Multiple sclerosis is an autoimmune disease. It develops when the body’s immune system mistakenly attacks its own central nervous system.

Nerve fibers in the body are usually coated with a layer of myelin, a substance that protects the nerves and helps to transmit electrical signals.

In patients with multiple sclerosis (MS), the myelin is damaged. Areas that have less myelin do not transmit signals effectively, meaning that commands from the brain do not reach the targeted muscles as quickly as they should.

MS is the most common disabling neurological disease of young adults.

Dietary factors appear to have some impact on the condition. Understanding the role of diet may lead to a person with MS having fewer relapses and a better quality of life.

Role of diet and nutrition for people with MS

A study published in Clinical & Translational Immunology notes that gut health appears to play a role in many diseases.

The intestinal flora, or gut flora, is a highly complex system of microorganisms that live in the intestines. In humans, these are largely bacteria.

The bacteria are responsible for breaking down food and nutrients, and they play a key role in digestion and in the health of the immune system. Healthy gut flora thrives in the intestine when there is ample fiber in the diet.

The lack of a healthy gut flora may contribute to a range of immune disorders.

Foods that are good for people with MS

Multiple sclerosis is a disorder of the immune system, so it is important to eat a diet that supports a healthy immune system. A diet that promotes beneficial gut flora might help to achieve this.

Probiotics

The authors of a study published in Nature Communications suggest that adjusting the gut flora using probiotics may be helpful for people with MS. Probiotics may help to boost levels of beneficial bacteria in the gut, helping to strengthen the immune system.

Probiotic bacteria are available in supplements and also in a range of fermented foods. Yogurt, kefir, Kim chi, sauerkraut, and kombucha, or fermented tea, all contain good levels of lacto-bacteria, which is one type of beneficial bacteria.

Prebiotics

As well as filling the gut with good bacteria, it is important to feed them. Foods that nourish probiotic bacteria are called prebiotics and they are mainly fibers.

Foods containing good levels of prebiotics include:

• Artichoke
• Garlic
• Leeks
• Asparagus
• Onions
• Chicory

Individuals should aim to get at least 5 to 7 grams of prebiotic fiber each day.

Fiber

Fiber is found in plant foods, such as fruits, vegetables, nuts, seeds, and legumes. It helps to promote optimal health through nourishing the gut bacteria, encouraging regular bowel movements, and keeping the heart healthy. Fiber is also a filling food source.

Vitamin D

Vitamin D is important for everyone, but it may be especially beneficial for people with MS.

Vitamin D may regulate the growth and differentiation of different cells. In an article posted to European Neurological Review, researchers found that people with MS might benefit by increasing their intake of vitamin D.

There is evidence that vitamin D has protective qualities for people with MS. Most of the body’s vitamin D is made through exposure to sunlight. Studies have associated a higher level of sun exposure and increased intake of vitamin D in the diet with a lower risk of developing MS.

Biotin

Biotin is a form of vitamin B, which has also been called Vitamin H. It is usually found in foods, such as eggs, yeast, liver, and kidney. Recent evidence suggests that high-dose supplements of biotin may benefit some people with MS.

While more research is needed to determine exactly who may benefit, adding biotin to the diet has not been linked with any serious safety issues.

Polyunsaturated fatty acids (PUFAs)

There is mixed evidence as to whether diets rich in PUFAs will help with MS symptoms directly, but they are known to support a healthy body and control inflammation. PUFAs appear to boost functions, ranging from the ability to think to cardiac health. Foods that contain PUFAs include fatty fish, such as salmon and mackerel, and some plant-based oils.

Foods people with MS should avoid

Saturated fats and processed foods

A healthy gut affects the well-being of the immune system, so it is important to avoid foods that contribute to poor gut flora. People with MS should avoid processed foods, especially those that contain high levels of saturated fats and hydrogenated oils

Sodium

Research has found that people who have MS and have a moderate to high sodium intake in their diet are more likely to relapse, and are at greater risk of developing a new lesion than those with a low sodium intake.

The study, published in ASN Neuro, also suggests avoiding sugar-sweetened drinks, excessive quantities of red meat, fried foods, and low-fiber foods.

Considerations for people on special diets

Anyone who is on a specific diet needs to be sure that they are consuming all the required daily nutrients. A person who eliminates a particular food or food group from their diet should ensure that the nutrients contained in the eliminated food are replaced by other foods.

Gluten-free diet

Research has not shown a link between gluten and MS, but many people with the disease opt for a gluten-free diet and say they feel better. A gluten-free diet is acceptable for people with MS as long as they replace the fiber that they would have got from the wheat by eating other fiber-filled foods.

Paleo diet

The Paleolithic, or paleo diet, is based on the idea that our bodies have not evolved to eat the highly processed foods we now consume.

The diet advocates switching to foods that were probably eaten by hunter-gatherers. The first step is to choose natural foods over processed foods, with an emphasis on meat and plant-based foods, but not grains.

Very small studies have shown that people with MS who follow a paleo diet may see improvements, but it is important to note that the participants also introduced lifestyle changes, such as stretching, massage, exercise, and meditation.

Swank diet

The Swank diet started in the 1970s, and it was used to treat MS patients for several years. It reduces saturated fat intake to below 15 grams a day and recommends limiting unsaturated fats to between 20 and 50 grams a day.

People on this diet are not allowed to eat processed foods or dairy fats at any time. They are forbidden from eating red meat during the first year but are allowed to eat as much white fish and shellfish as they want. The Swank diet also recommends an individual eats two cups of both fruits and vegetables every day. Eating whole grain pasta is also encouraged, and cod liver oil and multivitamins should be taken daily.

Followers of the Swank diet say it has helped them, although it is now considered dated. Researchers note that some people who follow this diet may become deficient in vitamins A, C, E, and folic acid.

How do the diets compare?

A paper published by the National MS Society in the United States reviewed a number of diets and their impact on MS. It concluded that there is not enough evidence to recommend one diet over another. It also pointed out that most of the diets agree on the same food items that should be cut out of the diet.

Foods to avoid are those that:

• Are highly processed
• Have a high glycemic index (GI)
• Are high in saturated fat

In general, the diets tend to recommend eating less fatty red meat and more fruits and vegetables.

Lifestyle changes that may help

Supporting the immune system may be the most important aspect of a healthy diet for a person with MS. As vitamin D is an important factor in MS, increasing sunlight exposure each day can help to increase the levels of vitamin D in the blood.

Exercising is also important for the immune system. Aerobic exercise helps flush the body of toxins, increases circulation, boosts the metabolism, and increases levels of “feel good” hormones in the brain. Anybody considering making major changes to their diet or lifestyle should talk to a doctor first.

Symptoms of MS

MS can affect any part of the body.

The most common symptoms include:

• Changes in thinking, such as attention problems, memory loss, forgetting certain words, and problems with abstraction.
• Vision problems, such as blurred or double vision, red-green color distortion, and partial or whole blindness in one eye.
• Muscle problems, such as weakness, numbness, and difficulty with coordination and balance. In severe cases, MS can result in partial or complete paralysis.
• Sensory feelings, such as tingling, prickling, or a “pins and needles” sensation. Some people also experience pain.

Because the central nervous system is affected, many other symptoms are possible.

Anyone who is experiencing new or increasing symptoms should seek medical advice.