Special diets and MS

Some people with MS say following a special diet gives them a feeling of control over their MS. Or makes them feel better and helps with their symptoms, but that’s not the case for everyone.

At the moment there isn’t enough evidence to recommend any special diet for people with MS. But if you feel better eating a certain way, it could be a change that works for you.

Like any lifestyle change, there's lots you might want to think about, including:

  • What’s the evidence for the diet - are any claims about its effects on MS backed up by science?
  • Can you still enjoy your food - at home, with others, and if you eat out?
  • Is the diet good for you - can you get a proper balance of all the nutrients you need?
  • How practical is the diet - does it work with your lifestyle, the time and money you have to spend?

Some special diets recommend changes which could have benefits for overall health, such as reducing saturated fats, or eating more vegetables – both generally recommended as part of a healthy, balanced diet. But they can also include restrictions which might be unhealthy, or make it hard for some people to stick to.

The important thing is to make sure you’re not missing out on the healthy nutrition you need. Speak to your doctor or dietitian before making any major changes, particularly if you have any other health conditions as well as MS.

On this page we look in a bit more detail at:

Paleo diets and the Wahls protocol

Paleo diets are based on foods that are thought to have been common in the Paleolithic era, before humans started farming. So they include meats, fish, nuts, vegetables and fruit. The idea is that our bodies are best adapted to eating these kinds of foods. Paleo diets limit dairy, grains, pulses, potatoes and processed food.

The Wahls diet is based on a Paleo diet, and it’s part of what’s called the Wahls Protocol. This combines the diet with vitamins, meditation, and exercise. There are also newer versions of the Wahls diet, including a ketogenic (keto) diet. The Wahls diet is named after Terry Wahls, an American doctor who has MS.

Do Paleo diets and the Wahls protocol help with MS?

One small but well-designed research study suggests a Wahls diet might help with fatigue. This study also looked at the Swank diet.

Read more about the 2021 research into Wahls and Swank diets

There hasn't been much research into Paleo diets in general and MS. At the moment, there’s no clear evidence to suggest they have benefits for people with MS.

Are Paleo diets and the Wahls protocol healthy?

Following a Paleo diet wouldn’t generally be considered bad for you, although you’d have to make sure you were getting all the nutrients you need. Current evidence around good diet suggests that we should eat nutritionally balanced diets, so cutting out whole groups of foods like dairy, wholegrains and pulses is restrictive.

Cutting out cereals and dairy could mean you miss out on some B vitamins, vitamin D and calcium. And if you have high energy needs or you’re underweight, excluded foods might make it harder to get the energy you need. The large amounts of meat recommended are higher than current health advice on how much meat you should eat - and could also make it expensive.

The Wahls diet doesn’t completely cut out all of the same foods as other Paleo diets do, but you should still check you get all the nutrients you need.

Intermittent fasting and keto diets

Intermittent fasting puts strict limits on calories some of the time, with the usual calories allowed the rest of the time. For example, it could mean cutting what you eat to just 500 calories for 2 days every week. On the other days, you’d eat your normal amount.

Keto diets (also called ketogenic diets) are low in carbohydrates. The idea is to get more of your calories from fats and protein instead. Intermittent fasting and keto diets stop the body getting energy from its usual carbohydrates, so the body has to work in a different way to make use of fats and protein.

Researchers are interested in these kinds of diet because of the idea that they might reduce inflammation and help protect nerves.

Read our factsheet about fasting for religious or cultural reasons

Do intermittent fasting and keto diets help with MS?

Early studies have suggested intermittent fasting and keto diets might have a positive effect on the immune system and the bacteria in the gut which affect it. But at the moment, there isn’t enough evidence to show they have an effect on people’s MS symptoms or how their MS develops.

Are intermittent fasting and keto diets healthy?

Keto diets don’t provide all the vitamins and minerals we need, without supplements. And intermittent fasting and keto diets can lead to weight loss, so they might not be advised if you’re underweight or have high energy needs.

Serious problems are rare, but the way the body gets energy from keto diets could lead to problems with the pancreas and liver. People fasting or following a keto diet can get headaches, fatigue, feel irritable and dizzy for the first few days.
Intermittent fasting can affect bone density and make menstrual periods irregular.

If you cut down on carbohydrates, your diet will be lower in fibre too. We need fibre for a healthy gut and to avoid constipation. And if your diet is high in fat, this could affect your health in the long term.

The Swank diet

The Swank diet is named after Dr Roy Swank, who developed the diet in the 1940s. It limits the amount of fat you can eat: no more than 15g of saturated fat a day, and between 20-50g of unsaturated fat. It limits your intake of red meat and oily fish, although you can eat as much white fish as you like. The diet also recommends that you take cod liver oil, vitamin C and E supplements and a multi-vitamin and mineral supplement.

Does the Swank diet help with MS?

Some people say that following this diet has made them feel better, and reduced the number of relapses they’ve had. Other people have not had any benefit from following it.

From the research that’s been published, there’s not enough evidence to show this diet can reduce relapses.

One small but well-designed research study in 2021 suggests the Swank diet might help with fatigue. This study also looked at the Wahls diet.

Read more about the 2021 research into Wahls and Swank diets

There have been a few other studies of the Swank diet, but they’ve 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.

Is the Swank diet healthy?

Following the Swank diet or a similar diet would not generally be considered bad for you. Not eating too much saturated fat is widely accepted as good health advice. But cutting down on meat and dairy products to reduce your saturated fat intake might mean you’re not getting enough protein and iron, so you’d need to find alternative sources like fish, beans and pulses.

Cod liver oil has a blood-thinning effect, so it should be taken with caution if you take aspirin or anticoagulant medications such as warfarin, or if you have a bleeding disorder. Cod liver oil also contains high levels of vitamin A, so you shouldn’t take it if you also take supplements containing vitamin A, or if you eat liver regularly. If you have diabetes you should speak to your doctor before taking cod liver oil.

This diet can be low in energy, so you might lose weight. If you have high energy needs or if you are already underweight then it may not be suitable for you.

The Overcoming MS diet

The Overcoming MS (OMS) diet was developed by Dr George Jelinek in 1999 following his own diagnosis with MS. It’s part of a lifestyle programme which includes diet, medication, exercise and meditation.

The OMS diet recommendations are similar to the Swank diet. It advises cutting out dairy and meat, and eating less fat – particularly saturated fat. It also recommends flaxseed oil as an omega 3 supplement and vitamin D supplements if you don’t get out in the sun much.

Does the Overcoming MS diet help with MS?

Research into this diet has not provided conclusive evidence of its benefits. A five-year follow up study showed that people who had followed this diet reported they felt better physically and mentally, but there was a very high drop-out rate. We don’t know what happened to the people who dropped out of the study. This is one of the reasons it’s impossible to draw firm conclusions about the diet.

Research published in 2021 suggests that the similar Swank diet might help with fatigue.

Is the Overcoming MS diet healthy?

Following the OMS diet isn’t likely to be considered bad for you as long as you’re sure to include the missing nutrients.
You should make sure you’re getting enough protein in your diet, through eating plenty of fish, beans or pulses. If you have high energy needs or you’re underweight, excluded foods might make it harder to get the energy you need.
If you take cod liver oil supplements, you should take the same precautions around that as for the Swank diet.

A Mediterranean diet

A Mediterranean diet is based on foods traditionally eaten in that part of the world.It usually includes a lot of vegetables, fruits, nuts, beans, cereals, grains, fish, and unsaturated fats like olive oil. Regular - but moderate - amounts of red wine are also sometimes recommended. Red meat and dairy are limited, but not cut out completely.

Does a Mediterranean diet help with MS?

There hasn’t been much research into MS and Mediterranean diets in particular, and the small amount of evidence we have doesn’t prove that they affect the course of MS. But they are usually a balanced diet, which can help you stay in the best health possible.

Is a Mediterranean diet healthy?

A Mediterranean diet is usually very similar to the Eatwell Guide that the NHS uses.

The Best Bet diet

The Best Bet diet was developed by Ashton Embry, a geologist whose son has MS. This diet recommends avoiding several different food types, including all dairy, grains and legumes (beans and pulses). It also recommends taking lots of supplements, including calcium and vitamin D.

The diet is based on the assumption that partly digested food protein can pass through from the intestines into the bloodstream. The theory is that certain food proteins are able to activate the immune system because they are similar to immune cells, leading to the symptoms of MS.

Does the Best Bet diet help with MS?

Current research doesn’t support the theory behind the diet, nor does it suggest there is any benefit to cutting out any of these food types completely. This particular diet hasn’t been tested in any research trials, so there is no evidence that it can help manage MS symptoms.

Is the Best Bet diet healthy?

The Best Bet diet restricts a lot of foods and can be low in energy, so it might not be suitable for you if you have high energy needs or if you’re already underweight. It also might not be suitable for vegetarians and vegans, as it cuts out an important source of protein.

You might need very careful planning to manage the restrictions of the diet, and to get all the recommended supplements so you don’t miss out on those nutrients.

The McDougall diet

The McDougall diet is a very low-fat vegan diet. It was inspired by the Swank diet, but it cuts out meat, fish and dairy completely. It’s high in carbohydrates, with lots of whole grain foods, fruit and vegetables.

Does the McDougall diet help with MS?

There’s no research evidence that the McDougall diet has an effect on MS.

Is the McDougall diet healthy?

Because it’s a very low-fat vegan diet, make sure you can find sources of protein and get enough calcium, vitamin B12 and zinc. You might need to take supplements. You could lose weight with this diet, and it might lower cholesterol and blood pressure. If you’re underweight or you’ve got high energy needs, this diet might not be suitable.

Read our diet and nutrition booklet

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