For many people with MS, diet offers a sense of control when living with a condition which is often unpredictable. Conventional treatments are often only partially effective, and a good diet can be part of active self-management. Following your diagnosis of MS, you may feel that good health and wellbeing are important to you.
Diet and MS
Maintaining a healthy diet is helpful for everyone. If you have MS, you may find a healthy diet helps with some of your symptoms, or reduces the impact of MS on your life. Currently, more than half of people with MS are following a diet plan or taking a dietary supplement.
There are several diet plans which claim to cure MS or made a significant improvement to their symptoms or relapse rate. However, no specific diet or dietary supplement is proven to help everyone with MS. It's a very personal choice.
You can read more in our page on about specific diets for MS.
The best approach to changing your diet to manage MS is simply to try it and see. You could start by making a diary to monitor changes to your diet. Notice how your food choices make you feel, and whether you feel there has been any effect on your own MS.
Expensive ingredients or supplements are rarely necessary, and you will stick to a diet better if it is easy for you to find and prepare. Finding a dietary strategy that works for you and your budget can take time.
It is important to stay safe when making changes to your diet, especially if you intend to cut out whole food groups or change your diet radically. Discuss your plans with a dietitian, doctor or MS nurse, and be careful not to leave out essential nutrients.
What is a healthy diet?
The NHS advice on a healthy diet is a good place to start. This advice is based on reducing your risk of developing heart disease, stroke and certain cancers. You need a balanced diet to provide you with all the nutrients needed to be as active and healthy as possible.
You are advised to eat food from all the food groups, in the general proportions shown in this food wheel. This balance doesn't have to be in every meal, but try to make it work out over the course of a day. Base your meals around starchy foods like bread, pasta or rice, with plenty of fruit and vegetables. Protein can come from animal or plant sources. Keep fatty, sugary and salty foods to a minimum. Take some appropriate exercise several times a week, and drink plenty of water.
The UK government recommends a minimum of five portions of fruit or vegetables a day. Many people believe that five is not enough, in fact France recommends ten portions a day. Just adding more fruit and vegetables to your existing diet can be done by choosing snacks such as cherry tomatoes, carrot sticks or fruit during the day. You could also add dried fruit to your breakfast cereal, make smoothies with fruit and vegetables, or add extra vegetables into your main dishes.
Counting calories or worrying about every ingredient can make some people anxious. There is no need to worry about ‘failing’ with your diet. Allowing yourself occasional treats can be good for you in different ways, such as in improving your mood or motivating you to exercise. The social side of eating is also important. Enjoying meals with friends and family helps everyone to feel connected and socially supported.
Why is diet important in MS?
Good diet can play an important role in managing symptoms such as depression, fatigue and constipation, whilst a poor diet can result in a worsening of some symptoms, for example, pain or weakness. A poor diet can also put you at risk of other diseases, such as vascular disease or osteoporosis. Where your MS results in you having reduced mobility, then these diseases can be more likely and also more difficult to manage.
You can read more on our page about how your diet can affect your MS symptoms.
A US study of nearly 7,000 people with MS recently reported that the people with the healthiest diets and lifestyles reported the least disability and lower burden of symptoms. This study wasn’t looking at particular ‘MS’ diets, but at general eating patterns. The researchers rated high intakes of fruit, vegetables and whole grains as healthy, and rated high intakes of sugars, red meat and processed meats as unhealthy. They also looked at age, sex, body weight, smoking and physical activity.
The people with the healthiest lifestyles were less likely to report severe fatigue, depression, pain or cognitive impairment. It could be that it is easier to follow a healthy diet if you have a lower burden of MS disability and symptoms. However, it’s also likely that making some dietary changes could be worth a try, if these are symptoms you are concerned about in the future.
Did diet cause my MS?
MS is probably caused by a combination of genetic susceptibility with viral infection and environmental risk factors. Some of the risk factors are related to food, but most are not. Many people share the same general diet but do not get MS, so you don't need to feel that your diet was to blame for your MS.
There is evidence that having low levels of Vitamin D is a risk factor. Vitamin D can be gained from sunlight as well as food, so this is not strictly a dietary link. MS is more common in countries which are closer to the poles, and get less hours of sunlight through the year.
High levels of salt in the diet may also be a risk factor for MS and other autoimmune conditions. There is no firm evidence that high salt intake affects the likelihood of acquiring MS or the age when it develops.
The countries where MS is common are also known for having diets high in saturated fats, animal fats and dairy products. However, these factors alone are not enough to cause MS. There is no direct link from eating the ‘wrong’ foods to getting MS.
There is no evidence that MS is related to food allergies or intolerances. However, it is possible to have MS alongside another condition that affects your gut. If you suspect you have an allergy or food intolerance, do seek advice from your GP or an NHS allergy clinic.
Can diet affect the progression of my MS?
There is no strong evidence for a direct benefit of any specific diet plan on MS progression or relapse rate in MS. However, many people with MS believe that a change in diet has made a difference to them and the way they feel day-to-day. There is evidence that diet can help manage or alleviate some MS symptoms or other medical conditions that make living with MS more difficult.
The foods we eat are digested in complex ways within our bodies. Some food components such as vitamins and fatty acids have been shown to affect the immune system and influence inflammation. In MS, inflammation around the nerves causes damage to the myelin coating around them. Some people try to eat foods that have an anti-inflammatory effect.
The food we eat is also fuel for our microbiome, the population of bacteria living in our gut. The foods we eat affect which types of bacteria will thrive. Bacteria associated with producing important anti-inflammatory substances tend to digest vegetable fibre. Having a diet rich in fruit and vegetable variety is likely to produce a healthy and diverse microbiome.
Some studies show a link between dietary components and MS relapse rate or progression. In children with MS, having a high intake of fat in the diet, especially saturated fat, increased the chances of a relapse. Having a large amount of vegetables in the diet decreased the chance of relapse. The relationship between saturated fats and MS has been suspected for decades, and forms the basis of several of the specific MS diets. Obesity is linked with higher MS rates, especially in adolescence, and also with higher relapse rate.
Some small studies have shown that replacing saturated fats in the diet with polyunsaturated or monounsaturated fats can benefit people with MS. The result was less inflammation, lower relapse rates and slower disease progression with diets rich in fats from seeds and oily fish. However, not all studies have agreed, and the relative benefit from different kind of fats is not clear.
Should I take dietary supplements to help my MS?
Some people with MS take dietary supplements, either as part of their overall diet plan, or on the recommendation of their MS team. Popular supplements include Vitamin D, biotin and omega-3 and omega-6 oils. Unless you have a diagnosed deficiency in an essential nutrient, supplements should not be necessary with a balanced, healthy diet.
One exception is Vitamin D. During winter in the UK, the sunlight is not strong enough to make Vitamin D, and a supplement is recommended for everyone.
Some supplements may interact with prescription drugs or treatments, and cause serious problems. Always tell your health professionals what supplements you take.
You can read more about dietary supplements and MS in our webpage.
Who can help me with my diet?
A dietitian is a therapist who assesses, diagnoses and treats diet and nutrition problems. Dietitians use their knowledge of food and nutrition to devise eating plans to help manage medical conditions, promote good health through healthy eating and educate individuals and groups on good nutritional habits. Dietitians often work as part of a wider multidisciplinary team and may also visit MS Therapy centres.
Dietitian is a protected title and all dietitians must be appropriately trained and registered with the Health and Care Professions Council (HCPC). You can ask your GP or MS team to refer you to a dietician.
Unlike a dietitian, the title nutritionist is not currently a protected term and anyone in the UK can refer to themselves as a nutritionist without any formal qualifications. The Nutrition Society has a list of accredited courses and maintains a register of nutritionists.
Find out more
- The Eatwell Guide - NHS
- Demystifying diets for MS part 1: Podcast featuring interviews with practitioners of two diets (Wahls Protocol and Overcoming MS).
- Demystifying diets for MS part 2: What is a healthy diet? Podcast featuring a registered dietitian who has MS herself and shares her perspective.
- Tips for a fatigue-friendly kitchen. Advice from people with MS and health professionals to help you save energy and eat well.
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Diet and Multiple Sclerosis
National Multiple Sclerosis Society USA
The Multiple Sclerosis Diet Book
Sheldon Press, 2017
Diet quality is associated with disability and symptom severity in multiple sclerosis
Neurology 2018 Jan 2:90 (1) e1-e11
Summary (link is external)
Dietary interventions for multiple sclerosis.
Cochrane Database of Systematic Reviews 2012; 12:CD004192.
Summary (link is external)
Exploring wellness interventions in progressive multiple sclerosis: an evidence based review
Current Treatment Options in Neurology 2018
Summary (link is external)
Dietary fatty acids and susceptibility to multiple sclerosis
Multiple Sclerosis Journal 2018 24 (1) 12-16
Summary (link is external)
Contribution of dietary intake to relapse rate in paediatric multiple sclerosis
Journal of Neurology Neurosurgery and Psychiatry 2018 Jan 89(10 28-33
Summary (link is external)
Pain in People with Multiple Sclerosis: Associations with Modifiable Lifestyle Factors, Fatigue, Depression, Anxiety, and Mental Health Quality of Life.
Frontiers in Neurology 2017 Sep 5;8:461
Full article (link is external)