Overview

When you live with multiple sclerosis (MS), the foods you eat can make a significant difference in your overall health. While the research on diet and autoimmune diseases like MS is ongoing, many people in the MS community believe diet does play a significant role in how they feel.

While there’s no specific diet that can treat or cure MS, many people are finding relief from symptoms by modifying their overall nutrition program. For some, simply making a few minor changes in their daily food choices is enough. But for others, adopting a diet program seems to help reduce existing symptoms and keep new ones away.

Healthline talked with two experts to find out the pros and need-to-knows of some of the most popular diets with the MS community.

Nutrition plays a vital role in boosting our health. And if you live with MS, you know how important diet is in managing symptoms like inflammation and fatigue.

While the buzz among the MS community is strong, the connection between diet and MS symptoms hasn’t been widely researched. Because of this, the theory that nutrition plays a role in managing its symptoms is a controversial one.

Evanthia Bernitsas, MD, a neurologist at Detroit Medical Center’s Harper University Hospital, explains that existing research studies on the topic are small, not well-designed, and tend to have a lot of bias.

But overall, Bernitsas says it’s common for people living with MS to follow an anti-inflammatory diet that’s:

  • high in nutrient-dense fruits and vegetables
  • low in fats
  • keeps red meat to a minimum

And Kiah Connolly, MD, agrees. “Because MS is a demyelinating autoimmune disease and autoimmune diseases involve inflammation, many theories on the potential positive effects diet may have on the disease are based in decreasing inflammation in the body and improving neuronal health,” Connolly explains.

Some of the more popular theories she’s referring to include the paleo diet, Wahls Protocol, Swank diet, and eating gluten-free.

Because most of the suggested dietary modifications involve healthy foods that may benefit anyone’s overall health, Connolly says making many of these diet changes is generally a safe option for people with MS to try.

The paleo diet is being adopted by a variety of communities, including people living with MS.

What to eat: The paleo diet includes anything people could eat during the Paleolithic era, such as:

  • lean meats
  • fish
  • vegetables
  • fruits
  • nuts
  • some healthy fats and oils

What to avoid: The diet leaves little to no room for:

  • processed foods
  • grains
  • most dairy products
  • refined sugars

That elimination of these foods, many of which can cause inflammation, can be helpful for people seeking dietary modifications to help manage their MS symptoms.

An article from the National Multiple Sclerosis Society says the first step to adopting the paleo diet is to eat natural foods while avoiding highly processed food, especially foods with a high glycemic load. These are carbohydrate foods that significantly raise blood sugar.

Additionally, it calls for the intake of game (undomesticated) meats, which makes up about 30 to 35 percent of the daily caloric intake, and plant-based foods.

The Wahls Protocol is a favorite among the MS community, and it’s easy to see why. Created by Terry Wahls, MD, this method focuses on the role food plays in the management of MS symptoms.

After her MS diagnosis in 2000, Wahls decided to do a deep dive into the research around food and the role it plays in autoimmune diseases. She discovered that a nutrient-rich paleo diet high in vitamins, minerals, antioxidants, and essential fatty acids helped reduce her symptoms.

How is the Wahls Protocol different from paleo?

The Wahls Protocol emphasizes eating a lot of vegetables to meet the body’s optimal nutritional needs through food.

What vegetables to eat: In addition to adding more deeply pigmented vegetables and berries, Wahls also recommends increasing your intake of green vegetables, and, specifically, more sulfur-rich veggies, like mushrooms and asparagus.

As someone who lives with MS and conducts clinical trials that test the effect of nutrition and lifestyle to treat MS, Wahls knows firsthand how important it is to include dietary strategies as part of an overall treatment plan for MS.

According to Dr. Roy L. Swank, the creator of the Swank MS diet, eating a diet very low in saturated fat (15 grams per day maximum) can help manage MS symptoms.

The Swank diet also calls for the elimination of processed foods containing fat and hydrogenated oils.

Additionally, during the first year on the diet, red meat isn’t allowed. You can have three ounces of red meat per week following the first year.

Now that you know what’s off-limits, what can you eat? A lot actually.

The Swank diet emphasizes whole grains, fruits and vegetables (as many as you want), and very lean proteins, including skinless white meat poultry and white fish. You’ll also increase the consumption of essential fatty acids, which is great news.

What does an expert say?

Bernitsas says since this diet emphasizes a high intake of omega-3s, it has the potential to benefit people living with MS. Plus, the focus on keeping saturated fat to a minimum also shows promise in helping keep inflammation down.

There are many theories about the role diet plays in managing MS symptoms, including the impact gluten (a protein found in wheat, rye, barley, and triticale) has on MS symptoms.

In fact, one study points to an increase in sensitivity and intolerance to gluten in people living with MS.

“Some people suspect that gluten is an undiagnosed allergen in many of us and functions as a source of inflammation contributing to ailments in all of us,” Connolly explains.

Why go gluten-free?

“While this is not proven, some rationalize that eliminating gluten from the diet will eliminate this source of inflammation and decrease the symptoms of MS,” Connolly adds.

When going gluten-free, your focus should be on eliminating all foods that contain the protein gluten, including wheat, rye, and barley. Some of the more common food items you’ll find wheat in include:

  • batter-fried foods
  • beer
  • bread, pastas, cakes, cookies, and muffins
  • breakfast cereals
  • couscous
  • cracker meal
  • farina, semolina, and spelt
  • flour
  • hydrolyzed vegetable protein
  • ice cream and candy
  • processed meats and imitation crab meat
  • salad dressings, soups, ketchup, soy sauce, and marinara sauce
  • snack foods, such as potato chips, rice cakes, and crackers
  • sprouted wheat
  • vegetable gum
  • wheat (bran, durum, germ, gluten, malt, sprouts, starch), wheat bran hydrolysate, wheat germ oil, wheat protein isolate

Overall, following a well-balanced and carefully planned diet is a smart choice when considering dietary modifications. If you have any questions about how to implement changes to your diet, talk with your doctor or healthcare provider.


Sara Lindberg, BS, MEd, is a freelance health and fitness writer. She holds a bachelor’s degree in exercise science and a master’s degree in counseling. She’s spent her life educating people on the importance of health, wellness, mindset, and mental health. She specializes in the mind-body connection, with a focus on how our mental and emotional well-being impact our physical fitness and health.