Introduction to Healthy Eating

Eating well is a key component of wellness. A balanced diet including all of the major food groups can help maintain health and prevent diet related chronic diseases that increase disability in MS.

A diet that has been well-studied and is good for the heart is the Mediterranean diet. Multiple studies have shown that it reduces the risk of heart disease and decreases damage in the brain. This diet emphasizes daily consumption of fruits, vegetables, whole grains, beans, nuts, olive oil; eating fish and seafood at least a couple of times per week, poultry, eggs, cheese and yogurt in moderation, and sweets and red meat for special occasions only.

A possible role of diet in MS was proposed more than 50 years ago. Since that time, this area has been a source of much controversy and confusion. Issues related to diet may be especially confusing for people with MS because some diet advocates exaggerate claims, and many healthcare professionals do not discuss the topic in much depth or with much enthusiasm.

A Well-Balanced Diet

It is essential to appreciate the basic components of a healthy diet before considering details about the possible influence of diet on MS. Regardless of an individual’s specific diet, adequate amounts of a variety of foods should be consumed. In general, eating a moderate amount of food from each food group should provide necessary nutrients.

Guidelines for a well-balanced diet

  • Eat a variety of foods.
  • Choose whole grain cereals and breads.
  • Eat at least five daily servings of fruits and vegetables.
  • Decrease total fat in diet to 30 percent or less of calories.
  • Limit saturated fat intake.
  • Eat fish two to three times per week.
  • Choose a diet moderate in salt, sugar, and alcoholic beverages.
  • Drink plenty of fluids and water.

Other Dietary Considerations in MS

Constipation is a frequent complaint in people with MS. One way to improve constipation is to increase the amount of fiber in the diet. Good sources of fiber include whole grain breads and cereals as well as fruits and vegetables. An increased intake of water and other fluids may also be beneficial for constipation; six to eight 8-oz. glasses of fluid daily are generally recommended. Some people with MS may have frequent urinary tract infections, and increased fluid intake may also be helpful for this problem. Finally, for some people with MS-associated fatigue, it may be beneficial to avoid large increases or decreases in the blood sugar level. This may be accomplished by eating small meals and snacks throughout the day.

Several other dietary factors should be kept in mind. Alcohol may, over the short-term, produce or worsen fatigue, bladder problems, walking difficulty, or clumsiness in the arms and legs. Grapefruit juice may increase the effects of many medications, including some that are commonly used for MS—diazepam (Valium®), clonazepam (Klonopin®), and carbamazepine (Tegretol®), sildenafil (Viagra®), and sertraline (Zoloft®).

Many diets have been recommended for MS with little or no supportive evidence. Avoiding foods that may cause allergies has been suggested. One example of this approach is a diet that does not contain gluten, a major component of wheat and wheat products. One clinical trial of a gluten-free diet in MS found no benefit. Studies of the blood and intestinal lining of people with MS do not indicate a sensitivity to gluten. There is no evidence to support the use of a pectin-free diet or a severely sugar-restricted diet.

If a specific diet is followed, it is important to always maintain a well-balanced intake of nutrients. Some of the more extreme dietary approaches that involve a focus on one specific aspect of the diet may actually create problems by causing nutrient deficiencies.