People with MS are well-advised to maintain a healthy diet, as diet can interfere with their energy level, bladder and bowel health, and possibly shift their immune system to a more inflammatory state.
Although a number of different diets are suggested as best for people with MS, solid evidence does not exist to support any one diet over another, leaving the issue much to an individual’s choice. A number of MS specialists recommend their patients simply follow the same general diet guidelines recommended for the public at large by the American Heart Association and the American Cancer Society: one rich in healthy foods and rounded off by regular exercise.
The National MS Society also offers a list of special diets of possible interest to patients.
Pavan Bhargava, MD, published a review paper on a Society webpage, “Diet and Multiple Sclerosis,” in which he identified the most important dietary factors linked to MS: low levels of vitamin D, a high salt intake, and changes in gut bacteria (the gut microbiota).
He also identified possible mechanisms through which diet may affect MS:
- Directly on the immune system, as metabolism has been shown to have a role in the functioning of various immune cells. Some immune system cells also have receptors that respond to such foods as vitamin D and fatty acids, with research suggesting that certain fats are linked to inflammation and polyunsaturated fatty acids to lower inflammation.
- Indirectly through gut bacteria that metabolize certain foods into short-chain fatty acids, which act in positive ways on the immune cells, and improve the regulatory function of T-cells. Diet also works to colonize the gut,or alter the bacterial mix there, which can shift the immune system away or toward an inflammatory state.
- May affect components of the nervous systemby providing nutrients and other factors that might protect neurons and glial cells, important supporting cells of the brain (Glial cells include oligodendrocytes, which produce myelin.) Research is ongoing in this possible effect.
Different diets are recommended by different MS specialists, but there is insufficient evidence to recommend any specific one. But almost all have points in common, such as avoiding highly processed foods, foods with a high glycemic index and foods high in saturated fat, and recommend reducing fatty red meat intake and increasing consumption of fresh fruits and vegetables.