The Best Diet for Multiple Sclerosis

If you have been diagnosed with multiple sclerosis (MS), you may be wondering if there are certain foods you should be eating—or avoiding.

Your best choices are fresh vegetables and fruits, whole grains, nuts and lean meats. In other words, just eat a healthy, balanced diet.

“When discussing a healthy diet, in some cases it’s frustrating for people,” says UNC Health registered dietitian Margaret Mangan. “They want me to tell them what to eat.”

She offers simple advice: Whether you have MS or another chronic condition, try to eat nutrient-dense foods that you like.

No “Best Diet” for People with MS

Despite much research, the National Multiple Sclerosis Society says there is not a specific “MS diet” that seems to change the course of the disease.

For example, though having low levels of vitamin D in the body is a risk factor for MS, studies have shown conflicting results on whether increasing the amount of vitamin D in your diet slows or reduces the progression of disease.

Research also has looked at increasing biotin, a form of vitamin B, increasing omega-3 fatty acids, reducing salt, and eliminating gluten or dairy products from the MS patient’s diet. Nothing has shown to have a lasting, positive impact.

“While there is no answer to which dietary approach is better, it usually comes down to what the patient wants to do, what is most feasible,” says UNC Health neurologist Irena Dujmovic Basuroski, MD. “You have to keep the family in mind when making dietary changes, since adhering to a certain dietary regimen is usually better if the whole household can make the adjustments.”

Financial and cultural issues need to be considered, too. “People usually cannot make large dietary changes all of a sudden, so small but consistent changes over time are recommended,” Dr. Dujmovic Basuroski says.

Dr. Dujmovic Basuroski says she and other UNC neurologists who treat MS patients often recommend the Mediterranean diet. It’s largely plant-based and limits saturated fats and sugar while emphasizing anti-inflammatory foods such as fruits, leafy green vegetables and olive oil. Fish, seafood, dairy and poultry are included in moderation.

Obesity can cause inflammation in the body, including the central nervous system, Dr. Dujmovic Basuroski says. Managing weight can help people with MS feel better.

Obesity or any extra body weight also can add stress to your joints and make moving harder, another important reason for people with MS to maintain a healthy weight, Mangan says.

“When we talk to patients who really want to address inflammation, we talk about the Mediterranean or DASH or MIND diets. More fruits and vegetables. If you’re going to eat bread, go with a whole-grain option. If you get protein from meat, choose a lean meat. Also, I like for folks to eat all kinds of foods, and that includes dairy, especially milk and yogurt.”

In addition, nuts, seeds and cold-water fatty fish (including salmon, mackerel, tuna and others) are good choices, she says.

Dr. Dujmovic Basuroski says some patients choose to follow other diets, including the Swank diet (low saturated fat); McDougall diet (plant-based, very low fat); ketogenic diet; Wahls diet (modified Paleolithic diet); or calorie restriction and intermittent fasting.

“We also refer our MS patients to UNC dietitians when they are obese, underweight or struggling with implementing dietary recommendations that providers are giving,” she says.

Find Ways to Enjoy Healthy Foods

People should enjoy the foods they eat, Mangan says. Healthy foods can become comfort foods, depending on how you cook and season them. Grandma’s mac and cheese recipe isn’t the only meal that can make you feel loved.

“People tend to consider healthy food as boring,” she says. “But you can take these ‘boring’ foods and make them absolutely delicious.”

Vegetables and salads are great examples. So are fish dishes, and soups and stews made with beans.

There are many resources at your local library and online that provide education and techniques for making healthy meals you will love eating. UNC Health offers free virtual nutrition education classes and in-person heart-healthy cooking classes.

“You want to fill your body with goodness,” Mangan says. “And if something doesn’t go right, you forgive and move on.”

Healthier Diet, More Movement

Eating better can make you feel more like moving, and that’s key to reducing or delaying the effects of MS, says UNC Health neurologist Monica Diaz, MD.

“Staying active can help prevent flares of symptoms,” she says. “Do exercises at home. Do physical therapy. Walk regularly, at least three times a week. Many MS patients are intolerant of heat, which makes it hard to get out and stay active, especially in the summer. Aquatic therapy is really good if you’re able to swim safely.”

Look for everyday opportunities to move your body, Mangan says. “Walking, gardening, dancing, bicycling. You could just walk back and forth to your mailbox 20 times. Your neighbors might think you’re crazy, but that’s all right.”

If you’re unsure about what foods and exercise are best for you, talk to your doctor, or find one near you.