Multiple sclerosis diet: What to eat, lifestyle changes, and more

While there is no single best diet for multiple sclerosis (MS), consuming or avoiding certain foods may help a person manage their symptoms. Certain lifestyle changes may also be beneficial for managing MS.
When a person develops MS, the myelin that coats nerve fibers becomes damaged. As a result, the nerves lose the ability to transmit electrical signals.
In relapsing-remitting MS, the symptoms come and go. A person experiences symptom flare-ups (relapses) and periods of remission. In other types of MS, which are progressive, the symptoms gradually worsen.
Treatment for MS focuses on managing symptoms and helping people live with the condition. A well-balanced diet can improve a person’s overall health and may assist in managing MS.
can improve
Understanding the role of diet in MS and making certain changes may result in fewer relapses, a lower risk of health complications, and a better quality of life.
How does diet affect MS?
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MS is an autoimmune disease in which the immune system mistakenly attacks the central nervous system.
autoimmune disease
immune system
The relationship between the diet and MS may involve:
the role of gut bacteria in immune disorders
vitamin deficiencies
vitamin
nutrients that can support and protect the central nervous system
the benefits of a healthy, balanced diet for overall well-being
Read an overview of MS.
overview of MS
Is there a best diet for MS?
Anyone following a specific diet needs to consume all the necessary daily nutrients. Before making large dietary changes, a person should speak with a registered dietitian to ensure they can replace any lost nutrients.
A 2020 review assessing the effectiveness of a gluten-free diet in people without celiac disease did not find enough evidence to support a link between gluten sensitivity and MS.
2020 review
gluten sensitivity
However, people with MS may be more likely to develop celiac disease, which prevents the body from tolerating gluten. As a result, some people with MS may benefit from avoiding gluten.
may be more likely
celiac disease
gluten
Gluten is a protein present in wheat, rye, and barley. Therefore, people avoiding gluten should avoid foods containing these grains.
Foods that contain gluten include:
include
wheat products such as bread and baked goods
many premade soups and salad dressings
barley products such as malt, soups, beer, and brewer’s yeast
barley
brewer’s yeast
rye, which is often present in bread and cereals
People who follow a gluten-free diet may miss out on important nutrients, including fiber, which is present in whole grains. They can boost their fiber intake by eating plenty of fresh vegetables, fruits, nuts, seeds, and pulses.
gluten-free diet
Anyone considering a gluten-free diet should consult a doctor first.
Many people who follow the Paleolithic, or “paleo,” diet believe that the human body has not evolved to eat the highly processed foods people now commonly consume.
follow the Paleolithic
The diet involves switching to foods that hunter-gatherers likely ate. The first step is to choose natural foods over processed foods, emphasizing meat and plant-based foods but not grains.
In a small 2017 study, people with relapsing-remitting MS who consumed a modified paleo diet reported improvements in fatigue severity and quality of life scales. However, the authors concluded that larger controlled studies are necessary to fully assess the benefit of a paleo diet for people with MS.
2017 study
relapsing-remitting MS
Learn more about the paleo diet.
paleo diet.
The Wahls diet, or Wahls protocol, is a modified version of the paleo diet. Dr. Terry Wahls developed the plan specifically to help people with MS.
Like the paleo diet, the Wahls diet features nutrient-dense, minimally processed foods. A person following the Wahls diet will prioritize green, leafy, and sulfur-rich vegetables; intensely colored fruits; and minimally processed animal proteins.
features
animal proteins
Small studies have linked the Wahls diet with an improvement in MS symptoms. However, larger, better-controlled randomized studies are necessary to fully examine the effectiveness of the diet.
Small studies
Doctors developed the Swank diet as an MS treatment in the 1950s.
Swank diet
It reduces saturated fat intake to 15 grams (g) per day and recommends limiting unsaturated fat intake to 20–50 g per day.
15 grams (g)
People on this diet:
cannot eat processed foods or dairy fats
cannot eat red meat during the first year
can eat as much white fish and shellfish as they like
should eat at least 2 cups each of fruits and vegetables every day
should eat whole grain pasta
pasta
should take cod liver oil and multivitamins daily
cod liver oil
While some consider the diet to be dated, others report that it helps.
Possible risks include deficiencies in folic acid and vitamins A, C, and E.
include
folic acid
vitamins A
C
E
Learn how much saturated fat to eat in a day.
how much saturated fat to eat in a day
In 2015, the National Multiple Sclerosis Society (NMSS) reviewed several diets and their impact on MS.
National Multiple Sclerosis Society (NMSS)
The authors of the review concluded that there is not enough evidence to recommend one diet over another and acknowledged that most diets restrict or leave out the same types of food.
In general, a person with MS should avoid foods that:
are highly processed
are high in saturated fat
have a high glycemic index
glycemic index
Foods to eat
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Certain foods may benefit people with MS by affecting the function of the immune system, nerves, and body.
Changes in gut health may contribute to immune disorders. Research indicates that gut health plays a role in many health conditions.
gut health
Research
The intestinal flora, or gut flora, is a highly complex system of microorganisms living in the intestines. In humans, these microorganisms are largely bacteria.
These bacteria are responsible for breaking down food and nutrients and play a key role in digestion and immune system health. Healthy gut flora thrives in the intestines when there is ample fiber in the diet.
fiber
The authors of a 2021 review suggest that adjusting the gut flora by using probiotics, for example, may be helpful for people with MS.
2021 review
probiotics
Probiotic bacteria are present in a range of fermented foods. They are also available in supplement form. The following foods contain healthy levels of Lactobacillus, a type of beneficial bacteria:
fermented foods
yogurt
yogurt
kefir
kefir
kimchi
sauerkraut
sauerkraut
kombucha, which is fermented tea
kombucha
After filling the gut with good bacteria, it is important to feed them. Foods that nourish probiotic bacteria are called prebiotics. Some dietary fibers are prebiotic.
prebiotics
are prebiotic
Foods that contain healthy levels of prebiotic fiber include:
artichokes
garlic
garlic
leeks
asparagus
asparagus
onions
onions
chicory
High levels of fiber are present in many plant-based foods, including:
fruits
fruits
vegetables
vegetables
nuts and seeds
nuts
legumes, such as lentils
legumes
lentils
whole grains
brown rice
brown rice
Learn more about high fiber food options.
high fiber food options
Consuming these products may have a range of health benefits for people with MS. A high fiber diet can positively affect the body in several ways, including:
nourishing the gut bacteria
promoting regular bowel movements
regulating blood pressure
blood pressure
keeping the heart healthy by helping manage cholesterol
cholesterol
reducing the likelihood of weight gain by leaving a person feeling full longer
weight gain
People with MS may have a higher risk of certain types of heart disease. While dietary measures may not reduce these risks, a balanced diet benefits overall heart health.
may have
heart disease
Vitamin D is important for everyone, but it may be especially beneficial for people with MS.
Vitamin D
According to the National Institute of Neurological Disorders and Stroke, people with high vitamin D levels appear to have a lower risk of developing MS.
National Institute of Neurological Disorders and Stroke
Vitamin D is also important for bone health. People with MS may be more likely to have low bone density and osteoporosis, especially if they cannot move around easily. An adequate intake of vitamin D may help prevent this.
may be more likely
low bone density
osteoporosis
Most of the body’s vitamin D comes from exposure to sunlight, but a person can also get it by consuming:
consuming
oily fish
oily fish
fortified dairy products
dairy products
some fortified cereals, yogurt, and orange juice
beef liver
beef liver
egg yolks
egg yolks
A 2018 review notes that while evidence of a link between low vitamin D levels and MS is increasing, confirming this will require more research.
2018 review
Biotin is a form of vitamin B. It is present in many foods, but foods particularly high in biotin include:
Biotin
vitamin B
particularly high in biotin
eggs
beef liver
sunflower seeds
sunflower seeds
almonds
almonds
spinach
spinach
broccoli
broccoli
whole wheat bread
Small studies indicate that a high dosage of biotin — at least 300 milligrams per day — could help people with progressive MS.
studies
Confirming and specifying the benefits of biotin supplementation will require more research, but following a balanced diet can often ensure that a person consumes enough of this vitamin.
There is evidence that polyunsaturated fatty acids (PUFAs) may help support a healthy body and manage inflammation.
inflammation
For example, the authors of a 2017 study concluded that a low intake of PUFAs may increase the risk of MS.
2017 study
PUFAs appear to boost bodily functions such as heart health and the ability to think. Foods containing PUFAs include fatty fish, such as salmon and mackerel, and some plant-based oils.
salmon
mackerel
Many vegetable-based foods contain polyphenols, which have antioxidant and anti-inflammatory effects on the body’s cells.
antioxidant
These effects may help prevent cell damage, making polyphenols potentially useful for people with MS.
Sources of polyphenols include:
include
fruits
vegetables
spices
cereals
legumes
herbs
tea
tea
Antioxidants can also help prevent oxidative stress, which researchers have linked to the development of several chronic conditions, including neurological and cardiovascular disease.
oxidative stress
researchers have linked
cardiovascular disease
For more science-backed resources on nutrition, visit our dedicated hub.
dedicated hub
Foods to limit
Components of some foods may be harmful to people with MS, so people should limit them in their diet.
Highly processed foods may affect a person’s health, especially if they contain high levels of:
saturated fats, trans fats, and hydrogenated oils
saturated fats
hydrogenated oils
added sodium, or salt
salt
added sugar
added sugar
A 2017 randomized clinical trial found that a high sodium diet does not directly affect MS disease progression. High sodium consumption can increase blood pressure and the risk of cardiovascular complications in everyone, but it is particularly important for people with MS to moderate their intake.
does not
People with MS have an increased risk of coronary artery disease, heart failure, and heart attacks. As a result, maintaining a moderate sodium intake is essential to promote heart health.
increased risk
A person with MS may benefit from limiting their consumption of:
may benefit
limiting
sugar-sweetened drinks such as sodas and energy drinks
processed meats, including burgers and sausages
fried foods such as french fries and potato chips
highly processed ready-made meals, including frozen pizzas
trans fats such as margarine and shortening
margarine
Weight management
According to a 2019 research article, obesity during childhood and adolescence may increase the risk of developing MS. The authors also note that obesity could affect the progression of the disease.
2019 research article
obesity
Moreover, a person with MS who loses mobility or finds movement more challenging may be more likely to gain weight.
Managing the diet to prevent weight gain may also help prevent MS symptoms from worsening. Dietary changes may boost a person’s well-being and reduce the risk of additional health conditions such as cardiovascular disease.
Lifestyle and diet tips
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 and support overall health and well-being
quitting smoking, if applicable, and avoiding secondhand smoke
quitting smoking
According to the NMSS, there is insufficient evidence to recommend specific diets for treating MS.
NMSS
A healthy diet for a person with MS is one that supports the immune system and provides all necessary nutrients. A varied diet that includes all the core food groups and avoids heavily processed foods and saturated fats is key to overall health.
Anyone considering making major changes to their diet or lifestyle should seek guidance from a doctor first.
Outlook
MS affects the nervous system and can lead to various primary and secondary health issues. It is a lifelong condition that may come and go or progress steadily.
Some people experience only mild tingling, while others lose the ability to move or talk. However, most people with MS remain mobile, and most have the same life expectancy as people without MS.
Some people
same life expectancy
Summary
Healthy dietary choices can benefit people with MS by boosting overall well-being and quality of life. Certain dietary habits may change the condition’s progression or prevent specific symptoms or complications, such as cardiovascular disease.
A range of special diets may help manage MS symptoms and reduce the chance of complications. However, more research is necessary to assess the effectiveness of these diets, and a person should consult a doctor before making any major dietary changes.
People with MS may wish to avoid highly processed foods, saturated fats, and added salt and sugar. Minimally processed whole foods, such as fruits, vegetables, pulses, legumes, and oily fish, are better choices.
A person can find more resources for living with MS by downloading the Bezzy MS app. This free app provides access to expert content on MS and peer support through one-on-one conversations and live group discussions. Download the app for iPhone or Android.
iPhone or Android
Read this article in Spanish.
Read this article in Spanish.