The impact nutrition has on the development of multiple sclerosis (MS) remains a point of contention amongst medical professionals. While food has traditionally been seen as a source of energy providing the body with the building blocks it needs to function effectively, academics within the medical community are taking a closer look at its role in disease prevention and/or management.
As part of this ongoing analysis, researchers are actively pursuing what diets can be helpful and harmful for those suffering from MS through medical studies and randomized controlled trials. While it is premature for the medical community to recommend a specific ‘MS diet’ to prevent, treat or cure MS, there are several dietary considerations that factor into the overall health and well-being of MS patients.
According to the National Multiple Sclerosis Society, MS specialists recommend that people with MS adhere to the same low-fat, high-fiber diet recommendations of both the American Heart Association and the American Cancer Society.[i] Making these important dietary changes may result in fewer relapses, a lower risk of health complications and a better quality of life.
Below, please find additional information on the role of diet and nutrition in MS management and progression.
Saturated fats, including coconut and palm oil, as well as fats from dairy and meats, have been linked to inflammation and are largely to blame for the rise in cardiovascular disease and obesity in developed Western nations. This is due to the fact that excessive intake of saturated fats increases cholesterol levels, which has been associated with poor outcomes in MS patients.
According to a study published in the The Journal of Neurology, Neurosurgery, and Psychology, obesity and high cholesterol increased the likelihood of disease progression in MS patients, with obesity and high triglycerides making the disease relapse more likely.[ii]
MS specialists recommend reducing saturated fat intake to less than 15 grams per day. This includes limiting intake of fatty meats, full-fat milk and milk products such as cream and cheese, fats like butter, lard, shortening, palm kernel and coconut oils, as well as processed foods and packaged snacks and sweets.
It is important MS patients maintain a healthy dose of unsaturated fatty acids, which are important for brain and cellular health. Unsaturated fatty acids contain omega-3s and vitamin D and are commonly found in avocado, nuts, fish, olive oils and vegetable oils and foods containing omega-3s.[iii]
Fruits, Vegetables and Whole Grains
Fruits, vegetables and whole grains are staple ingredients in any balanced diet. Not only do these food items reduce the risk for heart disease, including heart attack and stroke, but they have been known to protect against certain types of cancers.
The benefits of fruits, vegetables and whole grains also extend to MS patients. According to a 2017 study published in Neurology, eating a healthy diet made up of fruits, vegetables and whole grains may be linked to reduced disability and fewer MS symptoms. Authored by Kathryn Fitzgerald of Johns Hopkins School of Medicine in Baltimore, the study considered the diet, level of physical activity and lifestyles of 6,989 MS patients. Participants in the group considered to have the best diet ate an average of 1.7 servings of whole grains and 3.3 servings of fruits, vegetables, and legumes per day. These participants were 20 per cent less likely to suffer from a severe physical disability than those lacking these essential items in their diet.
The study also attributed an “overall healthy lifestyle” with significantly reduced rates of depression, fatigue and pain.[iv] Fitzgerald noted that while the study does not determine whether a healthy lifestyle reduces MS symptoms or whether having severe symptoms makes it harder for people to engage in a healthy lifestyle, she concluded it provides evidence linking the two.
A growing body of research suggests there is a link between vitamin D deficiency and MS. The link was prompted by population study results revealing MS is more prevalent in countries further away from the equator, where sunlight exposure is much lower, especially during the winter months.
Vitamin D regulates the immune system and suppresses pro-inflammatory T-cells. In addition, it also plays a role in repairing nervous tissue damaged by MS-related inflammation, helping to form myelin—an insulating layer, or sheath, that forms around nerves and is damaged by the immune system of those with MS. Researchers suggest, in addition to increasing the risk of developing MS, vitamin D deficiency may also affect disease activity and clinical course, making it a strong risk factor for long-term MS disability.[v]
MS specialists recommend a Vitamin-D enriched diet over and above the 600 units (IU) per day recommended for adults. Good food sources of Vitamin D include fish, especially salmon and mackerel, liver, mushroom, eggs and certain types of plant-based beverages like orange juice and almond milk.
Patients with MS should be consuming between 1,000 to 2,000 IU per day to protect against disease progression. If the patient exhibits substantially low vitamin D levels, it is recommended they take 50,000 IU per week until levels have normalized. If patients are not receiving enough Vitamin D through food or sunlight, supplements are also recommended.[vi]
A gluten-free diet eliminates all products derived from cereals—wheat, barley, rye and triticale (cross between wheat and rye)—that contain gluten. These diets are growing in popularity across North America, with anecdotal evidence suggesting becoming gluten-free will lead to improved health, weight loss and increased energy.
Some researchers have suggested there is a relationship between gluten intolerance and MS, arguing gluten triggers neurological antibodies that cause demyelination. Gluten has also been linked to vitamin and mineral deficiencies, which can disrupt the nervous system and lead to chronic inflammation and neuropathy.[vii] However, evidence on the effects of a gluten-free diet for MS patients has been inconsistent.
With support from their health team, MS patients are free to reduce or eliminate gluten from their diets provided they keep a record of food intake and associated symptoms. A good starting point is to cut wheat, barley, rye, triticale and oats to get a sense of what going gluten-free entails. If patients choose to eliminate gluten, specialists advise vitamin and mineral supplements to ensure proper intake of vitamin B, folic acid and fiber.
Meeting Personal Needs
While researchers continue to explore direct links between nutrition and its role in MS development, symptom management, disease progression, MS specialists recommend a balanced, low-fat and high-fiber diet. Registered dieticians can help patients come up with a plan that meets their specific needs.
If you have MS, following Canada's Food Guide will provide you with all the nutrients you need. Do not go on a special diet without talking to a Registered Dietitian. If you do want to make changes to the foods you eat, a Registered Dietitian can help you come up with a plan that meets your needs.
Did you know? Most Authorized PoNS Treatment™ Clinics offer dietary programs for interested patients. To learn more about PoNS Treatment™ for MS-related gait deficit, visit our website and contact a clinic near you.
Stay up to date on the latest news about neurological wellness, including information and developments surrounding PoNS Treatment™, by subscribing to our newsletter!
Disclaimer: This content is provided for general informational and educational purposes only and is not a substitute for professional advice. Contact your physician prior to acting on recommendations thereof.
[i] “Diet and Nutrition,” National Multiple Sclerosis Society, (Accessed July 20, 2020), https://www.nationalmssociety.org/Living-Well-With-MS/Diet-Exercise-Healthy-Behaviors/Diet-Nutrition
[ii] Kaltwasser, Jared, “Obesity, High Cholesterol Linked to Multiple Sclerosis Progression,” MD Magazine, April 13, 2017, (Accessed July 18, 2020) https://www.mdmag.com/medical-news/obesity-high-cholesterol-linked-to-multiple
[iii] “MS Foods to Avoid,” Healthline, September 19, 2018, (Accessed July 18, 2020) https://www.healthline.com/health/multiple-sclerosis/foods-to-avoid#saturated-fats
[iv]Kathryn C. Fitzgerald, Tuula Tyry, Amber Salter, Stacey S. Cofield, Gary Cutter, Robert Fox, Ruth Ann Marrie, “Diet quality is associated with disability and symptom severity in multiple sclerosis,” Neurology, Jan 2018, 90 (1). (Accessed July 20, 2020). https://n.neurology.org/content/90/1/e1
[v] “Vitamin D,” Multiple Sclerosis Society of Canada, (Accessed July 20, 2020). https://mssociety.ca/
[vi] Martina B. Sintzel,Mark Rametta and Anthony T. Reder, “Vitamin D and Multiple Sclerosis: A Comprehensive Review,” Neurology and Therapy, Vol. 7, no. 1 (2018) 59–85.
[vii] “Gluten Intolerance is Associated with Severe Vitamin and Mineral Deficiencies,” Health and Science, January 2020, (Accessed July 18, 2020). https://www.healthandscience.eu/index.php?option=com_content&view=article&id=2408:gluten-intolerance-is-associated-with-severe-vitamin-and-mineral-deficiencies-us&catid=20&lang=us&Itemid=374#:~:text=Gluten%20triggers%20inflammatory%20processes%20in,acid%2C%20zinc%2C%20and%20copper.