Recently, nutritional science has begun to prove that food can influence our health and well-being in many ways. This is particularly true for people who have certain chronic conditions, such as the autoimmune disease multiple sclerosis.
When the immune system begins attacking the protective sheath, called myelin, that covers nerve fibers in the spinal cord and brain, that causes communication problems between the brain and the rest of the body. When this occurs, it’s called multiple sclerosis or MS.
Symptoms of MS
Symptoms of the disease can vary widely, but may include:
— Numbness or tingling.
— Memory problems and cognitive changes.
— Mood changes or depression.
— Difficulty walking, balance issues, dizziness and vertigo.
— Blindness or hearing loss.
— Bladder and bowel problems.
Eating Right for MS
Symptoms can come and go in flares. And while there’s no specific diet that’s been found to support people with MS, eating right is an important piece of the puzzle in caring for yourself if you have MS.
Kristi Epstein, a nurse practitioner in the neuroimmunology department at the Ohio State University Wexner Medical Center in Columbus, says, “Diet can positively affect the overall health of an individual living with chronic disease,” as has long been understood in relation to other chronic diseases like Type 2 diabetes and heart disease.
The connection between food and MS extends to risk too, she says. The risk of developing MS is higher in people who:
— Eat a poor diet.
— Have obesity.
— Have low vitamin D levels.
These factors can contribute to increased inflammation throughout the body, which can set the stage for MS, and may make symptoms worse and flares more frequent. As such, an anti-inflammatory diet has been proposed to help people with MS have less severe symptoms.
Changes in Diet and Lifestyle to Focus On
If you’ve received a definitive diagnosis of MS, food can’t cure the disease. There’s “no evidence to suggest that any diet can reverse the disease process,” Epstein says. However, making certain changes can have an impact in how quickly the disease progresses and the severity of symptoms.
These changes include:
— Eliminating food allergens.
— Eating a healthy, balanced diet.
— Changing the timing of when you eat.
— Quitting smoking.
— Reducing belly fat.
— Supplementing with vitamin D.
If you’ve recently been diagnosed with MS or are trying to improve your diet to better support your health with MS, Epstein says “the most important thing to consider is food sensitivity and food allergies. The gut microbiome is very important in overall immunity, and constant exposure to an allergen breaks down the ability of the gut to function properly.”
The gut microbiome includes good bacteria that process the foods you eat and contributes to overall health and wellness in ways science has only begun to unravel. A balanced gut microbiome may offer extensive health benefits, says Emilie Vandenberg, a registered dietitian at the Ohio State University Wexner Medical Center in Columbus.
These benefits include:
— Reduced inflammation.
— Improved glycemic control, which may help people with diabetes and prediabetes.
— Increased calcium absorption.
“The gut microbiome also produces neurotransmitters that play a role in mental health including dopamine, serotonin and norepinephrine,” she explains.
Removing allergens is important to supporting good gut and overall health. Many foods can trigger allergic responses in people, an inflammatory process that could make symptoms of MS worse.
Epstein says as you journey to find the best diet for you and your symptoms, there’s a few things you can do to improve results:
— Keep a food journal. For two weeks or so before you make any major dietary changes, write down everything you eat, portion sizes, timing of meals and any and all symptoms you may experience. This can help you pinpoint specific foods that are causing problems.
— Try an elimination diet. After a period of observation, you can begin an elimination diet that takes out all the potential allergens or foods you may have sensitivities to. Then, add them back in one at a time so you can determine which foods are problematic.
— Get your vitamin D levels tested. Epstein adds that you should have your vitamin D levels assessed “and daily supplementation initiated as soon as possible” no matter what the level. “Vitamin D supplementation is a universal must for MS patients as vitamin D” reduces inflammation in the central nervous system.
— Get tailored advice. Working with a registered dietitian nutritionist who specializes in MS and allergies can help you make sure that your diet is healthy and well-balanced and often works better than trying to self-diagnose.
“Once food allergies and sensitivities have been identified and eliminated, MS patients should focus on balanced diets that include protein, healthy fats and carbohydrates,” Epstein says.
A Healthy, Low-Inflammatory Diet
Another goal of eating for MS health means reducing the number of foods that could trigger inflammation in the body.
Foods that have been linked with higher levels of inflammation include:
— Refined sugar and high-fructose corn syrup.
— Artificial trans fats.
— Processed foods, such as deli meat, cheeses and refined carbohydrates like white bread and white rice.
Following an eating pattern that avoids or removes these inflammatory foods can help you feel better, whether you have MS or not.
“There are many anti-inflammatory diets and diet protocols that patients can follow,” Epstein says. One of the best ones is the Mediterranean diet. The Mediterranean diet, ranked No. 1 in the annual U.S. News & World Report Best Diets ranking, has also been a consistent top performer.
If you’re not a fan of the bold flavors of the Mediterranean diet, there are other options, such as the Nordic diet. The key is to eat a “balanced diet that contains as few processed foods as possible,” Epstein says.
Epstein also notes that beyond simply what you eat, when you eat might have an impact on your experience with MS too.
Intermittent fasting, a pattern of eating that limits the window of time when you can eat so that your body gains some of the benefits of calorie restriction and fasting, “has recently received a lot of attention as a tool to reduce inflammation,” she says.
“There are some good results in MS trials regarding reduction of inflammatory markers and reduction of adiposity (body fat) which is pro-inflammatory.”
There are several different approaches to intermittent fasting you can follow, so work with your provider to determine whether it makes sense for you to try it and which pattern will best fit your needs.
[SEE: Lupus Diet and Nutrition.]
The Cleveland Clinic reports that smoking is common in patients with multiple sclerosis. Smoking in general has negative health impacts, but there’s a direct link between smoking and the progression of MS. Some of the thousands of compounds in cigarette smoke have been found to be toxic to certain cells in the brain and spinal cord, and these compounds may alter immune system function. These effects can make the disease process move more quickly than in people who don’t smoke.
People who do smoke or have previously smoked are also at higher risk of developing MS. Smoking can also obscure the cause of symptoms of MS, so may result in delayed diagnosis.
Having obesity can increase your risk of developing MS because adipose or fat tissue is metabolically active and can increase inflammation throughout the body. In people who already have MS, being overweight or having obesity can exacerbate symptoms or speed disease progression for the same inflammatory reasons.
This is especially true when excess fat accumulates around the midsection. Too much belly fat can be a sign of metabolic syndrome, which is associated with increased risk of a variety of chronic health conditions including diabetes and high blood pressure. Inflammation and dysregulation of blood sugars are central to this cascade of metabolic events, all of which can make symptoms of MS worse.
Vitamin D and Other Supplements
Epstein notes that there’s “ample research to support vitamin D supplementation in the MS community.” She recommends discussing the exact amount and product choices with your provider.
She also notes that in trials with MS patients, “there’s mixed evidence surrounding other supplements,” including:
— Antioxidants. Antioxidants fight inflammation and are found widely in a range of fresh fruits and vegetables.
— Alpha lipoic acid. ALA is an omega-3 fatty acid that has shown some promise in trials with people with MS. It’s found in yeast, organ meats, spinach, broccoli and potatoes.
— Turmeric-curcumin. Turmeric is a spice common in Indian cuisine, and its constituent component curcumin is thought to reduce inflammation in the body.
“You can discuss these individually with your provider to determine benefit as a part of a well-balanced, practical diet,” Epstein says. “In our MS clinic we offer specific visits to discuss and develop a wellness plan, which includes diet, supplements, exercise and sleep recommendations.”
Your Best MS Diet
Be sure to talk with your health care provider about what their recommendation is, based on your specific situation. “The ‘best’ diet is an individualized diet,” Epstein says. Your provider can also help you determine if intermittent fasting makes sense for you and how to establish appropriate calorie requirements for your energy needs.
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Update 12/28/21: This story was previously published at an earlier date and has been updated with new information.