Diet and MS symptoms


If you have MS, you may choose to take proactive steps to improve your general health, including making changes to your diet. Maintaining a healthy weight and providing the right fuel for your body at the right time of day can help make some MS symptoms easier to manage. 

Bladder problems

If you have bladder problems with your MS, you might be tempted to cut back on the amount you drink, so as to reduce the need to visit the toilet. However, drinking too little can lead to concentrated urine that irritates your bladder and increases the risk of a urine infection. You should drink enough to stay hydrated. The recommendation is for six to eight glasses of water per day. You could also try to avoid spicy foods, alcohol, caffeine and fruit juices, which can make bladder problems worse for some people.

Maintaining a healthy weight can help with bladder problems. Being overweight can increase pressure on your pelvic floor and result in stress incontinence.

Bowel problems

Constipation is a common MS symptom. For some people, it can be eased by eating regularly, and having enough fluid and fibre in the diet. However, do speak to your health team if this does not improve matters, as specialist medical help may be needed.

If you plan to increase your fibre intake, do so gradually to avoid causing further problems. You could do this by switching from white bread, pasta and rice to brown or wholegrain versions. You could also slowly increase the amount of vegetables and seeds in your diet.

Fatigue

Your body creates energy from the food you eat, and a poor diet will not provide all the fuel you need for the day. Fatigue is a complex MS symptom, and although it isn't just down to the fuel you have in your body, it makes sense to make sure that your diet is not making your fatigue worse.

A healthy, well-balanced diet including plenty of fruit and vegetables, plus complex carbohydrates will give you the best chance of maintaining your energy levels through the day. Complex carbohydrates are starchy foods that release energy slowly into your bloodstream, compared with simple carbohydrates like sugar.

The glycaemic index (GI) is a ranking of carbohydrate-containing foods based on how quickly they affect your blood glucose levels. Slowly absorbed foods have a low GI rating, while foods that are more quickly absorbed have a higher GI rating. Meals and snacks which are rich in complex carbohydrates, such as fresh fruit and multigrain bread, have a low glycaemic index, giving a slower, more sustained energy release. Lactose, the sugar found in milk and milk products such as yoghurt, also has a low glycaemic index. Taking a low-GI food at the same time as a high-GI food can slow down the rate of release of carbohydrate, for instance by drinking a glass of milk with a sweet biscuit.

It’s tempting to reach for sweet and sugary foods if you feel you need an energy boost. However, you will usually find that your blood glucose levels quickly crash again leaving your energy levels low. High sugar foods and drinks are often low in nutrients, and the extra calories can cause unwanted weight gain. Being overweight can make it harder to deal with fatigue.

It is also important when you are managing fatigue to drink sufficient fluids, especially water, as even mild dehydration can make you feel tired.​ 

You can read more in our blog about fatigue-friendly cooking.

Depression

Depression is a complex symptom that may be connected to other aspects of your MS. It might not be possible to cure depression with a good diet, but you can make sure you’re giving yourself the best chance to overcome it. Your brain needs good quality fuel to stay healthy.

Try to have some protein and starchy carbohydrates at every meal, plenty of non-caffeinated drinks, and avoid alcohol. High levels of alcohol can reduce the amount of B vitamins in your body, which has been shown to affect mood. Try to get some of your dietary fats from seeds and oily fish, rather than meat and dairy.

If you have depression, try eating with friends and family if you can. This can help you remember to eat regularly and avoid becoming isolated or lonely.

Pain

Pain can be associated with obesity and a poor diet. Studies show that people with MS who are overweight or obese can reduce their pain symptoms by losing weight. However, pain can also be a barrier to weight loss if it affects you exercising. 

A healthy diet can help you manage your weight, but you may wish to take advice from a health professional if you wish to make radical changes.

Cognition

Advocates of some special MS diets claim that they feel more alert and less 'foggy' since taking up these diets. These are individual opinions, and it is not easy to test them.

Having heart disease or hypertension is linked to faster cognitive decline and loss of brain volume in people with MS. If you can improve your cardiovascular health, you may improve your general wellbeing and experience of MS as well. Ask a health professional for diet and exercise advice that is suitable for you.

Swallowing problems

If you experience swallowing problems, then a dietitian can suggest types of food and ways of preparing food that makes it easier to eat. You might also be referred to a speech and language therapist, who will help with exercises to improve your swallowing ability.

Weight gain

You might find that you have gained weight with MS, perhaps as a result of loss of mobility, the side effects of medication or reduced opportunity to exercise.

More than half of people with RRMS are overweight or obese. This can also affect your mood and can result in a loss of self-esteem and confidence. Excess weight can also make mobility problems more difficult to manage.

Talking to a dietitian could help, and your GP can also refer you to a physiotherapist who can put together an appropriate programme of exercises.

Weight loss

Weight loss can also occur in MS where depression, cognitive impairment, fatigue or relapse can lead to a loss of appetite. Difficulty with swallowing can make it a challenge to get enough energy and nutrients from food. Some medications can suppress your appetite as a side effect.

Weight loss can put you at increased risk of pressure sores and malnutrition. If you are not getting enough of the right nutrients in your diet, you might be more susceptible to other illnesses. Being malnourished can also affect your mental functioning and reduce your muscle strength. Where weight loss is a problem, try to include food with a higher fat content in your diet. You might find guidance from a dietitian helpful.

Weight loss may also be an indication of other conditions. You should inform your doctor immediately if you've noticed rapid weight loss.

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