“To date, no study has been published that shows diets influence disease progression in MS,” says Dave Bexfield, the founder of the online MS community ActiveMSers.org, who was diagnosed with MS in 2006. Indeed, a study published in November 2019 in Multiple Sclerosis and Related Disorders concludes, “There is insufficient evidence to recommend the routine use of any specific diet by people with MS.” It continues, “Some diets touted for MS may have potential negative health consequences.” “In the 15 years I’ve run ActiveMSers, no one has written me gushing about symptoms reversing because of a diet, but I’ve gotten many pained emails wondering why a certain diet hasn’t worked,” Bexfield says. That said, new research indicates that certain dietary changes, including reduced meat intake, may influence disability progression in MS. Among more than 1,300 people with MS, consuming a high-quality, meatless diet was found to be associated with reduced disability progression, according to a study published in August 2021 in the European Journal of Neurology. In addition, early evidence shows that people with new-onset MS may benefit from the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, which emphasizes consumption of whole grains, berries, vegetables, fish, poultry, and olive oil. A study published in August 2021 in Multiple Sclerosis and Related Disorders, which included 180 people diagnosed with MS less than five years prior, found that adhering to the MIND diet was associated with greater tissue volume in certain parts of the brain and smaller lesion size. But more long-term research is needed to confirm these potential benefits, researchers note.
No Two Cases of MS Are Alike
In MS, the immune system mistakenly attacks the myelin sheath (the protective coating on nerve fibers in the brain, spinal cord, and optic nerve), potentially disrupting nerve activity throughout the body. The damage to the myelin sheath can have a broad range of physical and mental effects, including fatigue, weakness, difficulty walking or seeing, problems with swallowing, bladder control issues, constipation and other bowel changes, as well as emotional and cognitive changes, among others. Each person with MS deals with a unique set of symptoms, which are likely to change over time. The unpredictable nature of the illness makes it challenging to generalize nutrition recommendations and advice. According to Joey Gochnour, a registered dietitian nutritionist and the owner of Nutrition and Fitness Professional in Austin, Texas, “Many people with MS struggle with the same types of diet challenges as the rest of the population, including obesity and a sedentary lifestyle, but add to that a condition that affects different aspects of life for different people.” Like everyone else, people who have MS can benefit from a healthy diet — with modifications to fit their symptoms and lifestyles. RELATED: 7 Foods to Ask Your Doctor About When You Have MS Some find that following a balanced diet helps increase their energy level. Generally speaking, this means eating sufficient calories — but not too many! — from a mix of lean proteins, whole-grain carbohydrate sources, and healthy fats (from fish, nuts, seeds, and oil). For Jennifer and Dan Digmann, a married couple who live with and blog about MS, there isn’t necessarily one food that gives them more energy. They concentrate on having an overall healthy diet — fruits, vegetables, protein intake, and drinking more water — for energy. Nicole Lemelle, who was diagnosed with MS in 2000 and writes the blog My New Normals, uses wholesome foods to keep her going throughout the day. “Egg whites, whole-grain breads and bagels, and cereal for breakfast help me sustain my morning potency until lunch,” Lemelle says. “I eat almonds and cashews as a snack when I need a boost between meals.” Coffee also helps Nicole battle her fatigue. RELATED: 7 Ways to Fight MS Fatigue With Your Fork
How Whole30 Helped One Woman With MS Feel Better
Jennifer Powell, who was diagnosed with MS in 2010 and blogs at Multiple Sclerosis News Today, decided to try the Whole30 program with her husband several years ago. They went 30 days with no processed foods, as well as no added sugar, no gluten, no dairy, no alcohol, and no sulfites. “I lost that bloated look, and my joints began to feel better,” she says. “I felt like a sheath of yuck had been lifted.” Through this experiment, Powell realized that dairy was her worst enemy. “When I stopped dairy, I found my musculoskeletal pain lessened,” she says. Today, Powell continues to eat clean, though she admits it’s not always easy: “There’s a psychological element to this disease,” she says, “and when I feel sad and have pain, I often reach for comfort food. But it’s okay to be human. Even baby steps are huge.” RELATED: 8 Plant-Based Milks to Substitute for Dairy
How to Control Your Weight When You Have MS
The challenges posed by MS can make it tough to maintain a healthy weight. “Some people with MS have trouble moving due to the condition or are depressed because of it,” Gochnour says. Mobility challenges or mood disorders that make exercise difficult and reduce energy expenditure often lead to weight gain. Difficulty shopping and preparing meals may also lead a person with MS to rely more on processed, ready-to-eat foods or takeout, which are often high in calories, sodium, and fat, and low in nutritional value. So much so, in fact, that research published in the Journal of Clinical Neuroscience has suggested that malnutrition is not uncommon among those with MS. Still, people with MS can maintain a healthy weight and lose weight if necessary by controlling portion sizes and cutting down on junk food and eating out.
One Woman With MS Lost 75 Pounds by Switching Up Her Diet
Jennifer Digmann has successfully lost weight through dietary changes. “I have lost 75 pounds since I was diagnosed,” she says, “and I’m still trying to lose weight. I have tried to cut out fast food, eat more fiber, and drink more water. It is especially important for me to watch my weight because I no longer walk.” Lemelle says she avoids “sugary candies, white flour, and fried foods” to help control her weight. RELATED: Weight Loss Apps Will Likely Help You Shed Pounds, an Analysis Finds
Going Plant-Based May Help You Lose Weight
Moving toward a plant-based diet — not necessarily vegan but one that incorporates more plant foods and fewer animal products — may also promote a healthy weight. In a small study published in September 2016 in Multiple Sclerosis and Related Disorders, in which 22 people with MS followed a very-low-fat, plant-based diet for 12 months, participants lost just over a pound a month, on average. Plant proteins like beans, tofu, seitan, nuts and nut butters, and seeds are rich in nutrients yet lower in calories and saturated fat than animal proteins — traits that can assist with weight control and promote wellness. Plant foods — particularly grains, beans, fruits, and vegetables — are also good sources of dietary fiber, which promotes fullness and bowel regularity and helps reduce calorie intake. For those not used to vegetarian meals, it may be helpful to start with one meatless dinner each week. The website Meatless Monday is a good resource for vegetarian and vegan recipes and meal ideas. A registered dietitian can also help you learn about healthy food options that are easy to prepare. For example, because getting overheated can worsen symptoms of MS (that’s why many people with MS avoid taking hot showers or baths), food temperature may be an issue. Bexfield finds that hot soups will temporarily sap his energy, while a cold treat like a popsicle can help him stay cool. A rarer MS symptom, trigeminal neuralgia, which causes sudden severe facial pain, can make eating difficult. When Jennifer Digmann was struggling with this pain, “I found that softer, plainer foods such as breads, potatoes, and cottage cheese were easier to eat,” she says. For constipation — another common problem for those with MS — choosing higher-fiber fruits, vegetables, and grain products is key, along with getting adequate fluids. “We both have consciously increased our water and fiber intake to better alleviate issues with constipation,” says Jennifer Digmann, referring to herself and her husband. “I consume high-fiber fruits, cereals, and yogurt to help ease constipation,” says Lemelle. Eating fish appears to benefit MS symptoms like fatigue. In fact, regular fish consumption appears to be strongly associated with lower clinical fatigue levels, suggests a study of more than 2,400 people in the UK’s Multiple Sclerosis Register, published in January 2021 in Nutrition Research. People with MS who eat a healthy diet may experience mood benefits as well, according to a Dutch study published in February 2021 in Nutritional Neuroscience. Researchers found that eating a healthy diet, as specified by Dutch dietary guidelines, was associated with improved mental and physical quality of life, especially in women with MS. RELATED: 10 Good Foods to Help Relieve Constipation
Nutrients That May Play a Role in MS
Certain nutrients, including omega-3 fatty acids and vitamin D, have been studied — and continue to be studied — for their potential benefits for people with MS.
Omega-3 Fatty Acids May Reduce Inflammation
Omega-3 fatty acids are considered essential fatty acids, meaning your body needs them but cannot make them on its own, at least not in the quantities needed for good health. A diet high in omega-3 fatty acids has been shown to reduce inflammation and may help lower the risk of such chronic diseases as heart disease, cancer, and arthritis. Many studies of omega-3 fatty acid intake in people living with MS or at risk of developing MS have hinted at potential benefits, but the results have not been statistically significant. However, a review article published in August 2019 in the journal Nutritional Neuroscience concludes that omega-3 and fish oil supplementation do offer several benefits for people with MS. When the authors of the review assessed data from seven studies of the effects of omega-3 fatty acids and fish oil supplementation on MS, they found that supplementation lowered relapse rate, reduced inflammatory markers, and improved quality of life. The National Multiple Sclerosis Society currently recommends discussing omega-3 supplementation with your doctor before trying it. Omega-3 supplements can interact with anticoagulant medications (blood thinners) as well as with insulin and oral drugs for diabetes and high blood pressure. Little is known about the safety of combining omega-3 supplements with MS medications. Instead of taking supplements, a more moderate approach to increasing your intake of omega-3s is incorporating fatty fish, canola oil, flaxseed, and walnuts into your diet on a regular basis.
Vitamin D May Reduce MS Risk
This fat-soluble vitamin, which the body can produce in the skin with sun exposure, plays a role in regulating immune activity. Because MS seems to be more common in areas with less sunlight, researchers have suggested that vitamin D may protect against MS. “The National MS Society has reviewed the research on vitamin D and MS, and has found an increased risk of developing MS with lower vitamin D levels,” Gochnour says. “However, research is still controversial on how much vitamin D is needed and how effective supplementing vitamin D is when you already have MS.” Studies have shown that vitamin D supplementation may have beneficial effects on inflammation in people with MS, but more research is needed before people with MS can be advised to take more vitamin D than needed to correct a vitamin D deficiency, according to a review article published in May 2017 in Multiple Sclerosis and Related Disorders. Nonetheless, if an individual with MS is deficient in vitamin D, correcting low levels can be beneficial to health even if it doesn’t have a direct effect on symptoms. “Have your vitamin D levels checked before supplementing,” advises Gochnour, and discuss whether and how much to supplement with your healthcare provider.
Keep an Open Mind About Food
Since medicine and nutrition are constantly evolving fields, it’s important to keep an open mind about what might help and what will never work. At the same time, be wary of regimens or cures that sound too good to be true. Because MS is so individualized, Lemelle cautions, “a diet that helped someone else may not work for you. While there are general rules, which aid in good nutrition, there is no one-size-fits-all diet. It’s best to consult your physician and registered dietitian when making a plan. They will base a regimen on your symptoms and your type of MS.”
MS Nutrition Resources We Love
Best Diet Info From MS Patient Advocacy Orgs
National Multiple Sclerosis Society The National Multiple Sclerosis Society’s website offers extensive information on diet and nutrition through articles, videos, and links to outside resources. It summarizes the research on a number of nutrients that may help ease the symptoms of MS and has a helpful article on managing your weight while living with MS. Multiple Sclerosis Association of America The association’s annual MS Research Update is a great resource for those who want to know about the latest research on MS and diet. The 2020 update, for example, describes a study of how the MIND diet impacts brain function in people with MS. The study showed that the MIND diet had beneficial effects on the thalamus, or the part of the brain responsible for sensory information, as well as sleep and wakefulness. MS Society The MS Society, which is based in London and serves England, Scotland, Northern Ireland, and Wales, offers clear, concise information on healthy eating, weight management, and special diets for those living with MS. The society’s website also has an extensive message board section, and a quick search for “diet” will allow you to peruse dozens of conversations on the topic.
Video and Multimedia Nutrition Resources
MS Teamworks This website project of the Consortium of MS Centers offers a number of videos created both for and by those living with MS. One of these videos features Allen Bowling, MD, PhD, of the University of Colorado Hospital, discussing the missed opportunity of not accounting for diet in treatment of MS and recommending some healthy diet choices. While you’re there, check out the other videos posted on the website. They range from helpful to heartwarming, and all are worth watching. Aaron Boster, MD Aaron Boster, MD, is a neurologist and founder of the Boster Center for Multiple Sclerosis in Columbus, Ohio, but if you can’t make it there to see him, his YouTube channel is regularly updated with videos on a wide range of topics related to MS. Don’t miss his video on the best diet for MS, in which he reviews some of the American Heart Association’s heart-healthy diet recommendations. Once you’ve finished, check out some of his other videos, including his live MS Q&A sessions. Can Do Multiple Sclerosis Can Do Multiple Sclerosis is a Colorado-based nonprofit organization that offers both in-person and online information and resources for people with MS and their families. Here, you’ll find a comprehensive article on a variety of diets — including the paleo diet, Mediterranean diet, Swank diet, and others — and the mechanisms by which they might have an effect on MS. Its website also offers access to webinars, podcasts, articles, and an extensive Q&A section that answers all kinds of questions on diet and nutrition for those living with MS.
Online Food and Diet References
Mayo Clinic Expert Answers The Mayo Clinic’s Expert Answers column offers answers to common — and uncommon — questions about MS, including questions on diet and individual nutrients. The response on whether there’s a special diet for MS is clear and concise, with enough information to point you in the right direction. MultipleSclerosis.net This website contains information about living with MS, from the basics on up. Its recommendations on food and diet for those living with MS are clear and comprehensive, with plenty of practical advice and information on specific nutritional recommendations. You can also search the website’s Stories section or Q&A section to read diet and nutrition advice from other people living with MS.
Books, Magazines, and Other Publications
MS Focus Magazine This article on diet, appearing in the flagship publication of the Multiple Sclerosis Foundation and written by Matt Cavallo, speaks frankly about the difficulties of changing your diet after an MS diagnosis. MS Focus is one of several of the foundation’s quarterly publications that can be mailed to your door for free. MS Focus also maintains a free lending library that includes lots of books on diet, as well as MS Focus Radio, which offers on-demand, audio-based discussions of MS research and other topics. Overcoming Multiple Sclerosis This seven-step recovery program was developed by George Jelinek, MD, after he was diagnosed with MS in 1999, and is based on the work of Roy Swank, MD, who started researching diet and MS in 1950. Step 1 is to adopt a plant-based diet that includes oily fish for the omega-3 fats they supply. In addition to presenting the key dietary recommendations, the website features a helpful “What to Eat/Not to Eat” guide, as well as a number of recipes to help you stick to the diet. Additional reporting by Susan Jara, Laura McArdle, and Christina Vogt.
