Multiple sclerosis (MS) develops when the body’s immune system mistakenly attacks the central nervous system. There is no cure for MS, but certain treatments and dietary choices may help some people manage the condition.

When a person develops MS, the myelin that coats nerve fibers becomes damaged. As a result, the nerves start to lose the ability to transmit electrical signals.

In relapsing-remitting MS, the symptoms come and go. A person experiences symptom flare-ups, or relapses, and times of remission. In other types of MS, which are progressive, the symptoms gradually worsen.

Treatment for MS focuses on managing a person’s symptoms and helping them live with the condition. A well-balanced diet can improve a person’s overall health and may assist in the management of MS.

Understanding the role of the diet in MS and making certain changes may result in fewer relapses, a lower risk of health complications, and a better quality of life.

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MS is an autoimmune disease in which the immune system mistakenly attacks the nervous system.

The relationship between the diet and MS may involve:

  • the role of the gut bacteria in immune disorders
  • vitamin deficiencies
  • the fact that some nutrients can support and protect the nervous system
  • the benefits of a healthy, balanced diet for overall well-being

Certain foods may benefit people with MS by affecting how the immune system, nerves, and body work.

Probiotics and prebiotics

Changes in gut health may contribute to immune disorders. Research indicates that the health of the gut plays a role in many kinds of health conditions.

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

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

Authors of a 2016 study suggest that adjusting the gut flora by using probiotics, for example, may be helpful for people with MS.

Probiotics

Probiotic bacteria are available in supplements and a range of fermented foods. The following all contain healthy levels of Lactobacillus, a type of beneficial bacteria:

Prebiotics

After filling the gut with good bacteria, it is important to feed them. Foods that nourish probiotic bacteria are called prebiotics. Some dietary fibers are prebiotic.

Foods that contain healthy levels of prebiotic fiber include:

Fiber

High levels of fiber are present in many plant-based foods, including:

Learn more about high fiber food options here.

Consuming these products can have a range of health benefits for people with MS. A high fiber diet can positively impact the body in a number of ways, including:

  • nourishing the gut bacteria
  • promoting regular bowel movements
  • regulating blood pressure
  • keeping the heart healthy by helping manage cholesterol
  • reducing the likelihood of weight gain by leaving a person feeling full for longer

People with MS may have a higher risk of certain types of heart disease. While dietary measures may not reduce these risks, a balanced diet will benefit overall heart health.

Vitamin D

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

According to the National Institute of Neurological Disorders and Stroke, people with high levels of vitamin D appear to have a lower risk of developing MS.

Vitamin D is also important for bone health. People with MS may be more likely to experience low bone density and osteoporosis, especially if they are not able to move easily. An adequate intake of vitamin D may help prevent this.

Most of the body’s vitamin D comes from exposure to sunlight, but a person also takes it in by consuming:

A 2017 review notes that while evidence of a link between low vitamin D levels and MS is accumulating, confirming this will require more research.

Biotin

Biotin is a form of vitamin B. It is present in many foods, but foodstuffs particularly high in biotin include:

Findings from small studies indicate that a high dosage of biotin — between 100 and 600 milligrams per day — could help people with progressive MS.

Confirming and specifying the benefits of biotin supplementation will require more research, but following a balanced diet can often ensure that a person is consuming enough of this vitamin.

Learn more about what research says about biotin for MS here.

Polyunsaturated fatty acids

There is evidence that polyunsaturated fatty acids (PUFAs) may help support a healthy body and control inflammation.

For example, authors of a 2017 study conclude that a low intake of PUFAs may increase the risk of MS.

PUFAs appear to boost bodily functions ranging from cardiac health to the ability to think. Examples of foods that contain PUFAs include fatty fish, such as salmon and mackerel, and some plant-based oils.

Antioxidants

Many vegetable-based foods contain polyphenols, which are substances that have antioxidant and anti-inflammatory effects on the body’s cells.

These effects may help prevent cell damage, making polyphenols potentially useful for people with MS.

Sources of polyphenols include:

  • fruits
  • vegetables
  • spices
  • cereals
  • legumes
  • herbs
  • tea

Antioxidants can also help prevent oxidative stress, which researchers have linked to the development of several chronic conditions, including neurological and cardiovascular disease.

Some foods may be harmful to people with MS.

Saturated fats and processed foods

Processed foods can have a negative impact on a person’s health, especially if they contain high levels of:

Sodium

A 2015 article reports that people with MS who have moderate or high sodium intake are more likely to experience a relapse of symptoms or develop a new lesion.

This can trigger inflammation in the body. A balanced diet that includes fresh fruits and vegetables can reduce inflammation due to its antioxidant effects.

What to avoid

A person with MS may benefit from avoiding the following foodstuffs:

  • sugar-sweetened drinks, such as sodas and energy drinks
  • excessive quantities of processed meat, including burgers and sausages
  • fried foods, such as french fries and potato chips
  • highly processed ready-made meals, including frozen pizzas
  • trans fats, such as margarine and shortening

According to a 2016 review, obesity during childhood and adolescence may increase the risk of developing MS. Authors of the review also note that obesity could affect the progression of the disease.

Moreover, a person with MS who loses mobility or finds movement more challenging may be more likely to gain weight.

Managing the diet to prevent weight gain may also help prevent MS symptoms from worsening. Dietary changes may boost a person’s sense of well-being and reduce the risk of additional health conditions, such as cardiovascular disease.

Anyone following a specific diet needs to consume all the required daily nutrients. A person who eliminates a particular food or food group should ensure that they replace any nutrients lost.

Gluten-free diet

Research has not confirmed a link between gluten sensitivity and MS.

However, people with MS may have a higher likelihood of developing celiac disease, which prevents the body from tolerating gluten. As a result, some people with MS may benefit from avoiding gluten.

Gluten is a protein present in wheat, rye, and barley. Therefore, people avoiding gluten should avoid foods containing these grains.

Foods that contain gluten include:

  • wheat products, such as breads and baked goods
  • many premade soups and salad dressings
  • barley products, such as malt, soups, beer, and brewer’s yeast
  • rye, which is often present in bread and cereals

People who follow a gluten-free diet may miss out on important nutrients, including fiber, which is present in whole grains. That is why they should boost their fiber intake by eating plenty of fresh vegetables, fruits, nuts, seeds, and pulses.

Anyone considering a gluten-free diet should consult a doctor first.

Paleo diet

Many individuals following the paleo, or Paleolithic, diet believe the human body has not evolved to eat the highly processed foods that people now commonly consume.

The diet involves switching to foods that hunter-gatherers likely ate. The first step is to choose natural foods over processed foods, emphasizing meat and plant-based foods but not grains.

In a 2017 pilot study, people with relapsing-remitting MS consuming a modified Paleolithic diet reported improvements on both a fatigue severity and quality of life scale. However, the authors of the study conclude that larger controlled studies are necessary to fully assess the benefit of a paleo diet to people with MS.

Learn more about the paleo diet here.

Wahls diet

The Wahls diet, or the Wahls protocol, is a modified version of the paleo diet. Dr. Terry Wahls developed the plan specifically to aid people with MS.

Like the paleo diet, the Wahls diet features nutrient-dense, minimally processed foods. A person following the Wahls diet will prioritize green, leafy, and sulfur rich vegetables, intensely colored fruits, and minimally processed animal proteins.

Small studies have linked the Wahls diet with an improvement in MS symptoms. However, larger randomized better-controlled studies are necessary to fully examine the efficacy of the diet.

Swank diet

Doctors developed the Swank diet as an MS treatment in the 1950s.

It reduces saturated fat intake to 15 grams (g) per day and recommends limiting unsaturated fat intake to 20–50 g per day.

People on this diet:

  • cannot eat processed foods or dairy fats
  • cannot eat red meat during the first year
  • can eat as much white fish and shellfish as they like
  • should eat at least 2 cups each of fruits and vegetables every day
  • should eat whole grain pasta
  • should take cod liver oil and multivitamins daily

While some consider the diet to be dated, others report that it helps.

Possible risks include deficiencies in folic acid and vitamins A, C, and E.

How do the diets compare?

In 2015, the National Multiple Sclerosis Society reviewed a number of diets and their impact on MS.

Authors of the review conclude that there is not enough evidence to recommend one diet over another, and acknowledge that most of the diets restrict or leave out the same types of food.

In general, a person with MS should avoid foods that:

  • are highly processed
  • are high in saturated fat
  • have a high glycemic index rating

A healthy diet for a person with MS is one that supports the immune system.

Additional changes that may help include:

  • increasing sunlight exposure to boost vitamin D levels
  • exercising to help maintain strength and flexibility and support overall health and well-being
  • quitting smoking, if applicable, and avoiding secondhand smoke

Anyone considering making major changes to their diet or lifestyle should seek guidance from a doctor first.

MS affects the nervous system and can lead to a wide variety of primary and secondary health issues. It is a lifelong condition that may come and go or progress steadily.

Some people only ever experience mild tingling, while others lose the ability to move or talk. Most people with MS remain mobile, however, and the majority of people with the condition have the same life expectancies as people without it.

Healthy dietary choices can benefit people with MS, and certain changes may alter the progression of the condition or prevent specific symptoms.

In general, a healthy diet can boost a person’s overall well-being and quality of life while preventing complications such as cardiovascular disease.

A range of special diets may help manage MS symptoms and reduce associated complications. However, more research is necessary to assess the efficacy of these diets, and a person should consult a doctor before making any dietary changes.

Discover more resources for living with MS by downloading the free app MS Healthline. This app provides access to expert content on MS, as well as peer support through one-on-one conversations and live group discussions. Download the app for iPhone or Android.