Madeleine Hull
Multiple sclerosis (MS) is an autoimmune disorder that gradually destroys the protective coverings that wrap around nerve fibres, known as myelin sheaths. While there is no specific diet that has been proven to cure MS, some research suggests that making dietary changes may help people with MS better manage their symptoms. Several small studies have shown a positive impact of certain diets on MS symptoms, including a reduction of fatigue. Diets such as the ketogenic diet, the Mediterranean diet, the Swank Diet, and the Wahls Elimination Diet are among those that have been explored in clinical trials.
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Ketogenic diets
Multiple sclerosis (MS) is a neurodegenerative disorder that affects the central nervous system. It is an autoimmune disorder that gradually destroys the protective coverings (myelin sheaths) that wrap around nerve fibres. MS is a complex disease with no known cure, and the way it progresses varies from person to person.
The ketogenic diet, or keto, is a popular low-carbohydrate and high-fat way to lose weight. The diet is designed to mimic the biochemical effects of intermittent fasting on the body. It involves restricting carbohydrate intake to a minimum while increasing the intake of fats and ensuring adequate protein intake. The process of burning fat without carbs triggers the body to produce ketones, which circulate in the bloodstream.
The keto diet has been studied for its potential benefits in managing neurological diseases such as epilepsy, Alzheimer's, Parkinson's, and traumatic brain injury, with promising results. Some researchers are exploring whether it could also help manage MS. The diet may help restore damaged nerves, regenerate myelin, and lower inflammation.
Some studies have shown that the ketogenic diet led to significant improvements in body fat composition, fatigue, depression, quality of life, and levels of disability in people with MS. However, other studies have found that the diet did not improve symptoms in people with MS. One study found that 83% of participants maintained the diet, but two participants withdrew due to digestive side effects, including nausea and loss of appetite. The most common side effects were constipation, diarrhoea, nausea, weight gain, fatigue, worsened depression or anxiety, and acne.
While the ketogenic diet may be a safe and effective way to help manage MS, it is important to note that it is restrictive and can be difficult to follow. It may also have potential long-term negative effects, such as increasing the risk of cardiovascular disease, anemia, and elevated blood acid levels. Therefore, it is recommended that individuals consult with their doctors before starting this diet.
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Mediterranean diet
While there is no specific diet that has been proven to cure MS, some research suggests that making dietary changes may help people with MS better manage their symptoms. The Mediterranean diet, in particular, has been associated with reduced MS odds and improved health outcomes in the general population.
The Mediterranean diet is based on the traditional eating habits of people in countries bordering the Mediterranean Sea, such as France, Greece, Italy, Portugal, and Spain. It includes a high intake of whole grains, vegetables, fruits, legumes (beans, lentils, peas, and peanuts), olive oil, and fish. The diet recommends moderate amounts of low-fat dairy products, poultry, and red wine while limiting red meat, sweets, and animal fats.
Several studies have linked the Mediterranean diet to positive outcomes in people with MS. A large population-based study published in 2012 found that older adults who followed the Mediterranean diet showed less damage to the brain's small vessels, which is a common occurrence in aging and diseases like MS. Another study reported that higher adherence to the Mediterranean diet was associated with a lower burden of WMHV, suggesting potential benefits for brain health in people with MS.
Additionally, the Mediterranean diet has been associated with a reduced risk of disability in people with MS. Higher scores on the Mediterranean Diet Adherence Screener (MEDAS) predicted better outcomes on the Multiple Sclerosis Functional Composite (MSFC) and patient-reported outcomes (PROs). This suggests that following the Mediterranean diet may help reduce the impact of MS symptoms and delay disability progression.
Some small studies also suggest that the Mediterranean diet could help ease fatigue in MS patients. The exact mechanism behind this is not fully understood, but it may be related to the diet's potential to reduce inflammation and improve overall health. However, more high-quality observational studies are needed to confirm these findings and establish the link between the Mediterranean diet and improved outcomes in MS patients.
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Intermittent fasting
In one study, researchers compared two groups of mice. The mice in the fasting group ate a very low-calorie and low-protein diet 3 days a week for 3 weeks, while the other group ate a normal diet. The fasting mice had lower levels of cytokines, which are immune system chemicals that promote inflammation. They also had less damage to their myelin, the protective coating around nerve fibers, and their MS symptoms were less severe than the mice on a normal diet.
In a more recent mouse study, an intermittent fasting plan reduced the immune response. Mice that ate every other day had fewer inflammatory immune cells and more cells that helped control the immune response than mice fed daily. They also had fewer MS symptoms, such as weakness and trouble walking. In both mouse studies, mice that fasted had higher levels of the anti-inflammatory hormone corticosterone.
There are different ways to do intermittent fasting, including time-restricted eating, where you only eat within a set number of hours each day, and modified alternate-day fasting, where you vary between a normal calorie count one day and about 500 calories the next day.
While it is not a mainstream treatment, some researchers note that a Western-style diet is linked to inflammation, and intermittent fasting may help bring down inflammation and prevent the immune system from releasing chemicals that harm myelin. However, it is not necessarily healthy and can result in lightheadedness, headaches, and dehydration. If you have MS and are considering trying intermittent fasting, be sure to talk to your doctor first.
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Paleo diet
Multiple sclerosis (MS) is an autoimmune disorder that gradually destroys the protective coverings (called myelin sheaths) around nerve fibres. While diet cannot cure MS, some research suggests that making dietary changes may help people with MS better manage their symptoms. There is no single diet universally recommended for people with MS. However, several dietary strategies have been developed for MS, which generally aim to provide for the body's nutritional needs while avoiding foods that could worsen inflammation.
The Paleo diet is one such strategy that has been explored for people with MS. The Paleo diet is based on the concept that the human body cannot handle highly processed foods and is better adapted to eating foods found naturally. The diet includes fresh meat (lean game meats), fish, nuts, vegetables, and fruits, but excludes dairy, grains, pulses (certain types of legumes), potatoes, and all processed food. The Paleo diet is also central to the Wahls Protocol, created by Dr Terry Wahls after she was diagnosed with MS in 2000. The Wahls Protocol is similar to the Paleo diet but with some differences. It recommends eating lean meat, fish, chicken, and nuts, and avoiding processed foods and refined sugar. It also excludes eggs and allows legumes (such as in soy milk) and two servings of gluten-free grains (such as rice) per day. The Wahls Protocol also puts more emphasis on vegetables and fruit.
Some studies have found potential benefits of the Paleo diet for people with MS. A Phase 1 study from the University of Iowa evaluated the effects of a modified Paleolithic diet, exercise, stretching, massage, meditation, and electric stimulation of muscles in people with secondary progressive MS over 12 months. The study reported significant improvement in fatigue scores at the end, but its multimodal approach means it is impossible to link the fatigue decline to any one factor. Another small study from the Netherlands found that consuming a Paleo diet for two weeks improved cardiovascular risk compared to a healthy reference diet in people with metabolic syndrome. A recently published study also 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. However, it is important to note that the results of studies on the Paleo diet and MS are mixed, and more research is needed to validate whether there is reliable evidence that it could play a role in the management of MS.
It is always recommended to discuss your health with your doctor before implementing any dietary changes, especially if you have specific health concerns such as high blood cholesterol or digestive symptoms.
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Lifestyle changes
While there is no single diet proven to cure MS, some studies suggest that making dietary changes may help people with MS better manage their symptoms. Here are some lifestyle changes that may be beneficial:
Dietary changes
- A balanced diet that provides all the necessary nutrition may help patients better manage and control MS. A well-balanced diet can improve overall health and reduce inflammation, thus assisting in managing MS.
- The Mediterranean diet, which includes plenty of fruits and vegetables, whole grains, olive oil, low-fat dairy products, fish, poultry, and red wine, is generally considered well-balanced and nutritionally complete. Some studies suggest it could help ease fatigue and reduce the impact of MS symptoms.
- The Swank Diet, which is low in fat and restricts red meat and dairy products with high butterfat content, has been linked to a lower likelihood of disability progression and death from MS-related causes.
- The Paleo diet and the McDougall diet are also sometimes used to manage MS symptoms, but more research is needed to validate their effectiveness.
- Fasting-mimicking diets and the ketogenic diet have not shown any effect on relapsing-remitting MS, and the latter may increase the risk of cardiovascular disease.
- A high dosage of biotin (at least 300 milligrams per day) could potentially help people with progressive MS.
- Polyunsaturated fatty acids (PUFAs) found in fatty fish and some plant-based oils may help manage inflammation and support overall health.
- Staying hydrated and avoiding spicy foods, alcohol, caffeine, and fruit juices can help with bladder problems.
- Consuming enough fibre and fluids can help with bowel problems.
- Dried fruit, smoothies with fruit and vegetables, and extra vegetables in main dishes can be incorporated into meals.
Other lifestyle changes
- Exercise is one of the best non-pharmacological treatments for MS and can help reduce fatigue and improve overall health and well-being.
- Increasing sunlight exposure can help boost vitamin D levels.
- Quitting smoking and avoiding second-hand smoke can have positive health benefits.
- The social aspect of eating is important, and sharing meals with friends and family can enhance feelings of connection and social support.
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Frequently asked questions
No diet can cure multiple sclerosis. However, certain dietary changes may help people with MS better manage their symptoms.
A balanced diet that provides for all nutritional needs may help patients better manage and control MS. A well-balanced diet can improve a person's overall health and may assist in managing MS. A good diet can help ease some symptoms of the disease. For example, being obese or overweight is linked with worse severity of some MS symptoms, such as fatigue and pain.
Several small studies have shown a positive impact on MS symptoms, including a reduction of fatigue. The effects of the Paleo diet, the Mediterranean diet, the McDougall diet, the Wahls Elimination (WahlsElim) Diet, and the Swank Diet are still being investigated as experts attempt to validate whether there is reliable objective evidence that they could play a role in the management of MS.
Certain lifestyle and habit changes may benefit a person’s overall health and help them manage their MS. These include increasing sunlight exposure to boost vitamin D levels, exercising to help maintain strength and flexibility, quitting smoking, and avoiding secondhand smoke.
