What's the Best Diet for People With MS?
The short answer: a healthy one! We've got doctor-approved advice can improve your overall health and your quality of life, too. by Hallie Levine
If you’ve been diagnosed with multiple sclerosis (MS), there’s no doubt you put a lot of thought, time, and energy into managing your symptoms, slowing down their progression, and protecting your brain function, too. So what about the food you eat? Is there a special “MS diet” you should follow?
The short answer is no. There’s not one diet plan proven to be effective in treating MS, but there are general guidelines that can make a difference in your overall health, energy level, and risk for developing other conditions associated with MS, including heart disease, bladder issues, and bowel problems.
“More rigorous research is needed, but what does exist points to focusing on a healthy, plant-based diet that’s rich in fruits, vegetables, and healthy fats, and low in saturated fat,” says Ilana Katz Sand, M.D., associate medical director of the Corinne Goldsmith Dickinson Center for Multiple Sclerosis in New York City. More specifically, you can keep these six recommendations in mind.
1. Eat Like the Greeks
A Mediterranean diet has long been known to help with heart health. After all, it's typically packed with all the good stuff--fruits, vegetables, whole grains, nuts and seeds, fish, and healthy fats like olive oil and avocado--and low on the less healthy stuff like red meat, full-fat dairy, and processed foods. But new research suggests it may also be helpful for people with MS.
A study of 36 patients with MS at the Mount Sinai School of Medicine in New York City found those who followed a Mediterranean-style eating plan for six months reported improvements in day-to-day symptoms like numbness, limb weakness, dizziness, and fatigue.
“The Mediterranean way of eating is an anti-inflammatory diet, which in turn may reduce some of the inflammation that occurs in MS due to the body’s immune cells attacking its own nerve fibers,” explains Dr. Katz Sand, who was the lead study author.
Another reason it’s worth trying: Unlike most diet plans, this way of eating favors general guidelines and recommendations over strict rules. “It’s more a lifestyle,” says Keri Gans, R.D.N., author of The Small Change Diet. “It’s what we should all refer to as well-balanced, healthy eating.”
2. Cut Your Sodium Intake
Science points to sodium as a potential factor in MS flare-ups. One observational study published in the Journal of Neurology, Neurosurgery, and Psychology found that people who consumed a moderate or high amount of sodium experienced more relapses and had a greater risk of developing new lesions compared to people who consumed a low amount.
How much is too much? The American Heart Association recommends no more than 2,300 milligrams of sodium per day, with an ideal limit of 1,500 mg. That means not only removing your salt shaker from the table, but also watching your intake from sneaky sodium sources, like processed and fast foods.
3. Go Fish
Fish is already a key component of the heart-healthy Mediterranean diet, but there’s even more reason to support putting it on your plate once or twice per week. Fish is rich in omega-3 fatty acids, which may help improve MS symptoms by reducing inflammation that can impact nerve function, Dr. Katz Sand says.
“I encourage my patients to try to eat fatty fish such as salmon, sardines, and tuna instead of red meat as much as possible,” she says. “They not only get the health benefits from the fish, but they also reduce their consumption of saturated fat, which may also have a role in MS symptoms.”
4. Steer Clear of Strict Fad Diets (Unless One's Recommended by Your Doctor)
Three diet plans are often touted to help with MS symptoms, including:
The Paleolithic or “paleo” diet, which is high in protein and plant-based foods (except cereals) and low in dairy, eggs, and gluten
The McDougall diet, a low-fat, high-carbohydrate, moderate-sodium, vegan diet
The Swank diet, a low-fat diet that focuses on reducing both saturated and unsaturated fats
But a review by the National Multiple Sclerosis Society found there is insufficient evidence that any of these diets are effective in reducing MS symptoms. What’s more, following certain strict diets may do more harm than good if they skimp on crucial nutrients such as folic acid, thiamine, and vitamin B6 (due to reduced intake of cereals); calcium and vitamin D (due to lack of dairy intake); and iron.
“These diets are also very restrictive, making them tough to stick to long term,” says Julie Fiol, B.S.N., R.N., senior manager of MS information and resources at the National MS Society. And if you can’t stick to something, you’ll never reap the benefits it promises.
5. Bone Up on Vitamin D
Research in the journal Neurology Review points to a reduced level of vitamin D in the blood as a risk factor for developing MS. And more studies suggest vitamin D may help ease symptoms and improve quality of life for those living with MS.
Known as the “sunshine vitamin,” vitamin D aids immune function and has also been shown to boost brain health. Plus, it’s crucial for bone health, which is important for people with MS since they’re at higher risk of osteoporosis, Fiol says.
Start by incorporating vitamin D-rich foods into your diet, including fatty fish and foods fortified with D, like low-fat dairy products or orange juice. You may also want to get your blood levels of vitamin D tested to make sure you’re not deficient. If you are, ask your doctor what supplement dose you should take. The National MS Society recommends about 1,000 IU per day, but you may need more depending on your current levels and health status.
6. Go Easy on the Alcohol and Caffeine
Booze affects your central nervous system, which means it can impact your balance and coordination—two things you may already struggle with when you have MS, Fiol says. And too much caffeine can aggravate symptoms like muscle spasms and hand tremors.
Alcohol and caffeine are also both diuretics. That means they make you pee more, which is often already a problem if you have MS.
You don’t have to completely abstain from either but stick to 300 milligrams of caffeine or less per day—that’s about two cups of coffee—and one drink or less per day. One drink is defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor (one shot glass). Be careful: People usually pour more than these amounts when they serve one up.