While medications and therapies are crucial, there's a powerful, often overlooked ally for those with multiple sclerosis: diet. Research reveals that what you eat can significantly impact your symptoms, progression, and overall well-being. In this article, we’ll explore how the right dietary choices can transform your health and empower you to take control of your multiple sclerosis.

Overview

Multiple sclerosis is a long-lasting disease of the central nervous system (the brain and spinal cord) and is a condition in which the body attacks itself by mistake(autoimmune disorder). Multiple sclerosis is commonly diagnosed between the ages of 20-40, although it can develop at any age and affects every person differently. Some multiple sclerosis patients only have minor symptoms but others might have their speaking, writing, seeing, or walking ability impacted due to the disruption in communication between the brain and other parts of the body.²

There are 2 types of multiple sclerosis:¹

• Relapsing-remitting multiple sclerosis; where multiple sclerosis causes repeated attacks
• Primary progressive multiple sclerosis; where the symptoms progress over time without clear attacks

There’s currently no cure for both these types of multiple sclerosis but medicines and other treatments can help control the condition and ease the symptoms.

Relapsing-remitting multiple sclerosis is typically treated with injections of steroid medication administered in a hospital for three to five days, or with a five-day course of steroid pills taken at home. Steroids work by speeding up your recovery from a relapse, but they don't prevent further relapses or stop multiple sclerosis from getting worse over time.

Alternatively, disease-modifying therapies can be used to treat relapsing-remitting multiple sclerosis which can come in the form of a pill, an injection, or an infusion. They aim to directly target inflammation in the central nervous system by slowing the deterioration and reducing the amount of damage and scarring to a layer surrounding your nerves called the myelin sheath, which is associated with multiple sclerosis relapses.²

Treatment for primary progressive multiple sclerosis normally involves treating the specific symptoms that arise.²

Lifestyle factors such as physical activity, stress management, and sleep quality play a crucial role in influencing the course and symptoms of the disease. Among these, diet stands out as a particularly impactful element. This is because the foods that we consume can affect inflammation levels, immune function, and overall health, all of which can impact multiple sclerosis. By adopting healthy lifestyle habits, individuals with multiple sclerosis can potentially reduce the frequency and severity of relapses, improve their energy levels, and therefore enhance their quality of life.

Understanding multiple sclerosis

In those with multiple sclerosis, their body's defence system, which should usually fight off germs and illnesses, gets confused and starts attacking a part of the body.

How multiple sclerosis works

It begins with certain cells in our immune system, called T cells. These become overactive for reasons that might include a mix of genetics (things we inherit from our parents) and the environment (things we're exposed to in the world around us). 

The brain and spinal cord are normally protected by the myelin sheath, however, the overactive T cells manage to get through this layer and once inside, these T cells release signals that cause inflammation, which is like the swelling and redness you see around a cut or bruise. This inflammation involves other immune cells and creates a lot of damage. The myelin sheath helps nerve signals travel quickly and efficiently so when it gets damaged, the nerve signals slow down or get blocked.³

Symptoms

This process of immune attack and myelin damage leads to a wide range of symptoms. The symptoms are unpredictable and can differ depending on what type of multiple sclerosis they have. Some of the most common symptoms include:²

• Fatigue
• Vision problems
• Numbness and tingling
• Muscle spasms, stiffness and weakness
• Mobility problems
• Pain
• Problems with thinking, learning, and planning
• Depression and anxiety
• Sexual problems
• Bladder problems
• Bowel problems
• Speech and swallowing difficulties

Role of diet in multiple sclerosis management

Diet plays a crucial role in managing multiple sclerosis because what we eat can significantly influence inflammation and impact the risk of getting multiple sclerosis, including how the disease progresses. 

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

Certain foods can help reduce inflammation in the body⁴

For example, foods rich in omega-3 fatty acids (like fish, flaxseeds, and walnuts) have anti-inflammatory properties. Antioxidants found in fruits and vegetables (such as berries, spinach, and bell peppers) can help protect cells from damage and support a healthy immune response. 

Certain foods can improve your immune system⁴

Your diet can affect the composition of the bacteria that live in the gut (microbiome), which in turn has important effects on the immune system that may be relevant for multiple sclerosis. Dietary metabolites (such as vitamins, fatty acids , and amino acids that form proteins) have direct effects on the immune system and the brain and a diet high in fibre from fruits, vegetables, and whole grains promotes a healthy gut, which in turn supports immune health.

A healthy body weight is associated with a decreased risk of multiple sclerosis activity (e.g. relapses)⁴

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. 

Dietary components that play a role in managing multiple sclerosis 

Anti-inflammatory foods such as omega-3 fatty acids⁵

Common sources include:

•  Fatty fish (such as salmon, mackerel, and sardines)
•  Flaxseeds
•  Chia seeds
•  Walnuts
•  Hemp seeds

Omega-3 fatty acids have anti-inflammatory properties that can help reduce inflammation in the body. They support brain health, improve cardiovascular health, and may alleviate some symptoms of multiple sclerosis by protecting nerve cells and promoting myelin repair.

Antioxidant-rich foods⁵

Common sources include:

• Berries (such as blueberries, strawberries, and blackberries)
• Leafy greens (such as spinach and kale)
• Nuts
• Seeds
• Dark chocolate
• Colourful vegetables (such as carrots, bell peppers, and tomatoes).

Antioxidants help neutralize free radicals, which are unstable molecules that can cause cellular damage and contribute to inflammation, therefore, by reducing oxidative stress, these foods can help protect the nervous system and potentially slow the progression of multiple sclerosis.

Vitamins and minerals such as vitamin D⁵

Sources include:

• Sunlight exposure
• Fatty fish (such as salmon and tuna)
• Dairy products
• Egg yolks

Vitamin D is crucial for immune function and bone health. Low levels of vitamin D have been linked to an increased risk of multiple sclerosis and its progression. Adequate vitamin D levels can help modulate the immune response and may reduce the frequency and severity of multiple sclerosis relapses.

Dietary fiber⁵

Sources include: 

• Fruits (such as apples, pears, and berries)
• Vegetables (such as broccoli, carrots, and Brussels sprouts)
• Whole grains (such as oats, barley, and brown rice)
• Legumes (such as beans, lentils, and chickpeas), and nuts and seeds

Dietary fibre promotes healthy digestion by aiding regular bowel movements and preventing constipation, a common issue for people with multiple sclerosis. Additionally, fibre supports a healthy gut microbiome, which plays a crucial role in immune function and inflammation regulation. A diet high in fibre can help reduce systemic inflammation, thereby potentially alleviating some multiple sclerosis symptoms

Conclusion

Diet plays a crucial role in managing multiple sclerosis by reducing inflammation, supporting immune function, and providing essential nutrients for overall health. Anti-inflammatory foods like omega-3 fatty acids and antioxidant-rich fruits and vegetables help protect the nervous system. Vitamins such as D and B12 are vital for immune regulation and nerve health, respectively. Dietary fibre promotes digestive health and reduces systemic inflammation. 

FAQs

Where can I get support about multiple sclerosis?

The MS Society and The MS Trust are the two main organisations in the UK if you or someone you know has been diagnosed with multiple sclerosis and requires support. These groups finance continuing research and offer information, guidance, and support on multiple sclerosis.

What foods should I eat to help manage my multiple sclerosis symptoms? 

Focus on anti-inflammatory foods such as fatty fish, flaxseeds, walnuts, berries, leafy greens, nuts, seeds, and colourful vegetables. These foods can help reduce inflammation and support overall health.

How can multiple sclerosis patients ensure they are getting a balanced diet? 

MS patients should focus on including a variety of whole foods, staying hydrated, limiting processed foods, and consulting with healthcare professionals or dietitians to create personalized diet plans that meet their specific needs and conditions.