While there are currently no official dietary guidelines specifically tailored for individuals with multiple sclerosis (MS), adopting a nutrient-dense and balanced diet can significantly assist in minimizing inflammation and enhancing overall well-being. In the following sections, you will discover more about beneficial foods to incorporate into your meals as well as those that should be limited or avoided for optimal health.

Understanding Multiple Sclerosis (MS)

Multiple sclerosis (MS) is an autoimmune condition that progressively damages the protective layers known as myelin sheaths, which encase your nerve fibers. This deterioration can disrupt the transmission of signals within the brain and spinal cord over time, leading to a variety of neurological challenges.

The symptoms associated with MS can be quite diverse and may include:

  • exhaustion
  • numbness or tingling sensations
  • bladder control issues
  • motor function difficulties and muscle stiffness
  • visual impairments
  • cognitive impairments

The complexities of MS lead to varying progression patterns among individuals. Research has identified a potential link between the Epstein-Barr virus and the onset of MS, although a definitive cure is still elusive. While diet alone cannot cure MS, several studies indicate that implementing dietary modifications may enhance overall health and mitigate inflammation. Adopting a well-rounded diet can bolster your well-being, helping to alleviate the symptoms associated with MS.

Multiple sclerosis, commonly referred to as MS, is a neurological disorder characterized by the gradual degradation of myelin sheaths encasing nerve fibers. Even though a cure is not yet available, dietary choices can significantly contribute to improved health and reduced inflammation.

How Does Diet Impact Multiple Sclerosis (MS)?

At present, there are no formal dietary guidelines or definitive evidence supporting any specific dietary regimen for individuals living with MS. Consequently, any dietary recommendations for those with MS should focus on enhancing overall health and well-being.

Research suggests that diet can influence MS in various ways, such as:

  • slowing down disease progression
  • minimizing flare-ups

Ideally, a diet tailored for individuals with MS should be:

  • rich in antioxidants to help mitigate inflammation
  • high in fiber to support digestive health
  • sufficient in calcium and vitamin D to combat osteoporosis
  • abundant in vitamins and minerals to alleviate fatigue and enhance wellness

An effective diet for MS should also restrict foods associated with chronic inflammation and other adverse health outcomes, as well as those that may complicate daily life for someone with MS. For instance, it is advisable to steer clear of ultra-processed foods, which are widely recognized for contributing to various health issues.

The nutrients linked to these positive outcomes comprised increased levels of:

  • healthy fats
  • cholesterol
  • folate
  • iron
  • magnesium

A reduction in carbohydrate intake was also found to be advantageous. Additionally, preliminary findings suggest that individuals with MS might experience greater susceptibility to deficiencies in certain nutrients, including vitamins A, B12, and D3. Researchers recommend that supplementation with specific vitamins, minerals, fatty acids, antioxidants, plant compounds, and melatonin may assist in alleviating some symptoms.

Further research is necessary before definitive dietary recommendations can be established for the dietary patterns discussed in this context. While no official dietary guidelines exist for MS, it is important to note that although diet cannot cure MS, making informed dietary adjustments may lead to improvements in overall health.

Foods to Incorporate

Below is a curated selection of foods that one should consider adding to an MS-friendly diet:

  • Fruits and Vegetables: a wide variety of fresh fruits and vegetables
  • Grains: diverse grains including oats, rice, and quinoa
  • Nuts and Seeds: assorted nuts and seeds
  • Fish: all types of fish, particularly fresh varieties and oily fish like salmon and mackerel, known for their richness in omega-3 fatty acids and vitamin D
  • Meats: fresh meats, which include beef, chicken, lamb, and more, with a special emphasis on beef liver, renowned for its high vitamin D and biotin content
  • Eggs: a great source of biotin, vitamin D, and other essential nutrients
  • Dairy Products: such as milk, cheese, yogurt, and butter
  • Fats: healthy fats sourced from olive, flaxseed, coconut, and avocado oils
  • Probiotic-Rich Foods: like yogurt, kefir, sauerkraut, and kimchi
  • Beverages: water and herbal teas
  • Herbs and Spices: all varieties of fresh herbs and spices

In essence, the principles guiding an MS-friendly diet align closely with those of a nutrient-dense, well-rounded diet. This is largely due to the fact that plant-based foods and grains are abundant in fiber, vitamins, minerals, and hydration, all of which can alleviate MS symptoms such as constipation.

Moreover, these foods are rich in compounds that act as antioxidants, which are crucial in protecting your cells from free radical damage and inflammation. Such compounds play a role in combating inflammation and may even slow down the progression of MS. Fatty fish varieties, particularly salmon and mackerel, may offer significant advantages for individuals with MS. They are loaded with omega-3 fatty acids that can reduce the frequency of relapses and inflammatory markers associated with MS.

These fish are also excellent sources of vitamin D, which, when paired with calcium, can strengthen bones. Individuals with MS are often more susceptible to vitamin D deficiencies. Research regarding the impact of red meat and saturated fats on MS symptoms presents mixed findings.

Dairy products also yield inconsistent outcomes. In some studies, dairy has been linked to disease activity. However, they provide valuable nutrients such as calcium, vitamin D, vitamin A, and potassium, so consider including them in moderation in an MS-friendly diet. If you suspect that dairy products exacerbate your MS symptoms, it is advisable to consult with your healthcare provider. Consuming a rich variety of fruits, vegetables, grains, and fish could enhance health for individuals living with MS. Moderation in the intake of red meat and dairy is acceptable, given the current mixed evidence regarding their effects.

Foods to Limit or Avoid

Although a diet that supports multiple sclerosis (MS) offers a wide range of nutritious choices, there are certain food categories that you might want to limit or completely avoid to better manage MS symptoms. Many of these foods are associated with chronic inflammation, which can exacerbate discomfort. Key culprits include processed meats, refined carbohydrates, trans fats, and sugar-laden beverages, among others.

Here’s a curated list of foods to consider minimizing or avoiding entirely if you are living with MS:

  • Processed meats: such as sausages, bacon, canned meats, and products that are salted, smoked, or cured.
  • Refined carbohydrates: including white bread, pasta, biscuits, and flour tortillas.
  • Fried foods: like french fries, fried chicken, mozzarella sticks, and doughnuts.
  • Highly processed foods: encompassing fast food, potato chips, as well as convenience and frozen meals.
  • Trans fats: found in margarine, shortening, and partially hydrogenated vegetable oils.
  • Sugar-sweetened beverages: which include energy and sports drinks, soda, and sweet tea.
  • Alcohol: limiting all types of alcoholic beverages as much as possible is advised.

An MS-friendly diet resembles one that emphasizes overall health and wellness. It typically avoids or limits certain foods, like processed meats, refined carbohydrates, and trans fats, as these can hinder symptom management and potentially increase inflammation.

Specialty Diets

Several specialized diets are designed to assist in slowing the progression and preventing flare-ups of Multiple Sclerosis (MS). Notable examples include the Swank diet and various adaptations of the Wahls diet, both of which are well-received within the MS community. Prior to embarking on any diet, particularly those that impose restrictions on specific food groups, it is crucial to consult your healthcare provider. Your doctor can guide you in determining if a particular diet is suitable for your needs and ensure that you are receiving adequate nutrition.

Swank Diet

The Swank diet for MS is a low-fat, low-saturated fat dietary plan proposed by neurologist Dr. Roy Swank, MD, PhD, in 1948. Its key recommendations include:

  • Steering clear of processed foods that contain saturated fats or hydrogenated oils
  • Limiting saturated fat intake to 15 grams per day; consuming no more than 20 to 50 grams per day of unsaturated fats
  • Avoiding red meat for one year, after which it should be limited to 85 grams per week
  • Avoiding dark meat poultry and restricting fatty fish to 50 grams daily
  • Choosing dairy products with 1% fat or less
  • Excluding egg yolks from the diet
  • Consuming unlimited quantities of fruits and vegetables
  • Enjoying whole grain breads, rice, and pastas as staples
  • Snacking on nuts and seeds each day
  • Taking one teaspoon of cod liver oil and a multivitamin and mineral supplement each day

However, the evidence regarding the effectiveness of the Swank diet primarily comes from a series of reports published by Dr. Swank himself.

These reports focused on a group of individuals with relapsing-remitting MS who followed the Swank low-fat diet for a remarkable 50 years. Dr. Swank evaluated participants for their compliance with the diet, the frequency and severity of MS attacks, and their overall performance status (such as wheelchair dependency, mobility, and employment capabilities).

Individuals who strictly followed the diet (keeping fat consumption to 20 grams or less) experienced fewer and less severe exacerbations of MS compared to those who consumed more than 20 grams of fat per day.

Participants with lower performance levels at the beginning of the observation period or those in the progressive stage of MS were more likely to experience ongoing decline, even with adherence to the Swank diet. While Swank’s research had an extensive follow-up period and a large sample size, it lacked the rigor of randomized controlled trials and was susceptible to various biases. Future studies that are larger and more methodologically sound are necessary to ascertain whether the Swank diet can genuinely alleviate symptoms or delay the progression of MS.

Wahls Diet

Dr. Terry Wahls introduced the modified paleolithic Wahls diet for MS management in 2008. Some studies indicate that adopting a modified paleolithic diet along with supplements can enhance perceived energy levels in those with MS.

The Wahls diet is a variation of the paleolithic (paleo) diet, which encourages the consumption of:

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

Conversely, the paleo diet excludes:

  • processed foods
  • refined sugars
  • grains
  • most dairy products
  • legumes
  • artificial sweeteners
  • vegetable oils
  • margarine
  • trans fats

The modified paleo Wahls diet introduces the following variations compared to the general paleo diet:

  • Ingesting 9 or more cups of fruits and vegetables daily (3 cups each from green leafy vegetables, sulfur-rich vegetables, and brightly colored fruits or vegetables)
  • Emphasizing the intake of seaweed, algae, and nutritional yeast
  • Limiting servings of gluten-free grains and legumes
  • Avoiding eggs
  • Reducing meat and fish consumption compared to the paleo diet

A 2021 analysis revealed that the diet effectively alleviates fatigue symptoms and enhances the quality of life for individuals with MS. In 2015, Dr. Wahls developed the Wahls elimination diet, which restricts all grains (including gluten-free options), legumes, and nightshades (such as tomatoes, white potatoes, eggplant, peppers, and seed spices) to minimize lectin intake.

This version also advises against all dairy consumption and permits unlimited intake of saturated fats. Similar to the modified paleo Wahls diet, the Wahls elimination diet advocates for at least 9 cups of fruits and vegetables daily, in addition to seaweed, nutritional yeast, and fermented foods.

However, much of the available research, including the studies mentioned here, involves potential bias due to Dr. Wahls' direct connection to the diet. Therefore, further unbiased research is essential to thoroughly investigate the efficacy of this diet for MS. It’s crucial to recognize that diets excluding entire food groups (like grains and dairy in the Wahls elimination diet) can augment the risk of nutritional deficiencies. Consulting with a healthcare professional when taking supplements while following these diets can help mitigate the chance of nutritional inadequacies.

Both the Swank diet and the Wahls elimination diet were designed with the intention of slowing disease progression and preventing MS flare-ups. While research supporting the effectiveness of these diets for MS is encouraging, more robust, well-structured studies are necessary.

Alternative Diets

Ketogenic Diet

A research study conducted in 2022 aimed to explore the potential benefits of ketogenic diets for individuals with Multiple Sclerosis (MS). Unfortunately, the findings were not particularly encouraging. Despite this, the investigation into the impact of dietary choices on MS continues, highlighting the necessity for further research in this area.

The ketogenic diet has been a subject of interest in MS studies due to its high fat and low carbohydrate content. Given that myelin is primarily composed of lipids (fats), researchers have speculated whether adopting a diet rich in fats could aid in the regeneration of myelin. Nonetheless, the current evidence does not support this hypothesis.

Additionally, the restrictive nature of the ketogenic diet can present challenges for those attempting to adhere to it. This diet limits various food groups that are typically recommended for a well-rounded nutritional plan.

Ongoing investigations are examining the impacts of both ketogenic diets and intermittent fasting on MS, aiming to provide clearer insights.

Fast-Mimicking Diets

A comprehensive meta-analysis from 2022 indicated that fast-mimicking diets, characterized by intermittent cycles of reduced calorie consumption, along with ketogenic diets, failed to demonstrate significant effects on relapsing-remitting MS.

Nonetheless, researchers emphasize the need for larger, forward-looking clinical trials to gain a better understanding.

In one study, individuals with MS were placed on a ketogenic diet that limited carbohydrate consumption to under 20 grams per day for a duration of six months. This intervention appeared to alleviate symptoms of fatigue and depression, encourage fat loss, and lower inflammatory markers.

However, this particular study involved only 19 participants, with just 15 completing the full 6-month period. Thus, the call for larger-scale studies remains pertinent.

Dietary Recommendations for Managing MS

Alongside the dietary guidelines provided in this article, individuals living with Multiple Sclerosis (MS) may benefit from implementing these additional food strategies to effectively manage their symptoms.

  • Ensure adequate caloric intake: Consuming insufficient calories can lead to increased fatigue, which is especially challenging for those with MS.
  • Prepare your meals ahead of time: If time permits, preparing meals in batches can conserve energy for later use. This practice is particularly advantageous for those experiencing chronic fatigue.
  • Optimize your kitchen layout: Organizing food items, utensils, and cooking equipment in easily accessible locations can significantly reduce the effort required for meal preparation and cleanup, thereby conserving energy.
  • Utilize convenient food options: Purchasing precut fruits and vegetables can save valuable time in the kitchen and simplify the cooking process.
  • Create thicker beverages: For those experiencing swallowing difficulties, crafting thicker drinks, such as a nutrient-dense smoothie, may prove easier to handle.
  • Opt for softer foods: If chewing becomes exhausting, consider incorporating softer food options such as baked fish, bananas, avocados, and well-cooked vegetables into your diet.
  • Limit foods that crumble easily: For individuals who struggle with swallowing, it may be wise to reduce the intake of crumbly items like toast and crackers, which can pose choking risks.
  • Seek assistance: Even if you feel hesitant to ask, enlisting support from friends or family for minor tasks like meal preparation, cleaning, or table setting can alleviate fatigue.
  • Maintain an active lifestyle: While exercise might induce fatigue for some with MS, it is crucial for achieving and sustaining optimal health and a healthy weight. Additionally, staying active helps prevent osteoporosis, a condition that is more prevalent among individuals with MS.

If you have any other MS-related concerns that are not covered here, it’s essential to communicate these to your healthcare team. They can provide tailored advice to enhance your symptom management.

The strategies mentioned in this section can significantly enhance your quality of life with MS by aiding in weight management and alleviating symptoms such as fatigue and swallowing difficulties. If you have further concerns, don’t hesitate to reach out to your healthcare provider.

Valuable Resources for Managing MS Through Diet

If you are contemplating a dietary change to alleviate your MS symptoms and seek additional information, consider exploring the following beneficial resources:

  • National Multiple Sclerosis Society: Nutrition and Dietary Guidelines
  • Swank MS Foundation: The Swank Low-Fat Diet Approach to MS Management
  • MS Society: Exploring Specialized Diets for MS

Engaging with a registered dietitian nutritionist (RDN) who focuses on Multiple Sclerosis can provide you with tailored dietary advice aimed at helping you effectively manage your symptoms and minimize MS flare-ups.

To locate a qualified professional in your vicinity, utilize the Find a Nutrition Expert tool available on the Academy of Nutrition and Dietetics website.

The Key Insights

Multiple sclerosis (MS) is an autoimmune disorder that primarily impacts the nervous system, leading to various neurological symptoms. While there are no established dietary guidelines specifically for managing MS, adopting certain dietary modifications may alleviate prevalent symptoms such as constipation and fatigue, and enhance overall life quality.

Incorporating more wholesome grains, fish, and plant-based foods into your diet can be beneficial. Furthermore, steering clear of low-nutrient food options may assist in managing MS symptoms and could potentially slow the progression of the disease.

It is advisable for individuals with MS to limit their intake of specific foods, such as processed meats, refined carbohydrates, trans fats, and beverages high in sugars.

Here are some additional strategies to help manage MS symptoms effectively:

  • Preparing meals in larger quantities
  • Utilizing “ready-to-use” grocery products
  • Organizing your kitchen for better accessibility
  • Selecting foods that have suitable textures
  • Seeking assistance with daily tasks

Before implementing any significant dietary changes to aid in managing MS, it is crucial to consult with your healthcare team.