The effects of diet on MS treatment and progression are uncertain. Although a topic of interest for the MS community, conclusive evidence supporting dietary claims is scarce. Research investigating the effect of dietary manipulation on MS is challenging, as these types of studies are difficult to design and control for. Below is a summary of various talked-about diet regimes for MS.
Currently there is a lack of sufficient evidence conferring the efficacy of any of these and other specialized MS diets.
The Paleo diet has become of interest lately, due largely to its popularity with a number of celebrities. Recently, two celebrities diagnosed with MS have publicized their use of the Paleo diet and benefits derived from prescribing to it. The diet recommends ingesting greens, sulfur-containing vegetables and fresh meats. It advocates the elimination of gluten, processed foods, dairy and eggs from the diet. The Paleo diet claims its advantage lies in its “caveman-based” style of eating, favoring the ingestion of foods that were available in prehistoric times. Scientific evidence regarding the effect of the Paleo diet in MS is lacking, with most information stemming from personal narratives. In 2014, a small uncontrolled pilot study examined the effects of a Paleo diet in combination with strengthening exercises, as well as meditation and massage. Results found a significant improvement in reported fatigue in individuals who adhered to the program. While it is encouraging, the study was limited by the small sample size and lack of a control group. Overall, the scientific evidence available is unable to conclusively determine the impact of a Paleo diet in MS.
Developed by Dr. Roy Swank in the 1940’s, this diet centres on limiting the intake of fats, especially saturated fat, to 15g or less per day. The diet also recommends taking cod liver oil supplementation, a major source of omega-3 fatty acids. Studies examining the Swank diet have discovered benefits in MS progression in those who adhered to the diet. However, researchers find fault with these studies, citing methodological concerns including the lack of a control group for comparison.
Overcoming MS Diet
Similar to the Swank diet, the Overcoming MS Diet - developed by George Jelinek in 1999 - advocates avoiding saturated fat intake along with eliminating dairy and meat. Supplementation with omega-3 and vitamin D is recommended along with meditation and exercise.
Best Bet Diet
This diet was developed by Ashton Embry and focuses on excluding dairy, grains and legumes from the diet. The premise for the Best Bet Diet diet is that protein from foods which are not fully digested can gain access to the blood stream and activate the immune system. Although some anecdotal evidence supports an improvement of symptoms in those adhering to the Best Bet Diet, no published results have supported the efficacy of this model.
A recent report by Dr. Markus Kleinewietfeld and colleagues examined the effect of a sodium-rich diet in mice with an MS-like disease. Results showed that increased salt concentrations increased the number of Th17 cells, which are cells that play an important role in autoimmune diseases including MS. The increase in Th17 cells led to an increase in the number of pro-inflammatory cytokines, molecules that promote inflammation. Additionally, mice that were fed the sodium-rich diet experienced more severe MS-like symptoms. Findings from this study suggest that increased dietary sodium may represent a risk factor for developing autoimmune diseases, including MS.
Statins are drugs commonly used to lower levels of bad cholesterol. Emerging evidence has demonstrated that statins may also have neuroprotective and immunomodulatory properties. Earlier studies by Wang et al. and Bhardwaj et al. reported a lack of beneficial (or harmful) effects of statins in people with RRMS. However, a recently published phase II clinical trial led by Dr. Jeremy Chataway in the U.K. demonstrated promising results of statin treatment in people with secondary progressive MS. Trial participants received either a high dose of simvastatin (80mg) or a mock drug over two years. Findings revealed a 43% lower rate of brain shrinkage in participants treated with simvastatin compared to those who received a mock treatment. Treatment with the high dose of simvastatin was reported to be well tolerated in this study but larger and longer-term trials are required to determine the safety and long-term tolerability of a high dose statin. Although promising, the results of the trial are preliminary and warrant further research to capture the full clinical benefits of statins in MS.
- Latimer-Cheung AE et al. Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis: a systematic review to inform guideline development. Arch Phys Med Rehabil. 2013; 94(9): 1800-1828.
- Petajan JH et al. Impact of aerobic training on fitness and quality of life in multiple sclerosis. Ann Neurol. 1996; 39(4): 432-441.
- Briken S et al. Effects of exercise on fitness and cognition in progressive MS: a randomized, controlled pilot trial. Mult Scler. 2014; 20(3): 382-390.
- Yadav V et al. Complementary and alternative medicine for the treatment of multiple sclerosis. Expert Rev Clin Immunol. 2010; 6(3):381-395.
- Das UN. Is there a role for saturated and long-chain fatty acids in multiple sclerosis? Nutrition 2003;19:163–166.
- Swank RL & Goodwin J. Review of MS patient survival on a Swank low saturated fat diet. Nutrition. 2003;19:161–162.
- Swank RL & Dugan BB. Effect of low saturated fat diet in early and late cases of multiple sclerosis. Lancet 1990; 336:37–39.
- Swank RL. Multiple sclerosis: twenty years on low fat diet. Arch Neurol. 1970;23:460–474.
- Swank RL. Treatment of multiple sclerosis with low-fat diet. AMA Arch Neurol Psychiatry. 1953; 69:91–103.
- Bhardwaj, S et al. Efficacy of statins in combination with interferon therapy in multiple sclerosis: a meta-analysis. Am J Health Syst Pharm. 2012; 69(17): 1494-9.
- Wang J et al. Statins for multiple sclerosis. Cochrane Database Syst Rev. 2011; (12): CD008386
- Chataway J et al. Effect of high-dose simvastatin on brain atrophy and disability in secondary progressive multiple sclerosis (MS-STAT): a randomised, placebo-controlled, phase 2 trial. 2014. Lancet [Epub ahead of print]
- Bisht B et al. A multimodal intervention for patients with secondary progressive multiple sclerosis: Feasibility and effect of fatigue. J. Alt Comp Medicine. 2014; 20(5): 347-355.