Appendix #2: Healthy Food Choices for Individuals with MS

Adopting a Healthy Diet Plan

In terms of identifying good eating habits and the best diet for MS, advocates of various eating plans and researchers assessing those plans tend to agree on two things:

• Avoid processed foods as much as possible
• Eat plenty of fruits and vegetables, although some diet plans carry important caveats about which types of vegetables to eat

MSAA’s Chief Medical Officer Barry Hendin, MD, explains, “We know, from extensive research, that the Mediterranean diet reduces cardiovascular risk and improves general health, and we think, from early and continuing research, that it also improves MS symptoms. Actually, many of the diets that are of interest to people with MS right now, such as the Mediterranean diet or the Wahls Protocol, emphasize a lot of these foods, although each eating plan differs in important ways,” he says.

Dr. Hendin adds that while studies still need to establish the full benefits and potential drawbacks of specific diets in MS, the weight of the evidence supporting the advantages of healthy eating has changed the way he counsels patients. “I used to say that adopting healthy eating patterns would improve their prognosis over the long term, 10 or 20 years down the line. I still tell patients that, but now I’ve seen enough data to tell them that good nutrition also will help them feel better now, in terms of fatigue and other conditions.”

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The preceding excerpts are from the cover story, “The Importance of Diet and Nutrition in MS,” appearing in MSAA’s Summer/Fall 2023 issue of The Motivator.

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A Quick Overview of Specific Diet Plans

When looking at different dietary options, experts say that it is valuable to talk with your MS clinician and/or primary care provider about how well a particular diet is suited to your overall health needs. It’s also important to think about how easy or difficult a particular diet is to follow over the long term.

And finally, beware of fads, extreme diets, and diets making claims that cannot be supported by study results.

You do not have to follow a specific diet in order to practice healthy eating. For those interested in learning more about different diet plans, a number of common approaches are described below.

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Vegetarian or Vegan Diets

Definitions vary, but as a general rule, vegetarians do not eat meat, poultry, game or fish, including shellfish, while vegans not only avoid those items, but also do not eat any other food products that come from animals, such as eggs, milk, and butter. Fruits and vegetables are a large part of these diets, which include soy, beans, and legumes.

 

Mediterranean Diet

This eating plan emphasizes plant-based foods, including vegetables, fruits, whole grains, beans and other legumes, nuts, herbs, and olive oil. Fish is also a key component. Small amounts of poultry, eggs, and dairy are other sources of animal protein, while red meat is limited. Moderate consumption of wine with meals is allowed.

 

DASH Diet

Like the Mediterranean diet, the DASH plan calls for people to center their diet on vegetables, fruits, whole grains, fish, poultry, beans, and nuts. It also entails reduced consumption of red meat, sodium, and foods and drinks with added sugars.

 

MIND Diet

This eating plan emphasizes eating the vegetables, fruits, nuts, whole grains, and other items in its “parent” diets (the Mediterranean and DASH diets), while significantly limiting red meat, fried foods, sweets and pastries, and butter.

 

The SWANK Diet

The diet calls for avoiding processed foods containing saturated fats or hydrogenated oils, no red meats during the first year on the diet, and only three ounces of red meat per week thereafter. Skinless white-meat poultry, white fish, and low-fat dairy products are permitted. People are encouraged to eat whole grain breads, rice, and pasta, and as many servings of fruits and vegetables as they wish.

 

The Wahls Protocol Diet

This approach emphasizes consumption of vegetables (particularly leafy greens), berries and other brightly colored fruits, meat and fish, and omega-3 fatty acids, plus other fat from animals and plants. People following this diet steer clear of sugar; dairy products and eggs; tomatoes, potatoes, and other “nightshade” vegetables; legumes, such as beans; and grains, such as wheat or rice.

 

Anti-Inflammatory Diets

Like the Mediterranean and DASH diets, eating plans focused on reducing inflammation include abundant fruits and vegetables. Minimally refined, high-fiber whole grains, coffee and tea, herbs, and dark chocolate with a high percentage of cocoa solids are also components of these diets, which allow for moderate amounts of beer or wine. In addition, these diets place an emphasis on monounsaturated fats, such as those found in nuts, seeds, olive oil, and avocados, as well as polyunsaturated omega-3 fats, which are found in salmon, sardines, other fish, and walnuts.

 

Gluten-Free Diets

Gluten is a protein found in some cereal grains, such as wheat, rye, and barley. While avoiding gluten is essential for people with celiac disease, research has not shown gluten to play a role in multiple sclerosis development or course, or to be detrimental to people with MS.

 

As a reminder, no specific diet is recommended for individuals with MS. Please be sure to consult your physician before making any changes to your diet.

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The preceding information originally appeared in the cover story, “A Closer Look at Diet and MS,” published in MSAA’s Winter/Spring 2024 issue of The Motivator. For more details on these diet plans and how they might relate to MS, please refer to this edition.

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