Why Diet Matters for People with MS
Multiple sclerosis is an inflammatory autoimmune disease, and diet is a powerful tool to manage overall health and inflammation levels. Eating healthy foods provides the body with the nutrients needed for nerve cell repair, gut health, and immune system regulation. A poor diet, conversely, can increase inflammation and contribute to other health conditions that complicate MS management. Several dietary patterns have been explored for their potential benefits in people with MS.
The Mediterranean Diet for MS
Widely supported for its heart and brain health benefits, the Mediterranean diet is a sound starting point for many people with MS. This diet emphasizes fruits, vegetables, whole grains, legumes, fish, and healthy fats like olive oil, while limiting red meat and saturated fats. Research suggests it can reduce disability progression, improve quality of life, and benefit cognitive function in people with MS. It is also easier to adhere to than more restrictive options and promotes gut health, which is key for immune function.
The Wahls Protocol: A Modified Paleo Approach
Developed by Dr. Terry Wahls, who has MS, this protocol is a modified Paleolithic diet that focuses on nutrient density. It encourages high consumption of leafy greens, sulfur-rich vegetables, and brightly colored fruits, along with meat, fish, and organ meats. The diet strictly limits grains, legumes, and dairy. Some small studies indicate it may reduce fatigue, but the evidence is limited and often involves other lifestyle interventions. Potential drawbacks include being restrictive and the risk of nutritional deficiencies if not carefully managed.
The Ketogenic Diet and MS
A ketogenic diet (keto) is high in fat, moderate in protein, and very low in carbohydrates, forcing the body into a state of ketosis. In this state, the body produces ketones, which some research suggests may have anti-inflammatory effects. A recent systematic review found that ketogenic diets show promise for improving fatigue, depression, quality of life, and possibly neurological function in some MS patients. However, this diet is highly restrictive, and side effects like constipation and the keto flu are common. Medical supervision is recommended due to potential long-term side effects and nutritional concerns.
Comparison of Popular MS Diets
| Feature | Mediterranean Diet | Wahls Protocol | Ketogenic Diet |
|---|---|---|---|
| Focus | Whole foods, plants, healthy fats | Nutrient-dense vegetables, protein, healthy fats | High fat, very low carbs |
| Dairy | Moderate, low-fat dairy allowed | Eliminated | Eliminated or limited |
| Grains | Whole grains encouraged | Eliminated | Eliminated |
| Meat | Poultry and fish preferred, red meat limited | Grass-fed meat, fish, organ meats | Moderate protein, including meat |
| Fruits/Veggies | High intake emphasized | Very high, specific types emphasized | Limited, especially starchy vegetables and high-sugar fruits |
| Evidence | Strong for general health, growing for MS | Limited, primarily self-reported outcomes | Promising pilot studies, needs more research |
| Difficulty | Moderate; more sustainable long-term | High; very restrictive | High; restrictive and potential side effects |
Foods to Prioritize
Include foods rich in omega-3 fatty acids, antioxidants, and fiber to support overall health and manage inflammation. Good sources include fatty fish, flaxseeds, walnuts, fruits, colorful vegetables, whole grains, and legumes. Vitamin D is also important for immune function, often requiring supplementation. Lean protein from fish, poultry, and legumes is also beneficial.
Foods to Limit or Avoid
Reduce or avoid saturated and trans fats found in red meat and processed foods, as they can increase inflammation. Processed foods, refined carbohydrates, and added sugars can cause blood sugar spikes and fatigue. Excessive alcohol should also be limited as it can interfere with nerve function.
Tips for Managing Diet with MS
Managing diet with MS can be challenging due to symptoms like fatigue or mobility issues. Simplifying meal preparation through batch cooking, using frozen foods, or getting help from others can be useful. For swallowing difficulties, focus on moist and soft foods.
Conclusion
While there isn't one definitive best diet for MS, an anti-inflammatory eating pattern focused on whole, plant-based foods, healthy fats, and fiber is widely recommended. The Mediterranean and OMS diets are good examples. More restrictive diets like Wahls or keto may suit some individuals but require careful planning and medical guidance. Choosing a sustainable, nutrient-rich diet tailored to your needs is key, ideally with support from a healthcare professional. You can find more information on the Overcoming MS website.
