How Do Lifestyle Factors Affect MS Risk?

Reviewed by: HU Medical Review Board | Last reviewed: June 2022.

There is no single cause of multiple sclerosis (MS). Doctors think MS is caused by a combination of genes, environment, and lifestyle choices. While you cannot change your genes, you can modify other risk factors to reduce your risk.

Lifestyle factors and MS risk

Eating a healthy diet, getting regular sunshine, and avoiding cigarettes and excessive amounts of alcohol may help to reduce your risk of MS and MS progression. Also, managing your stress levels and reducing your exposure to toxins can help lower these risks.1


The gut is often looked at as a "second brain." The gut-brain connection is a communication pathway that works in both directions:2

  • The brain regulates gut function.
  • Healthy bacteria in the gut regulate signals from the gut to the brain.

The diet you eat affects the mix of bacteria in your gut (your gut microbiome). This, in turn, has an effect on your immune system. In fact, there is a growing theory that imbalanced gut bacteria is a common underlying condition of several autoimmune diseases. So, your diet may relate directly to your risk of MS.2,3

A healthy gut acts as a barrier to keep gut bacteria from leaking into the body. Your immune system's reaction to viruses and germs, such as a cold or flu, likely can be affected by how healthy your gut is. Inflammation can lead to chronic, low-grade irritation in the gut.2

According to the leaky gut theory, inflammation may lead to the breaking down of your intestinal walls. This process exposes cells in the immune system to bacteria, which may cause an immune reaction.2

All of this means that a healthy diet is a crucial part of your MS therapy plan for the long-term health of your brain and nerves. Some tips to keep in mind include:3

  • Avoid processed foods and refined sugars.
  • Eat a wide variety of fresh fruits and vegetables daily.
  • Plan and cook your meals at home.
  • Eat whole grains instead of refined grains if you choose to eat them.

No diet has been proven to change how MS progresses. There is still more research that needs to be done to link specific diets with changes in gut bacteria and the development of MS.2,3

Vitamin D

Vitamin D has important functions in the body, including:4

  • Helping absorb calcium, which is needed for bone health
  • Supporting the body’s response to infection
  • Helping reduce inflammation
  • Regulating the immune system

Some population studies have shown that having too little vitamin D can increase a person's risk of developing MS. Other studies have linked low vitamin D levels with worsening MS symptoms. However, correcting vitamin D levels has not proven to have an overall impact on the course of MS.4

Getting at least 15 minutes of sunshine a day can help raise or maintain vitamin D levels. Eating foods that contain vitamin D can also help boost your levels. Foods with vitamin D include:4

  • Oily fish
  • Egg yolks
  • Pork
  • Beef liver
  • Fortified juices and milk


Smoking has many adverse health effects, including making MS worse. Cigarette smoke contains harmful chemicals that can damage the cells in your brain. People who have smoked at any point are more likely to get MS than those who have never smoked. Those who have been exposed to secondhand smoke are also at higher risk.5

The effect of e-cigarettes (vapor cigarettes) on MS is not well-known because it has not been studied as much.5

Other factors

Other lifestyle factors may contribute to MS, though they have mixed study results. These include:1,6

Excessive alcohol useIncreased stressExposure to some environmental toxinsThe exact cause of MS is not known. Doctors think complex relationships between immune response, genes, and lifestyle factors lead to MS. Reducing risk factors may reduce your chances of developing MS and decrease progression if you have MS. Talk to your doctor about your risk and ways to reduce it.

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