Multiple sclerosis is a condition that affects the nervous system, and some people believe that a ketogenic diet may slow the progression of the disease or control its symptoms.

The ketogenic diet is low in carbohydrate, moderate in protein, and high in fat. There is currently not enough evidence to recommend it for everyone with multiple sclerosis.

Proponents of the ketogenic diet believe that it can help people lose weight and possibly reverse degenerative diseases. The ketogenic diet does offer some benefits, but people with multiple sclerosis (MS) need to consider certain factors before trying the diet.

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A ketogenic diet may help reduce multiple sclerosis symptoms.

The purpose of the ketogenic diet is to encourage the body to switch from burning carbohydrates to burning fats.

The body usually turns the carbohydrates from food into the sugar glucose, which it then uses for energy or stores for later. Glucose is the body’s preferred fuel.

However, if a person starves their body of glucose by removing carbohydrates from their diet, the body will switch to using fats as its source of fuel instead.

People refer to this adaptation as ketosis, which gives the diet its name.

Advantages of ketosis

In a ketogenic state, the body reduces its blood sugar levels and causes the liver to create chemical byproducts called ketones. As a result of either the reduction in carbohydrates or the increase in ketones, the ketogenic diet may help with:

One effect of ketones is that they may help protect the body at a cellular level. This potential benefit can make the diet appealing to some people with MS.

What do the studies say?

The results of a 2015 trial in Germany suggest that people with MS can improve their quality of life by sticking to a ketogenic diet. However, the study only lasted for 6 months and involved just 60 people.

A review from the same year investigates the potential beneficial effects of the ketogenic diet for people with MS. The researchers note that the ketogenic diet appears to have the potential to treat the neurodegenerative component of MS.

The ketogenic diet appears to benefit the body at the cellular level. It increases the amount of food available to the cells while reducing oxidative stress and increasing antioxidant levels in the blood. This combined effect may help protect the nerve and brain cells, which could potentially slow neurodegeneration.

It is important to note that these benefits are theoretical. There is not yet enough data on the ketogenic diet and MS in humans to confirm them. Researchers are currently unsure how long these effects may last and whether or not there may be other long-term effects.

The results of these studies on the ketogenic diet look promising for MS though, and the researchers call for more investigation.

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People with MS may find that following a ketogenic diet causes fatigue.

The National Multiple Sclerosis Society list some factors that may affect how beneficial a low-carb diet is for people with MS. They include the following:

  • Fatigue: Ketones may curb some people’s appetite and help them lose weight, but extra ketones in the bloodstream can also cause fatigue.
  • Fiber and nutrients: Ketogenic diets cut out processed carbohydrates, but they also exclude carbohydrates that are nutritious.
  • Constipation: The reduction in fiber may increase the likelihood of constipation.
  • Bone health: People with MS may have a higher risk of osteoporosis, which causes the bones to become brittle and more porous than healthy bones.

The ketogenic diet allows people to reach and maintain a state of ketosis by eating fats and proteins and avoiding carbohydrates.

Fats

In general, most people tolerate the ketogenic diet well.

However, people on this diet should be aware that not all fats are the same. The American Heart Association recommend avoiding trans fats and hydrogenated oils and increasing the intake of unsaturated fats.

Healthful fats to incorporate into a ketogenic diet may include:

  • olive oil
  • avocado
  • nuts, such as almonds or pistachios
  • cold, fatty fish, including salmon or sardines

Proteins

The ketogenic diet can include protein from both plant and animal sources, including:

  • meat
  • dairy
  • eggs
  • nuts, such as peanuts and cashews

Carbohydrates

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People need to limit carbohydrates when following a ketogenic diet.

The ketogenic diet restricts both simple and complex carbohydrates. Simple carbohydrates include:

  • any sugar
  • fruit juices, sodas, sweetened teas
  • all types of candy
  • milk, which contains the sugar lactose

Complex carbohydrates include:

  • pasta
  • bread
  • baked goods
  • beans
  • fruits
  • cereal grains
  • starchy vegetables, such as potatoes and corn

A person could eat the following on the ketogenic diet:

Breakfast

  • two fried eggs
  • bacon strips
  • black coffee

Morning snack

  • half an avocado, seasoned

Lunch

  • sliced squash
  • meatballs in spaghetti sauce

Afternoon snack

  • almonds

Dinner

  • roasted salmon
  • steamed cauliflower with butter
  • baby spinach

Other drinks throughout the day may include water, sparkling water with lemon, or herbal tea.

The above is just one example of a full day of eating. There are many ways to make the ketogenic diet feel less restrictive and more enjoyable depending on individual taste.

More research is necessary on the effects of these diets over time, particularly on people who have MS.

Although most doctors recommend that these individuals adhere to basic dietary guidelines, that does not prevent people from trying different diets. Some people with MS may be comfortable eating a ketogenic diet, but this does not mean that it is suitable for everyone.

The ketogenic diet can also be a shock for the body. It is best to make dietary changes under the guidance of a healthcare professional. They can help identify any nutrients that a person may be lacking, which could be harmful to health.

Anyone with MS who is considering a significant change in diet should speak to their doctor first.

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.