease progression?

Research into the effects of diet on MS symptoms and the progression of MS is limited. However, some promising findings suggest that making certain dietary changes could specifically benefit people with MS.

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How does diet affect MS?

Research has found that eating nutrient-dense foods regularly and following a generally healthy dietary pattern could help improve MS-related symptoms.

For instance, a 2018 study included nearly 7,000 people with MS. They found that people whose diets were higher in fruits, veggies, legumes, and whole grains and lower in added sugars and red meat reported lower disability levels and symptom severity compared with people who followed less healthy diets.

In a 2023 study, researchers followed the dietary intake of 163 people with MS for 100 days. Participants who followed plant-rich diets reported significantly fewer MS symptoms than those who had a Western dietary pattern high in red and processed meats.

In fact, compared with those who ate few veggies, people who ate a lot of veggies had anywhere from a 32–74% reduction in symptoms — including pain, bladder dysfunction, walking difficulties, and fatigue.

Another study from 2023 also showed the possible benefits of people with MS following diets rich in fruits, veggies, oily fish, and whole grain bread while avoiding ultra-processed foods, processed meat, added sugars, and other less nutritious foods and drinks. They had smaller lesions — areas of damage or scarring to the central nervous system that are also referred to as plaques — compared with people who followed less nutritious diets.

Some researchers think that eating more nutritious foods could help reduce systemic inflammation and support immune function — both of which can benefit people with MS.

Interestingly, diet during childhood also seems to influence the risk of developing MS later in life.

Children who have poorer diet quality, including diets high in candy and fast food, have a higher risk of developing MS in adulthood compared with children who follow more nutritious dietary patterns, such as those that include whole grains and seafood.

Inflammation is at the root of MS, and some researchers think that eating more nutritious foods could help reduce systemic inflammation and support immune function — both of which can benefit people with MS.

Fruits, vegetables, and other nutritious foods, such as fish, nuts, and seeds, have powerful antioxidant, anti-inflammatory, and immune-modulating effects on the body.

Regularly eating foods that help reduce inflammation and support the immune system may help improve MS symptoms and overall quality of life and even slow MS disease progression.

On the other hand, it seems that following a diet high in added sugar, processed meats, and ultra-processed snack foods contributes to inflammation and cellular damage, so these may have the opposite effect.

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Are specific diets helpful for people with MS?

While it’s been established that following a diet high in nutrient-dense foods can benefit people with MS, there’s limited research on the effects of specific diets on MS symptoms and disease progression.

That said, certain dietary patterns — such as gluten-free diets, intermittent fasting, and very low carb diets — may be helpful for some people with MS.

Gluten-free diets

Gluten is an umbrella term used to describe a group of proteins called prolamins and glutelins that are found in grains such as wheat and barley.

Though gluten is safe to eat for most people, it can cause health issues for people with celiac disease, non-celiac gluten sensitivity (NCGS), and some autoimmune diseases.

While some anecdotal evidence suggests that some people with MS may benefit from avoiding gluten, only one very small study so far has shown that gluten-free diets may help reduce MS symptoms, as well as MS activity on MRIs.

A handful of poorly designed studies have shown that the popular Wahls protocol, which eliminates gluten as part of its approach, may have similar benefits. But more high quality research is needed.

Gluten proteins are highly resistant to digestion, and experts believe that gluten proteins can:

  • cause increased gut permeability
  • contribute to a pro-inflammatory environment in the body
  • negatively interact with the immune system

Although current evidence does not show a clear link between gluten and MS symptoms, some people with MS may find that following a gluten-free diet helps them feel better.

Gluten-free diets are safe as long as they’re balanced, so there’s no harm in trying a gluten-free dietary pattern to see if it benefits your specific health needs and symptoms.

Intermittent fasting

Intermittent fasting (IF) refers to severely restricting your food intake for longer than a typical overnight fast.

Some research has shown that IF can benefit neurological health in several ways and that it might be a helpful tool for those living with MS.

A 2021 research review suggests that IF could benefit people with epilepsy, Alzheimer’s disease, and multiple sclerosis by improving symptoms and slowing disease progression. Researchers found that fasting may help reduce neuroinflammation and lead to protective changes in gut microbiota.

Animal studies also suggest that IF may help reduce T-lymphocytes, which are types of white blood cells that contribute to MS progression.

Intermittent fasting may also increase levels of brain-derived neurotrophic factor (BDNF), a molecule that can reduce neuroinflammation and preserve nerve health.

IF can be paired with any dietary pattern and can be modified based on your preferences. If you’re interested in trying fasting, it’s best to work with a healthcare professional to ensure you’re fasting safely.

Ketogenic diet

The ketogenic diet (aka keto diet) is a very low carb diet that limits carbohydrate intake to less than 50 grams per day.

In addition to being very low in carbs, keto diets are very high in fat, with the “classic” ketogenic diet getting 85–90% of its energy from fat. When following a ketogenic diet, the body reaches a state of ketosis, where it uses molecules called ketones as its main energy source instead of carbohydrates.

Ketones are produced in the liver from the breakdown of fat. This release of ketones into the blood may have an anti-inflammatory effect, potentially benefiting inflammatory conditions like MS.

A handful of small studies in people with MS suggest that keto diets may lead to improvements in quality of life, fatigue, depression, and overall level of disability.

This includes a small 2022 study of 65 people with MS, which found that participants experienced a nearly 50% decline in self-reported fatigue and depression scores after following a ketogenic diet for 6 months.

However, the diet is extremely restrictive and has been associated with side effects such as:

  • nutrient deficiencies
  • weight loss
  • gastrointestinal symptoms like constipation

Other diets

Several other diets, such as plant-based diets like the McDougall diet, low fat diets like the Swank diet, and the popular Mediterranean diet, may also be helpful for reducing MS symptoms and improving quality of life in people with MS.

For example, the Swank diet significantly limits certain kinds of saturated fats, such as those found in red meat, which activate pro-inflammatory pathways in the body.

Many of the diets shown to be beneficial for MS share one thing in common: They prioritize anti-inflammatory and antioxidant-rich foods, such as fruits and vegetables, and cut out or significantly limit foods known to increase inflammation.

If you have MS and are interested in changing your diet to see how it affects your symptoms, it may be best to start with a less restrictive diet that focuses on prioritizing foods known to support immune function and reduce inflammation.

Consider adding more items from the following food groups to your diet:

  • Vegetables: spinach, asparagus, zucchini, broccoli
  • Fruits: berries, cherries, apples, citrus fruits
  • Complex carbohydrates: beans and lentils, sweet potatoes, quinoa
  • Healthy protein sources: fish, chicken, turkey, beans
  • Healthy fats: avocados, olive oil, nuts, seeds
  • Anti-inflammatory foods and drinks: green tea, probiotic-rich foods like kimchi, spices

Increasing your intake of foods known to reduce inflammation and support overall health is just one half of the equation.

You may also feel better and experience fewer MS symptoms if you limit foods and drinks that contribute to inflammation and increase disease risk, such as processed meats, fast food, and foods and drinks high in added sugar.

The takeaway

While diet can make a big difference in your health, it’s also essential to focus on healthy lifestyle choices — exercising regularly, avoiding smoking and heavy drinking, maintaining a healthy body weight, and getting enough restful sleep.

If you’re interested in making dietary or lifestyle changes to support your health and improve MS symptoms and disease progression, speak with a healthcare professional. They can give you specific, evidence-based recommendations and may recommend working with others, such as a registered dietitian, to make safe and appropriate dietary and lifestyle modifications.

Medically reviewed on December 06, 2023

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About the author

Jillian Kubala, MS, RD

Jillian Kubala is a registered dietitian based in Westhampton, NY. Jillian holds a master’s degree in nutrition from Stony Brook University School of Medicine as well as an undergraduate degree in nutrition science. She runs a private practice based on the east end of Long Island, NY, where she helps her clients achieve optimal wellness through nutrition and lifestyle changes.

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