Do Multiple Sclerosis Diets Work?

Anna Sweeney was 15 when she was diagnosed with multiple sclerosis (MS). She started disease-modifying medication, graduated high school and completed her undergraduate degree in 2½ years. She earned a master’s degree and was working as a registered dietician nutritionist (RDN) when she decided to try the Wahls diet, an eating approach popularized by Terry Wahls, MD, a physician with multiple sclerosis who said she “beat MS” with diet and lifestyle adaptations.

Sweeney was skeptical. As a dietician, she knew that strict eating plans—particularly those that eliminate specific foods or food groups, as the Wahls diet does—may cause nutrient deficiencies and disordered eating. And she knew that no diet had been scientifically proven to alter the course of MS. But her symptoms were getting worse.

“I had to try it because I was desperate,” Sweeney said. So, she dramatically upped her intake of fruits and vegetables to nine cups daily. She eliminated gluten, dairy and eggs.

“It was the first time in my life that I didn’t enjoy eating,” Sweeney said. “I held my nose to eat things.”

She persisted, but her symptoms did not improve. Sweeney has since abandoned the Wahls diet.

“I think the best thing that we humans with chronic illness can do for ourselves is to minimize stress,” she said. “Obsessing about food or worrying that we’re contributing to our own downfall with what we eat is not helpful.”

Evidence suggests that healthy eating may be beneficial to people with MS, but many of the popular MS diets don’t live up to their hype.

The Appeal of MS Diets

MS is a chronic, unpredictable disease of the central nervous system. It gradually breaks down the protective covering that surrounds our nerves. There is no known cure for MS, and the disease can cause significant disability. Treatment may reduce relapses and slow progression of the disease.

The idea that a person may be able to alter their experience with the disease—and increase their functional ability—by eating certain foods is attractive. And it makes sense: We know that the foods we eat and drink may make us healthier and prevent disease.

Healthy eating supports healthy functioning of the human body, and some evidence suggests that nutritious, well-balanced meal plans may help decrease nervous system inflammation. Eating a lot of sugar, red meat and processed foods can contribute to inflammation. Instead, ating meals focused on whole grains, vegetables, fruit, and lean poultry and fish is recommended.

That said, there is no evidence that your diet either triggers or cures MS. And no diet can reverse damage already caused by MS.

Can a special diet help? It’s unclear. Since the 1950s, researchers have investigated the impact of certain foods and eating patterns on MS symptoms and disease progression, with some studies showing positive outcomes. A few doctors and scientists developed and tested specific protocols, which they named after themselves: the Swank diet, McDougall diet, Wahls protocol. Some diets got attention-attracting names: the Best Bet diet, Overcoming MS diet. However, most research studies of dietary interventions for MS have been small or biased. There’s no conclusive evidence that any of these diets have a significant impact on MS.

“The confusing messaging around nutrition is testament to the fact that we are just beginning to be able to devise robust studies to help us understand how diet—and not just nutrients—impact people,” said Samantha Josephs, a UK-based nutritionist whose husband has MS. “The studies that are connecting diet with MS disease trajectory all suggest that a healthier diet is helpful—and by ‘healthier,’ they mean more fruits and vegetables, more plant proteins, less highly processed foods, less salt, less sugar, less saturated fats and lots of omega fatty acids from food sources like oily fish and flax seeds.”

Evidence-Backed Nutrition Tips

“While no particular diet has sufficient evidence to stand alone as ‘the best for MS,’ a healthy diet (and lifestyle) is recommended for reducing fatigue and disease progression,” Josephs said.

To help you improve your overall diet and develop healthy meal planning, ask your MS team if you can speak to a dietitian—or seek one out yourself.

Because MS affects energy, dexterity and function, nutritionists recommend these practical strategies:

• Eat for overall health. Unless you have specific food allergies or intolerances, you don’t need to eliminate any foods or food groups from your diet because you have MS (although eliminating processed food and junk food is good for all of us).
• Don’t restrict calories. Eat a variety of foods and be sure you’re getting enough calories. Too few calories can contribute to fatigue.
• Simplify. Use pre-chopped, canned, frozen foods and meal delivery services as needed to minimize stress and exhaustion. Ask for and accept help from family and friends.