What Should Be on the Menu (Literally) for MS Patients?

As a caregiver who helps my wife navigate through a multitude of complex MS issues and decisions, it has become apparent that pinpointing the best diet is one of the trickier tasks. There is an abundance of information and misinformation that can cause confusion and frustration. (Searching “MS diet” produced millions of results.)

An overview of diets for MS

This article attempts to provide a simple, helpful summary of potential diets for MS patients.

The Wahls Protocol

First, we should consider the diets that have been promoted to control or modify the disease. The Wahls Elimination Diet is a Paleo diet that emphasizes vegetables, fruit, omega-3 oils, animal protein and plant protein, with no gluten, dairy, or eggs. It is popular because physician Terry Wahls, who suffers from secondary progressive MS, regained her ability to walk while adhering to this diet. However, Dr. Wahls also treated with physical therapy and neuromuscular electrical stimulation, so it is unclear to what extent the diet may have contributed to her improvement. Also, the diet includes fatty meats at a time when many are reducing or eliminating meats from their diet for health or humanitarian reasons.

The Swank Diet

The Swank Diet is low in fat (read: little to no butter or margarine or red meats) and emphasizes whole-grain cereals and pasta, fruits/vegetables, and seafood. A few limited studies show the diet may have a small positive effect on the disease or no effect at all.

The Ketogenic Diet

The Ketogenic Diet is a strict diet that minimizes carbohydrates. The goal is to reach ketosis, a metabolic state in which the body must use fat for energy. Research has shown no evidence that the Ketogenic Diet helps MS patients. Also, because the diet is high in fat, it increases the risk of heart disease.

The Fasting Mimicking Diet

The Fasting Mimicking Diet is based on an animal study suggesting that periodic three-day fasts over a one-week period reversed MS symptoms. But there are no human studies to date and fasting can cause lightheadedness, headaches and dehydration.

The Mediterranean Diet

The Mediterranean Diet promotes consumption of whole grains, vegetables, fruits, fish, and legumes such as beans, peas and nuts. This diet has not been found specifically helpful in fighting MS symptoms, but many experts recommend it because it is nutritionally sound and is generally associated with reduced inflammation (a primary goal in treating MS).

What diet does the National MS Society recommend?

Do any of these diets appeal to you? The National MS Society recommends the following: none of the above.1 They suggest that most diet regimens do not work in the long run.

According to Orhun Kantarci, M.D., a renowned MS expert at the Mayo Clinic, “There is no evidence that a specific diet can prevent, treat or cure multiple sclerosis...some can be harmful because they contain too much of certain vitamins and not enough of others.”2

General diet & nutrition suggestions

While I am a health fanatic and not a dietician, I feel confident in making some general healthful suggestions based on reviewing countless nutrition and fitness books, newsletters, and articles:

  1. Avoid rigid diet plans that you are unlikely to follow in the long run. If you feel that you need the structure of a plan, your best bet, according to Dr. Kantarci, is the Mediterranean Diet.
  2. Emphasize anti-inflammatory foods such as beans, nuts, fatty fish (tuna, salmon), fruits, vegetables (especially avocado), turmeric, and ginger.
  3. Eat small meals and stop eating before you are full. Enjoy healthy snacks such as peanuts, walnuts, raisins and fresh fruit between meals.
  4. Limit your intake of bread and other gluten-containing products, as gluten may trigger an immune response.
  5. Avoid processed foods such as potato chips and deli meats.
  6. Limit or avoid alcohol, foods with white refined sugar and fried and other high-fat foods.
  7. A good general formula for dinner: 3-4 ounces of protein (poultry, fish, plant-based burgers, beans) 6-8 ounces of vegetables and a healthy starch (sweet potatoes, rice).
  8. Do not keep sugary foods in the house, except perhaps dark chocolate bars if you can limit yourself to 1-2 small pieces a day.
  9. Limit supermarket breads generally. You can easily bake flavorful, healthy breads for desserts or snacks, including pumpkin, raisin bran, whole wheat blueberry, sweet potato, banana, and chocolate chip bread. By baking your own bread, you can use a reduced amount of raw, unrefined sugar, whole wheat flour (or gluten-free flour if preferred), ground flaxseed, and low-fat yogurt (as a substitute for butter). Adding some powdered buttermilk also improves the texture and flavor.
  10. Combine exercise with good diet! Even if you can only walk a short distance or at a slow pace, any exercise is beneficial to your health. If you are not ambulatory, swim if possible or do upper body exercises in consultation with your neurologist.
  11. Finally, it is okay to splurge on occasion. If you crave pizza, then have a slice or two of pizza. Try to combine it with a healthy soup or salad.

What tips do you have for MS patients who want to eat healthy?

Editor's note: If you have any concerns or questions about your diet and how it affects your MS, you should always consult with a doctor or other healthcare professional. Likewise, always consult your doctor before making any changes to your diet or nutrition program.

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