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MS: Should You Avoid Certain Foods?

Medically Reviewed by Brunilda Nazario, MD on January 20, 2021

Could skipping certain foods help you manage symptoms of multiple sclerosis (MS)? Plenty of people with MS believe that’s the case. When the Multiple Sclerosis Society of America asked members of its Facebook page whether specific foods triggered their MS symptoms, dozens answered with a resounding “yes.”

People who responded blamed a variety of foods and ingredients for making them feel worse, such as sugar, dairy products, gluten (proteins in wheat and some other grains), and others. Cutting out culprit foods, many said, helped prevent relapses.

It may well be true that some people feel better when they steer clear of certain dishes. But experts say that completely quieting your symptoms by skipping specific foods is far less certain. Nonetheless, paying close attention to what you eat does play a key role in managing MS and your overall health.

Many Diets, Little Evidence

If you have MS and have searched online for tips on what to eat and which foods to skip, then you know there’s no shortage of opinions on those questions. A 2019 study by researchers in Australia found at least 32 websites offering dietary advice for people with MS. In addition to recommending specific foods, these meal plans cautioned against a number of supposed MS triggers, including dairy foods, gluten, saturated fat, and refined sugar.

Unfortunately, there’s little evidence that following any of these restrictive diets will improve your symptoms. “There is no one diet that has been scientifically proven to be effective for managing MS,” says Julie Fiol, a registered nurse and director of MS information for the National Multiple Sclerosis Society. She says scientists are very interested in the link between food and MS, and the society is updating its dietary advice. But she stresses that any diet that requires you to omit certain foods or food groups isn’t based on science.

Worse, some restrictive diets that are promoted as helpful for people with MS could backfire, says Whitney Linsenmeyer, PhD, a registered dietitian and spokesperson for the Academy of Nutrition and Dietetics. She cites the so-called Wahls Protocol as an example. “It omits dairy foods, eggs, grains, legumes, and certain vegetables, all of which are highly nutritious.”

Some people with MS end up cutting certain foods because they can’t get around well or have fatigue, making it a challenge to shop for and cook the dishes they prefer. Those people don’t need to get rid of even more food groups, she says. Doing so could make them more likely to lack the nutrients they need.

Should You Go ‘Keto’?

One popular weight loss meal plan that has gained interest for controlling MS is the so-called ketogenic (“keto”) diet, which calls for strict limits on carbohydrates, including fruits, vegetables, and starchy foods such as bread and pasta. Cutting carbs, which are a key source of energy, causes your body to produce other fuel sources called ketones. According to one theory, ketones may protect nerves and prevent inflammation.

German researchers are studying whether adopting the keto diet might benefit people with the most common form of MS, called relapsing-remitting MS. But right now, there’s no solid evidence that embracing the keto diet will tamp down MS symptoms. What’s more, people who go on the keto diet must take vitamin supplements to make up for all the nutrients they’re missing. And some people have reported unwelcome side effects, like stomach problems and pancreatitis (an inflamed pancreas) while on the diet.

Right Idea, Wrong Reason

Cutting back on certain things may help relieve specific MS symptoms. For example, at least 80% of people with MS have bladder problems. “Certain fluids can irritate the bladder, which can worsen bladder function,” says Fiol, who calls out caffeinated drinks, alcohol, and artificially sweetened beverages as common culprits.

Meanwhile, some food groups that are often blamed for causing relapses and worsening MS may be worth avoiding or at least eating less of. But while there’s not a lot of evidence that dialing back on these foods will improve MS symptoms, doing so will likely boost your overall health.

For example, one diet for people with MS that has been around since the 1950s dramatically limits saturated fat, the kind you find in whole milk, butter, cheese, and red meat. Another theory holds that sodium, the main chemical in salt, worsens MS, so you should avoid foods with high levels, such as deli meats, canned soups, and fast food, for example.

“There isn’t enough proof that saturated fat or sodium have a direct effect on MS symptoms,” says Linsenmeyer, who’s also an assistant professor of nutrition at Saint Louis University. On the other hand, she notes, diets rich in saturated fat and sodium are associated with serious medical conditions such as heart disease, high blood pressure (or hypertension), and diabetes, all things that people with MS get, too.

Linsenmeyer points out that current recommendations are to limit saturated fat to less than 10% of your daily calories and to keep sodium under 2,300 milligrams a day. “Following these strategies can reduce the risk for cardiovascular disease and hypertension for people with MS,” she says, adding that many Americans far exceed these levels.

Similarly, people with MS may sometimes be advised to avoid foods that promote inflammation by adopting meal plans such as the Mediterranean diet, which restricts red meat, dairy products, and sugary foods. But evidence that the Mediterranean diet eases MS symptoms is limited to one small study, Fiol says, so the jury is out. But, she says, an anti-inflammatory diet can help lower your risk for other health conditions, like cardiovascular disease and diabetes.

If you’re determined to pick one category to avoid, Fiol says, make it processed foods like frozen dinners and packaged snacks, which tend to be loaded with unhealthy fats, sodium, and added sugar. Swap refined grains such as white bread for whole-grain varieties, like 100% whole-wheat loaves. And focus on nutritious foods to include in your diet, such as colorful fresh fruits and vegetables.

WebMD Feature

Sources

SOURCES:

Celiac Disease Foundation: “What is Gluten?”

Multiple Sclerosis Association of America: “Can Certain Foods Trigger MS Symptoms?”

Julie Fiol, registered nurse; director of MS information, National Multiple Sclerosis Society, New York City.

Whitney Linsenmeyer, PhD, registered dietitian; spokesperson, Academy of Nutrition and Dietetics; assistant professor of nutrition, Saint Louis University, St. Louis.

Interactive Journal of Medical Research: “Diet and Multiple Sclerosis: Scoping Review of Web-Based Recommendations.”

Academy of Nutrition and Dietetics: “What is the Ketogenic Diet?”

University of California, San Francisco: “Diabetes Education Online: Ketones.”

Trials: “Ketogenic diet and fasting diet as Nutritional Approaches in Multiple Sclerosis (NAMS): protocol of a randomized controlled study.”

Multiple Sclerosis and Related Disorders: “An overview of the current state of evidence for the role of specific diets in multiple sclerosis,” “Randomized-controlled trial of a modified Mediterranean dietary program for multiple sclerosis: A pilot study.”

National Multiple Sclerosis Society: “Bladder Problems,” “Is there an MS diet?”

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