There is no specific diet or dietary supplement that is proven to help everyone with MS. However, many people with MS have found benefit in switching to a healthy diet, from small changes to radical overhauls. Currently, more than half of people with MS are following a diet or taking a dietary supplement.
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. There are several diet plans where their advocates claim to have cured their MS or made a significant improvement to their symptoms or relapse rate. In this page we will evaluate the evidence for all kinds of diets on MS and MS symptoms, as well as giving you some ideas to help with improving your diet in general.
The best approach to changing your diet to manage MS is simply to try it and see. 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, but you could start a diary and monitor how changes to your diet make you feel, and whether you find any effect on your own MS.
Do stay safe with dietary changes, 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 five portions of fruit or vegetables a day. Many people believe that five is not enough, in fact France recommends ten portions. 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.
There is no need to worry about ‘failing’ with your diet. Counting calories or becoming concerned about every ingredient can make some people anxious. 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 really important. Enjoying meals with friends and family helps everyone to feel connected and socially supported.
Why is diet important in MS?
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 is part of active self-management. Following your diagnosis of MS, you may feel that good health and wellbeing are even more important to you.
Good diet can also 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.
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.
There is no evidence that MS is related to food allergies or intolerances. However, there is no reason why you couldn’t have MS alongside another condition that affects your gut. If you suspect you have an allergy or food intolerance, do seek advice from an NHS allergy clinic.
Did my diet cause my MS?
Multiple Sclerosis is probably caused by a combination of genetic susceptibility with viral infection and environmental risk factors. Some of the risk factors are dietary, but some are not. 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, but studies have not confirmed this yet. High-salt diets are associated with other autoimmune conditions, but there is no firm evidence that salt intake affects the likelihood or age of acquiring MS.
There is also some evidence that having high levels of saturated fat or animal fat in the diet are risk factors for getting MS. 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.
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 good evidence that diet can help manage or alleviate some MS symptoms or other medical conditions that make living with MS harder.
It is theoretically possible that diet could affect MS in a more significant way than in simply managing the symptoms. The cells of the immune system are influenced by components of the diet, particularly vitamin D and fatty acids. The way these components are digested and used by the body can promote or reduce inflammation. However, a diet is more than a single component, and the metabolic processes going on in the body are highly complex.
Indirectly, 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. The role of the microbiome in MS has a lot of research interest currently, not just in MS, but other auto-immune and metabolic diseases. This could lead to the use of faecal transplant as a way to get beneficial bacteria into an unhealthy gut.
Some observational studies do seem to 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 discussed below. Obesity is linked with higher MS rates, esepcially in adolescence, and also with higher relapse rate.
There is some evidence that replacing saturated fats in the diet with polyunsaturated or monounsaturated fats can benefit people with MS. Small studies have shown less inflammation, fewer relapse rates and slower disease progression with diets rich in these fats, which generally come from seeds and oily fish. However, not all studies have agreed, and the relative benefit from different kind of fats is not clear.
Some people with MS take dietary supplements, either as part of their overall dietary strategy, or on the recommendation of their MS team. Popular supplements include Vitamin D, biotin and omega-3 and omega-6 oils. You may wish to investigate these for yourself, but be aware that the quality of supplements can vary, and the costs can be high. We have extensive A-Z pages on many of these topics.
Unless you have a diagnosed deficiency in some essential nutrient, supplements should not be necessary with a balanced, healthy diet. An exception is Vitamin D. This is made in the skin when exposed to sunlight, as well as being found in food. During winter in the UK, the sunlight is not strong enough to make Vitamin D, and a supplement may be reasonable.
Some supplements may interact with prescription drugs or treatments, and cause serious problems. Always tell your health professionals what supplements you take.
Where can I get help with my diet?
Dietitian is a protected title and all dietitians must be appropriately trained and registered with the Health and Care Professions Council (HCPC).
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.
Having a special diet need not prevent you from eating out with family and friends. Most professional kitchens now have ingredient lists to hand, and will be able to advise you on dishes you can choose. It can be helpful to carry a diet card that lists the ingredients you wish to avoid. This can be passed to the chef so that your instructions are not muddled between the waiter and the kitchen. It could be translated into other languages when travelling abroad. You can create this yourself or find one produced by a company or an allergy charity.
If you are concerned that you might have an allergy or food intolerance, speak to your doctor. The charity Allergy UK may also be able to help.
If you are finding it hard to stick to a healthy diet, then enlist the help of the people around you. Explain what you are trying to achieve, and ask them to remind you to make healthy choices. Perhaps you will inspire the whole family or office to improve their diet?
Many people find technology helpful in managing their diet and health. You might find a smartphone app that helps you track your food and MS symptoms, or enjoy using wearable gadgets that can track your activity, daily footsteps or heart rate. Many of these link to your phone or computer and allow you to input your food and water intake as well. There's no need to get anxious about your diet, or spend a lot of money, but gadgets like this can help some people feel in control.
- National Multiple Sclerosis Society USA Full article Diet and Multiple Sclerosis
- Sheldon Press, 2017 Summary The Multiple Sclerosis Diet Book
- Neurology 2018 Jan 2:90 (1) e1-e11 Summary Diet quality is associated with disability and symptom severity in multiple sclerosis
- Cochrane Database of Systematic Reviews 2012; 12:CD004192. Summary Dietary interventions for multiple sclerosis.
- Current Treatment Options in Neurology 2018 April 10:20 (5) 13 Summary Exploring wellness interventions in progressive multiple sclerosis: an evidence based review
- Multiple Sclerosis Journal 2018 24 (1) 12-16 Summary Dietary fatty acids and susceptibility to multiple sclerosis
- Journal of Neurology Neurosurgery and Psychiatry 2018 Jan 89(10 28-33 Summary Contribution of dietary intake to relapse rate in paediatric multiple sclerosis
- Frontiers in Neurology 2017 Sep 5;8:461 Full article Pain in People with Multiple Sclerosis: Associations with Modifiable Lifestyle Factors, Fatigue, Depression, Anxiety, and Mental Health Quality of Life.