Best foods for MS

Multiple sclerosis (MS) diet tips

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

Probiotics and prebiotics

Changes in gut health may contribute to immune disorders, and research indicates that the health of the gut appears to play a role in many kinds of diseases.

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.

The 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 thrive in the intestines when there is ample fiber in the diet.

A lack of healthy gut flora may contribute to a range of immune disorders, including MS. Anyone with the condition should have a diet that supports a healthy immune system, and one that promotes beneficial gut flora may help.

Probiotics are foods that can boost levels of beneficial bacteria in the gut, helping to strengthen the immune system.

The authors of a study in Nature Communications suggest that adjusting the gut flora, by using probiotics, for example, may be helpful for people with MS.

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

  • yogurt
  • kefir
  • kimchi
  • sauerkraut
  • kombucha, or fermented tea

Prebiotics

After filling the gut with good bacteria, it is important to feed them. Foods that nourish probiotic bacteria are called prebiotics, and they contain fiber.

Foods that contain healthful levels of prebiotic fiber include:

  • artichokes
  • garlic
  • leeks
  • asparagus
  • onions
  • chicory

Fiber

Fiber occurs in plant-based foods, such as:

  • fruits
  • vegetables
  • nuts and seeds
  • legumes, such as lentils
  • whole grains
  • brown rice

It helps promote health in the following ways:

  • nourishing the gut bacteria
  • encouraging regular bowel movements
  • keeping blood pressure and the heart healthy by helping manage cholesterol
  • reducing the risk 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 healthful diet will benefit overall heart health.

Find out more about fiber and why we need it.

Vitamin D

Share on PinterestOily fish are a dietary source of 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 chance 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:

  • oily fish
  • fortified dairy products
  • some fortified cereals, yogurt, and orange juice
  • beef liver
  • egg yolks

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

Learn more about the benefits of vitamin D.

Biotin

Biotin is a form of vitamin B, and some people call it vitamin H.

It occurs in many foods, but good sources include:

  • eggs
  • yeast
  • beef liver
  • sunflower seeds
  • almonds
  • spinach
  • broccoli
  • whole-wheat bread

Researchers have been looking into whether biotin might benefit people with MS. Findings from small studies indicate that a high dosage of biotin — between 100 and 600 milligrams per day — could help people with progressive MS, in which symptoms gradually become more severe.

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

What does the research say about biotin for MS? Learn more here.

Polyunsaturated fatty acids

Investigations into whether a diet rich in polyunsaturated fatty acids (PUFAs) directly helps relieve MS symptoms have yielded mixed results. However, there is evidence that these acids help support a healthy body and control inflammation.

A study published in 2017 concluded that a low intake of PUFAs may increase the risk of MS. The study looked at data from more than 170,000 women.

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 substances called polyphenols, which 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
  • fruits
  • herbs
  • tea

Antioxidants can also help prevent oxidative stress, which researchers have linked to a wide range of health problems.

Some antioxidants — specifically resveratrol, which occurs in grapes — appear to help protect the nervous system.

What are antioxidants and why do we need them? Learn more here.

Weight management

A review published in 2016 concluded that obesity during childhood and adolescence might increase the risk of developing MS. The researchers also noted that obesity could affect the progression of the disease.

In addition, a person with MS who loses mobility or who finds movement more challenging may have a higher risk of putting on extra weight.

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

What to Eat When You Have Multiple Sclerosis

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Look online and you’ll find any number of diets that purport to “cure” multiple sclerosis. The truth, though, is that “so far we haven’t found a particular diet or style of eating that cures MS, or even makes a huge impact,” says Rosalind Kalb, PhD, vice president of clinical care at the National Multiple Sclerosis Society. Even so, you shouldn’t overlook the importance of proper nutrition. Certain types of foods may help alleviate— or exacerbate— common health issues associated with the disease. Something else to keep in mind: “You’re at risk of developing the same chronic conditions as anyone else—, such as diabetes or heart disease—, and those issues can make it even more difficult to live with MS,” Kalb says. Maintaining a balanced diet helps ensure that your body is getting the nutrients it needs to function optimally. Here’s what to fill up on, and what to stay away from.

RELATED: 17 Multiple Sclerosis Treatments

Get plenty of…

“Constipation is very common among MS patients, and it can be difficult to manage,” Kalb says. Foods that are rich in fiber, such as brightly colored fresh fruits and vegetables, lentils and whole grains, can help ease bowel troubles.

Scientists are still exploring what appears to be an important connection between vitamin D levels and multiple sclerosis. “Studies show that people who are low in vitamin D are at greater risk of developing MS, as well as having more frequent relapses and a more aggressive progression of the disease,” Kalb says. While there aren’t many great dietary sources of vitamin D, it may help to stock your refrigerator with D-fortified drinks like milk and orange juice. Lean protein By regulating blood sugar, lean protein can help combat one of the most challenging symptoms of MS: fatigue. Eat fish regularly, particularly salmon, herring, tuna, sardines and trout—all of which are high in omega-3 fatty acids. Also good: skinless chicken and turkey or lean meats trimmed of visible fat.

RELATED: Could You Have MS? 16 Possible Symptoms

Caffeine and alcohol

MS patients are often plagued by sleep issues such as insomnia. Skipping that afternoon latte or second glass of wine can help you drift off more easily.

Artificial sweeteners

These additives can irritate the bladder, Kalb explains, and bladder-control issues affect at least 80 percent of folks with multiple sclerosis.

Saturated fat

On the steer-clear list: highly marbled meat, butter, cheese and any other high-fat dairy products. Instead, use vegetable, seed and fish oils in your cooking—and try butter substitutes, but sparingly.

Sugary snacks

Fatigue can be a problem, and when you’re exhausted, it’s tempting to reach or convenience foods like candy bars or store-bought cookies and muffins. Thing is, the resulting energy crash will hit you even harder. So choose snacks that will sustain you, such as fiber-rich cereal, a handful of unsalted nuts or a piece of fresh fruit.

Salty stuff

Studies show that eating a diet high in sodium may lead to a poorer prognosis, so you want to watch your salt intake. Season your dishes with antioxidant-rich fresh herbs and spices instead. You’ll get the same bang for your bite.

Special diets and MS

Following one of these diets is an individual choice – but if you do decide to try a new diet, it’s important to make sure you still get enough energy and all your essential nutrients.You should speak to your doctor before making any major changes to your diet, particularly if you have any other health conditions which might also affect your dietary needs.

The Swank diet

The Swank diet is perhaps the best known diet associated with MS. It is named after Dr Roy Swank, who developed the diet in the 1940s. It restricts the amount of fat you can eat: no more than 15 grams of saturated fat a day, and between 20-50 grams of unsaturated fat. It also limits your intake of red meat and oily fish, although you can eat as much white fish as you like.

Research into this diet has not definitely proved any benefits. Although a number of studies have been carried out, they have not generally been well designed. They also had very high drop-out rates, so without knowing what happened to the people who dropped out of the study, it’s hard to draw clear conclusions. But following this or a similar diet would not generally be considered bad for health.

Cutting down on meat and dairy foods to reduce saturated fats might leave a shortfall in protein, so it’s important to find alternative sources such as fish, beans and pulses.

Cod-liver oil has a blood-thinning effect and should be taken with caution if you take aspirin, drugs that help prevent blood clots (known as anti-coagulant medications, including warfarin) or have a bleeding disorder.

If you have diabetes you should speak to your doctor before taking cod-liver oil. This diet can be low in energy and unless care is taken to maintain energy intake, it may not be suitable if you have high energy needs or are underweight.

George Jelinek’s Overcoming MS programme

The Overcoming MS (OMS) programme was developed by Dr George Jelinek in 1999 following his own diagnosis with MS. It combines a number of different elements, including diet, exercise, meditation, vitamin D and medication.

The OMS diet recommendations are similar to the Swank diet. It advocates cutting out dairy and meat, and reducing fat intake – particularly saturated fat. It also recommends supplementation, particularly with omega 3 (in the form of fish oil or flaxseed oil) and vitamin D if your exposure to sunlight is limited.

Research into this diet has not provided conclusive evidence of its benefits. However, as with the Swank diet, following the OMS programme is not likely to be considered bad for you. You should make sure you’re getting enough protein in your diet, through eating plenty of fish, beans or pulses. Likewise, the diet may be low in energy, so it may not be suitable for you if you have high energy needs or you are already underweight.

The Best Bet diet

The Best Bet diet recommends avoiding several different food types, including all dairy, grains and red meat. Fish, chicken and turkey are recommended for protein. It also recommends having allergy tests to discover other foods to be avoided and includes a list of 18 recommended supplements.

Currently, research doesn’t suggest that there are benefits for MS from taking large numbers of supplements or from cutting out any of these food types completely. It’s also worth remembering that taking supplements can be expensive.

Like the Swank diet, this diet can also be low in energy so care should be taken if you have high energy needs or are underweight.

The Paleo diet

The Paleo – or Paleolithic – diet is based around the foods that a caveman would have had access to. The idea is that these are the kinds of foods our bodies are best adapted to eating. This includes meats, fish, nuts, vegetables and fruit, but excludes dairy, grains, pulses, potatoes and processed food.

There has been very little research into the benefits of this diet for people with MS. Currently, there is no evidence to suggest that it will affect the course of someone’s MS. One small study, looking at a programme which included the Paleo diet alongside exercise, supplements and meditation, found that it may reduce fatigue.

Following the Paleo diet would not generally be considered bad for you, although you would have to make sure you were getting all the nutrients you need. Cutting out whole food groups such as dairy, wholegrains and pulses is restrictive. The large amounts of meat recommended are higher than current health advice on how much meat you should eat, and can also be expensive.

8 Anti-Inflammatory Foods for Multiple Sclerosis

When you have multiple sclerosis (MS), it’s important to follow a healthy diet. After all, your diet plays a significant role in your cardiovascular and overall health, both of which can have an impact on your MS symptoms and how disabled you feel from your disease.

Lately, though, it’s been popular in some circles to make more sweeping claims about diet and MS — such as that following a particular diet plan can directly reduce MS symptoms or slow progression of the disease. These claims present a paradox: They’re often unfounded based on current knowledge, and yet some of them may turn out to be true.

“Right now, we cannot really make any big statements about the role of diet,” says Laura Piccio, MD, PhD, a neurologist at the Washington University School of Medicine in St. Louis. “There are suggestions that diet may be important, but we don’t have any robust clinical evidence that allows us to suggest one specific diet over another in patients with MS.”

One claim that’s often made about food and MS is that following an anti-inflammatory diet may be beneficial. This makes intuitive sense, since it’s well established that MS is an inflammatory disease.

It’s Unclear How Diet Affects the Inflammation That Occurs in MS

“Inflammation definitely plays a role, probably both in the development of the disease and in the subsequent clinical course,” says Dr. Piccio. But, she adds, that doesn’t mean we currently have a clear understanding of how diet affects this process.

Numerous studies involving animal models, as well as some smaller studies of people with MS, are under way to explore the connection between diet and MS and to understand how different foods could affect inflammatory processes in the body. “Probably in the next few years, we’ll have some answers,” says Piccio.

In the meantime, she recommends following a generally healthy diet rich in vegetables, fruits, whole grains, and legumes, and low in sugar, salt, saturated fat, and all processed foods. “We know for sure,” says Piccio, that such a diet “will impact the cardiovascular system, and so indirectly, this will benefit MS.”

Most foods that are widely touted for their anti-inflammatory effects, it turns out, are also good for you in other ways, and bear Piccio’s stamp of approval. “Definitely, those would be good recommendations that I would give to any patient to promote general health,” she notes.

Here are eight foods widely touted for their anti-inflammatory properties that you should check out if you have MS — even if we’re still waiting on solid evidence regarding their benefits.

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Multiple sclerosis (MS) is one of the most baffling of all diseases – we do not know enough about what causes it and what factors influence its progression and outcome. MS begins with localized inflammatory damage of the myelin sheaths surrounding nerve fibers due to attack by the immune system. The resulting damage interferes with nerve impulses, leading to such symptoms as muscle weakness, loss of vision, and other impairments.

Your question about dietary changes to influence multiple sclerosis is timely. A discussion at a November 2018 European conference on MS reviewed investigations on the effects of diet for helping slow the progression of the disease. Results of a Johns Hopkins observational study with 280 MS patients showed that those consuming high-quality foods had a higher processing speed (the speed at which you can understand and react to information), a slightly faster walking speed and slightly better manual dexterity compared to patients whose diets were not as good. High quality diets were defined as those that included plenty of fruits, vegetables, legumes, seafood/plant proteins, whole grains and monounsaturated fats.

A study from New York’s Mount Sinai Hospital looked at young patients with early MS to see how their consumption of monounsaturated fats, polyunsaturated fats and saturated fats affected brain matter atrophy, a change closely linked with disability. The researchers didn’t see associations between polyunsaturated or saturated fats and atrophy, but they did see less brain atrophy in patients whose intake of monounsaturated fats was high, suggesting that these fats may be protective.

A modified ketogenic diet for MS has been under investigation at the University of Virginia. This diet is very low in carbohydrates and high in fat. It has long been used to treat drug-resistant epilepsy in children. Although it is a very hard diet to follow, the Virginia researchers were able to recruit 20 patients to join the study and stick with it for six months. The team reported lessening of the patients’ fatigue and depression.

A pilot study at Mount Sinai looked at the effects of a modified Mediterranean diet that included fish, nuts, avocados, fruits and vegetables and whole grains but eliminated meat, dairy products and most processed foods. Researcher Ilana Katz Sand, M.D., reported a statistically significant reduction in fatigue among the patients who joined the study and followed the diet for six months, as well as improvements in the impact of the disease on quality of life. She also said that many of the patients “really felt like their lives were better and they were healthier.” Dr. Sand added that some of the improvement may be related to weight loss; the patients participating in the diet group lost an average of six pounds over the course of the study.

These new findings are promising, but more research with larger study populations is needed to determine what kind of dietary changes would best benefit people with MS.

Andrew Weil, M.D.

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