Diet and MS

A healthy diet

The following is taken from the American National Multiple Sclerosis Society:

Diet and fluid intake are important in multiple sclerosis. Lifestyle factors such as healthy eating, fluid intake and exercise, as well as smoking, increase the risk of getting MS and can affect how the disease progresses.

A healthy diet may have a positive effect on your MS for several reasons:

• A steady and healthy body weight is associated with less risk of MS activity (such as relapses and lesions on MRI) and related disability. Diet has a strong relationship to body weight and cardiovascular (heart and blood vessels) risk factors, such as high blood pressure, high cholesterol, and diabetes. Cardiovascular risk factors:
  • are associated with higher levels of MS activity and related disability
  • can lead to other health issues, such as heart disease and stroke
• Diet affects the number and type of bacteria that live in the gut (microbiome), which in turn has important effects on the immune system that may be relevant for MS
• Nutrients from food—like vitamins, fatty acids, and amino acids directly affect how the immune system and brain work

Currently, there is no specific diet that has been proven to benefit MS, or specifically alter MS progression or relapse rate. The most important thing is getting the right and proper balance of nutrients for your body and brain function. The best way of getting nutrients is through food and fluids.

Experts recommend the following for good health:

• Prepare meals at home as much as possible
• Include colourful fresh fruits and vegetables daily
• Choose lean proteins and healthy fats
• If you eat grains, choose wholegrains over refined grains
• Consider adding herbs and spices to add flavour to meals
• Avoid, or limit, processed foods and added sugars as much as possible

The NHS recommends a balanced diet which will provide you with all the nutrients needed to be as healthy as possible. This includes:

• At least 5 portions of a variety of fruit and vegetables each day
• Opting for high fibre and wholegrain starches such as brown rice, wholewheat pasta and potatoes
• A good variety of protein including beans, pulses, fish, eggs or meat
• Some low-fat dairy, or dairy alternatives, such soya and coconut yoghurts and drinks
• Food high in fats, salts and sugars (such as cake and chocolate) should be eaten in small amounts, and unsaturated oils and spreads should be opted for where possible
• Drink plenty of fluids (6-8 cups of water per day is the recommended amount, but this will depend on your height, weight and activity levels)

The Eat Well Guide can be accessed here: The Eatwell Guide - GOV.UK (www.gov.uk)

Even though getting nutrients from food is best, some people might need to take supplements. Please see supplements for more details regarding some that can be considered beneficial in MS.

Special Diets for MS

There is a lot of information about special diets for MS on the internet. Despite this it is currently still recommended that a healthy balanced diet, as described above, is the best diet for someone with MS.

If you are considering a specific diet, it is important to make sure that there is proof (scientific evidence) the claims about the diet are true.

The important thing is to make sure you're not missing out on the healthy nutrition you need, as some diets include restrictions which might be unhealthy, or make it hard for some people to stick to.

Healthy body weight

Maintaining a healthy diet and body weight is important for everyone's overall health and well-being and will help to manage some symptoms of MS. A good diet can help improve symptoms such as low mood, fatigue, constipation and can help boost your immune system. A poor diet can make some MS symptoms worse, and increase pain or weakness. A poor diet can also increase your weight and cause other medical conditions such as diabetes, vascular disease and osteoporosis which can in turn make living with MS even harder.

Research has shown people who are obese are likely to have higher numbers of MS lesions (areas of MS damage) than people who maintain a healthy weight. Obesity is also linked with a higher risk of disability in people with MS.

Evidence is starting to show that whilst exercise and activity has huge health benefits, it doesn't play as big a role in weight management as previously thought. Diet is the most important factor in managing weight.

Live Well Dorset has a team of advisors and coaches who can offer support to those struggling to maintain a healthy weight.

Dietary tips to help manage MS symptoms

Bladder

• Certain foods and fluids can irritate the bladder. To help manage this it is recommended to drink plenty of water to avoid strong (concentrated) urine. Don't be tempted to cut back on the amount you drink to reduce your trips to the toilet, as concentrated urine can irritate the bladder and cause infection
• Caffeine, spicy foods, fizzy drinks, alcohol and fruit juices should be cut down, or avoided, as these can also irritate or stimulate the bladder
• Maintaining a healthy body weight can also reduce bladder symptoms, as being overweight increases pressure on the pelvic floor
• See bladder for more information on the bladder and MS

Bowels

• Eating at regular intervals, eating plenty of fibre and drinking plenty can help avoid constipation and improve bowel management. Seeds and powders, such as flaxseed, can also be added into the diet to help aid bowel movements
• The NHS has helpful information in how to get more fibre into your diet and good foods to help your digestion: Digestive health - NHS (www.nhs.uk)
• See bowel for more information on the bowels and MS.

Fatigue

• Fatigue in MS is complicated and not just caused by food, but eating enough healthy, nutrient-rich meals can help give your body the energy it needs. This means including lots of fruits, vegetables, and whole grains to keep your energy steady during the day
• Sweet, sugary foods aren't recommended as these tend to give you a blood sugar spike, followed by a blood sugar crash, leaving energy levels low
• Plenty fluids are also needed to help manage fatigue levels and are an important factor in maintaining a healthy weight
• See fatigue for more information.

Mood

The organisation Mind advises the following information on diet, mood and mental health:

• Eating different fruits and vegetables can add a good range of nutrients to your diet. These nutrients help to keep us mentally as well as physically healthy
• Diets higher in protein can support your mental health. Protein contains chemicals called amino acids, which your brain needs to produce chemicals called neurotransmitters. These help to regulate your thoughts and feelings.
• Caffeine can:
  • Make you feel anxious and depressed
  • Disturb your sleep, especially if you have it just before bed
  • Give you withdrawal symptoms like feeling irritable or depressed, if you suddenly stop having it
• Your brain needs certain fatty acids, such as omega-3 and omega-6, to keep it working well. You can find these healthy fats in:
  • Nuts and seeds
  • Avocados
  • Oily fish, such as sardines and mackerel
• To help overcome low mood, it is recommended that alcohol is avoided. It is also known that alcohol reduces the B vitamins in our bodies which play a role in the development of our brain chemicals directly impacting mood.
• See mood for more information about low mood.

Dietary support

If you are struggling with food preparation due to fatigue, reduced strength in your hands, or other symptoms, the MS Trust provides tips on food preparation which can be found here: Diet and symptoms | MS Trust.

See living well with MS for more details.

Links for further information

Healthy eating | MS Trust

The Eatwell Guide - NHS (www.nhs.uk)

The Eatwell Guide - GOV.UK (www.gov.uk)

Diet and symptoms | MS Trust

Brain health: A guide for people with multiple sclerosis (msbrainhealth.org)