This article explores the top ten best and worst foods for multiple sclerosis. Learn how foods can either positively or negatively impact MS symptom severity, and use this understanding to guide food choices for yourself or your clients.
What is Multiple Sclerosis?
The CNS is made up of the brain, spinal cord, and optic nerves. The exact antigen—the target that the immune cells are sensitized to attack—remains unknown. This is why many experts consider MS to be “immune-mediated” rather than “autoimmune.”
The Body with Multiple Sclerosis
When a person has MS, the immune system attacks patches of the myelin sheath, a fatty substance essential to the functioning of the nervous system. As a result, individuals have mild to severe impairment of the limbs, weakness, and visual and sensory losses as well as bladder and bowel malfunction.
While years ago physicians believed that people with MS would inevitably need to use a wheelchair at some point in their lives, the Multiple Sclerosis Trust states that treatment options are now improving, so most people with MS will not need to use a wheelchair at any point in their lives.
Multiple Sclerosis and the Diet
For many individuals with MS, symptoms can be abated and the disease progression can be significantly slowed by making health-promoting food choices. There is ample evidence that diet quality has an impact on symptom severity and disability. In fact, food choices can have a significant impact on the quality of life of MS patients.
It is important to note that no singular diet has stood out from the rest regarding its effectiveness in slowing or reversing the progression of MS. There is evidence, however, in favor of low-fat, plant-based diets; a high-fat, moderate protein and very-low-carbohydrate (ketogenic) diet; and a modified Paleo diet.
Dr. John A. Mcdougal, renowned for his work on the effects of diet on disease prevention and reversal, as well as neurologist Dr. Roy Swank, who did extensive research back in the late 1940 and 1950s, believed eating a low-fat diet can help patients with MS and that animal products and tropical oils worsen MS symptoms. MS specialists today recommend a low-fat, high-fiber diet.
Dr. Terry Wahls was able to stop the progression of her own progressive multiple sclerosis by adopting Paleo-diet principles combined with functional medicine.
Clearly, the evidence around different foods and macronutrient distributions and their role in stopping the progression of MS varies significantly. Researchers have found that this variation is likely due to the role of individual metabolic differences and non-MS health factors in individuals with MS, including hypertension, hyperlipidemia, salt intake, and obesity.
As an AFPA-Certified Autoimmune Holistic Nutrition Specialist, you can educate your clients on the best and worst foods for Multiple Sclerosis.
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Top Ten Best Foods for MS
Foods Rich in Vitamin D
A higher incidence of MS is found in patients with low vitamin D levels. The main way we get vitamin D is from sunlight, but we can also get it through our diet. If you don’t consume dairy products, eat foods fortified with vitamin D, such as orange juice, or take a vitamin D supplement to help prevent and slow disease progression.
In addition to low-fat dairy, salmon, mackerel, tuna, herring, and egg yolks are good sources of vitamin D. Mushrooms are the only good plant-source of vitamin D.
You can read more about vitamin D, multiple sclerosis, and dosage requirements on the website for the U.S. National Library of Medicine.
If your diet includes meats, select unprocessed meats, and avoid processed meats like cold cuts, cured meats, and sausages.
While traditional recommendations focus on excluding red meats from the diet and consuming only white meats, like poultry and fish, new research suggests that higher consumption of non-processed red meat is associated with a reduced risk of MS.
In fact, a pilot study supervised by Dr. Terry Wahls, a pioneer in the subject of the impact of diet on MS, suggested that a paleolithic-style diet high in unprocessed meats and low in carbohydrates, together with stretching and meditation exercises, significantly reduced fatigue. A larger study is currently being carried out.
On the other hand, those who had diets high in animal fats and meat products had a higher prevalence of MS.
A meal rich in refined carbohydrates increases insulin levels, which in turn activates a cascade of chemical processes that can exacerbate MS symptoms.
Eating whole grains instead of refined flour or processed carbohydrates will increase fiber, maintain stable blood sugars, promote healthy bowel habits, and help with the fatigue MS patients experience.
Oats, brown rice, and quinoa are good examples of whole grains you can incorporate into your diet.
Fresh fruit is one of the best foods for Multiple Sclerosis because it provides a myriad of micronutrients and antioxidant chemicals, including polyphenols, carotenoids, and anthocyanins.
Many fruits, like kiwi, berries, banana, and papaya, are also high in magnesium, a lack of which could be linked to MS progression. In general, MS experts recommend getting nutrients, like magnesium, from foods rather than from supplements.
Since MS is a condition that is made worse by oxidative stress, antioxidant intake can have an important role in stopping disease progression as well.
Additionally, constipation is a constant battle with people who suffer from MS. Eat a variety of brightly colored fruits for an increase in fiber to increase motility and prevent and ease constipation.
Eating whole foods such as fruit instead of refined sugars will help stabilize blood sugar and battle fatigue.
Filling up on veggies will help maintain a healthy weight and prevent the onset of other chronic diseases such as diabetes and heart disease. A low-fat, high-fiber diet is recommended by Dr. Roy Swank, and filling up on vegetables is a good way to go. He also recommends a mostly vegetarian diet with very little animal fat.
Additionally, vegetables, especially dark green vegetables like spinach, broccoli, and kale, are good sources of calcium and iron. Researchers have found that people with progressive MS tend to be lacking in iron and calcium, so eating more vegetables that are good sources of these foods may slow disease progression.
Increase your intake of fish high in omega-3s, such as salmon, sardines, tuna, trout, and mackerel. They have good fatty acids that prevent inflammation and are good for balancing out our diet, which is usually higher in omega-6 fatty acids. The imbalance of too much omega-6 fatty acids to omega-3 can cause your immune system to become overactive, which is an issue in multiple sclerosis.
The type of fat we choose to consume could have a big impact on the levels of inflammation in our body. Since MS patients have an inflammatory response in multiple parts of their bodies, including their immune system, the brain, and the blood vessels, consuming oils that help to reduce inflammation is an important part of a dietary strategy to managing MS.
Multiple sclerosis is a disease that causes inflammation and scarring to the neural pathways. Eating foods that stop inflammation can help ease symptoms of MS and possibly prevent disease progression. Turmeric is a spice that has been proven to fight inflammation due to the ingredient curcumin it contains.
A large body of studies have demonstrated the potent anti-inflammatory and antioxidant properties of curcumin, and it has the potential to modulate several factors that influence the progression of central nervous system disorders like MS.
The research is so promising that some researchers propose considering curcumin as part of the treatment for MS.
Avocados are another one of the best foods for Multiple Sclerosis due to their strong anti-inflammatory properties. They are rich in monounsaturated fats, lutein, glutathione, vitamin E, and phenolic antioxidants, all of which help to fight inflammation.
Additionally, the phytosterols avocados contain also help to suppress inflammation.
These components are not only beneficial for the chemical processes behind MS but also contain nutrients that help promote heart and brain health. There are so many ways to enjoy avocados; make guacamole and enjoy it with fish or chicken or spread it on toast.
Ginger possesses strong anti-neuroinflammatory characteristics thanks to a component called 10-gingerol.
Select a firm, smooth root, and add a slice or two to your favorite tea or make it an ingredient in your favorite salads, dressings, or marinades.
Top Ten Worst Foods for MS
Avoid foods high in saturated fats, as they are among the worst for Multiple Sclerosis. In a landmark longitudinal study that began in 1954 and was led by Dr. Roy Swank, data showed that diets low in saturated fat resulted in a lower risk of developing MS. In 2003, a follow-up study was carried out with the same people enrolled in the first study, and they found that people with MS who followed the “Swank diet” lived longer and lived otherwise normal lives.
The research suggests that MS is caused by animal-sourced saturated fat and recommends consuming less than 10–15 grams of saturated fat per day, plant sources included.
Alcohol is a central nervous system depressant, and it has the potential to worsen neurological symptoms or have additive effects when combined with MS medications.
While some studies suggest that limited alcohol drinking (one or two drinks) may suppress symptoms and might help to reduce the progression of disability in relapsing onset MS, it has a neutral to detrimental effect in people with progressive onset MS.
However, people with MS may be more likely to abuse alcohol, and that can contribute to high rates of depression. While alcohol consumption is not recommended in general, you may want to speak to your doctor about your consumption patterns and how it could potentially affect your MS.
Avoid foods high in simple sugars, as they contribute to an imbalance in blood glucose. Research shows that severe blood glucose spikes and drops associated with high consumption of refined sugar contribute more severe symptoms and a higher level of disability compared to people with MS who seldom consume sugar-sweetened foods and beverages.
In fact, one study found that people with MS who had the highest consumption of sugar-sweetened beverages were up to five times more likely to have a severe disability than people who seldom drank sugar-sweetened beverages.
Ultra-processed foods are those that tend to contain numerous additives to lengthen their shelf-life and to modify their color and flavor. What is the connection between additives and MS? Additives commonly used in processed foods can damage intestinal mucosa and thus weaken our natural immune system. Immune balance is essential for preventing multiple sclerosis and for slowing and stopping MS progression.
In fact, research suggests that the regular consumption of foods with industrial food additives change the tight junction permeability of the intestine, and this could be an explanation for the rising incidence of autoimmune diseases on a population level, MS included.
While all food undergoes some sort of processing (like cleaning, peeling, etc.), stick to eating fresh, whole foods with all-natural ingredients.
Like sugar, refined grains are among the worst foods for Multiple Sclerosis because they also cause a spike in blood glucose. Blood glucose spikes can cause damage to myelin sheaths on neural cells and can cause neural dysfunction. Since MS is a neurological condition, it is important to avoid foods that might damage cells, such as refined grains, and contribute to the progression of MS.
Avoid white rice, potatoes, white bread, and all refined grains.
The health effects of the food additive monosodium glutamate (MSG) has been a hot topic of debate for decades. While most research shows that the effect might be minimal to null in healthy people, the immune system of people with MS likely responds abnormally to the molecules that make up MSG.
MSG is an excitatory neurotransmitter that may cause damage to neurons. Since MS is a condition where neurons are already damaged, it is important to avoid MSG.
MSG is found mostly as an additive in some Chinese cuisine and as a flavor enhancer in packaged savory snacks. Always check the labels of foods you purchase and avoid restaurant food that might use MSG in their ingredients.
As mentioned above, foods high in saturated fat, especially those that come from animal foods, should be avoided. While consuming milk could be beneficial for MS symptoms due to its vitamin D content, choose skim options instead to skip out on the fat. Choose low-fat dairy products or limit dairy products to maintain a low-fat diet.
According to Nature Neuroscience, high salt intake is linked to the exacerbation of MS symptoms. Limit adding salt to season your foods by using alternative spices, such as black pepper. Buy fresh or frozen vegetables, and avoid all canned products, which are extremely high in sodium. If you do have to resort to canned goods, wash the food thoroughly to get rid of excess sodium.
MS patients often experience issues with an overactive bladder. Since caffeine is a natural diuretic, it may exacerbate bladder activity in some people. Avoiding caffeine can help manage some of the symptoms associated with bladder-related issues found in MS patients and prevent irritation.
Note that people with some types of MS find that caffeine helps to relieve the symptoms of fatigue and two independent studies found that people who consumed caffeine regularly were at lower risk of developing MS.
This is one of the foods where research can be confusing, so it is important to speak to your doctor about how specific foods may affect the symptoms of the type of MS you or your patient has.
Wheat, rye, barley, and any foods made with these grains, including white flour, contain gluten. Researchers have explored the link between multiple sclerosis and celiac disease—a condition in which eating foods containing gluten causes damage to your small intestine. MS patients should be tested for gluten intolerance and, if found to be intolerant, allergic, or sensitive to gluten, they should follow a gluten-free diet.
Read our post on Top 10 Superfoods for additional suggestions on which foods can be beneficial for those with MS.
Note that while there is no miracle diet that is definitively shown to prevent or treat MS, there is plenty of research on the roles of dietary patterns and their influence on the onset and progression of MS. Note that there are different types of MS, and the underlying mechanisms behind their appearance and progression are different for each. As a result, the interaction foods and beverages have with different types of MS could vary. It is important to discuss any dietary changes with your doctor and follow up with them regularly.