4 Myths About Multiple Sclerosis and Diet
Thinking about cutting out dairy or gluten in hopes of beating MS? Think twice before you do, says a registered dietitian nutritionist with relapsing-remitting MS.
Many people with multiple sclerosis (MS) may wonder whether trying a certain diet — or eliminating a certain food group from their diet — can ward off MS symptoms, like fatigue or cognitive decline, or even change the course of the disease entirely.
It’s no wonder: Special diets, supplements, and even food-sensitivity testing are routinely touted online as ways to substantially lessen MS symptoms or even “beat” or “cure” the disease. Sometimes these diet recommendations for MS are made by medical doctors, sometimes by practitioners of complementary or alternative medicine, and sometimes simply by individuals who feel better after changing their diet.
As a registered dietitian nutritionist with relapsing-remitting MS who counsels other people with MS about diet, I’ve encountered many myths about the role of diet in managing MS.
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In most cases, there’s little to no evidence that the recommended dietary change has any effect on MS. And worse, some of these changes can make it harder for you to get all the nutrients you need to stay healthy.
Here are some of the most common myths I’ve come across?about MS diets — and the truth about each one.
1. Is Dairy Bad for People With MS?
Many so-called MS diets discourage dairy products.
One of the reasons given for this advice is the assertion that dairy is inflammatory — a claim that’s been widely debunked. A review of studies showed that including dairy in your diet was not associated with inflammation among people without any health conditions or among those with diabetes or metabolic syndrome.
When it comes to MS in particular, any theory suggesting a strong connection between MS and dairy products has not been sufficiently tested, which means there’s no evidence that consuming dairy has any effect on MS.
Another theory related to dairy products, called “molecular mimicry,” suggests that butyrophilin — a protein found in cow’s milk and in foods like cheese, butter, chocolate, and ice cream — may mimic part of myelin oligodendrocyte glycoprotein. This is the component of myelin thought to initiate the autoimmune reaction in MS.
But this theory is based only on animal studies and has not yet been tested in human clinical trials — so there’s no need to avoid butyrophilin protein unless you know you’re allergic to it.
Finally, some have suggested that people with MS are more likely to be lactose intolerant — meaning they lack an enzyme needed to digest lactose, the natural sugar in milk — and that therefore eating dairy products causes them uncomfortable gastrointestinal symptoms such as bloating, gas, and diarrhea.
But lactose intolerance is not an inflammatory process and is not mediated by the immune system. And there has been no evidence to suggest that people with MS are more likely to be lactose intolerant. It’s important to speak to your doctor if you have the symptoms mentioned above, as they can have multiple causes. Lactose intolerance is only one potential cause.
The truth is that low-fat dairy foods are an excellent source of calcium and vitamin D, nutrients that play an essential role in bone health. This is especially important for people with MS, who have an increased risk of fractures, according to research.
In addition, consistently getting enough vitamin D in your diet may be associated with less frequent or severe MS symptoms, as well as a better quality of life, according to the Mayo Clinic.
Why opt for low-fat over high-fat dairy foods? The key nutritional difference between the two is the fat content, all of which is saturated fat. People only need this nutrient in small quantities each day (10 percent of your daily calorie intake, according to the Dietary Guidelines for Americans). And regularly eating too much of these fats may be associated with high cholesterol and heart disease.
If you abstain from dairy for any reason, such as lactose intolerance diagnosed by your doctor, make sure that your dairy alternatives contain added calcium and vitamin D to help protect your bones.
2. Should You Stay Away From Gluten if You Have MS?
You may have heard warnings to avoid gluten — a protein found in wheat, rye, and barley — if you have MS. These are often anecdotal reports that gluten makes some people with MS feel worse and that avoiding gluten helps them feel better. In addition, many people assert that gluten is associated with inflammation in the body in general.
However, the National Multiple Sclerosis Society (NMSS) states that there’s no clear relationship between gluten and MS, and not everyone with MS is gluten-intolerant.
Harvard Health Publishing adds that there’s “no compelling evidence” to show that eating a gluten-free diet will prevent disease or improve your health in general, unless you have celiac disease — an autoimmune disease that inhibits proper digestion of gluten.
Something else to consider: Gluten-free foods are often the most refined foods on the market. They’re not fortified in the same way that conventional foods are.
What does that mean? Unnecessarily avoiding foods that contain gluten may deprive you of valuable nutrients like fiber, which helps support gut health and bowel regularity.
3. Are Grains and Beans a No-Go for People With MS?
Some diets include recommendations for people with MS to avoid foods that contain lectins — a type of protein found in grains, beans, and other plant foods. Some claim that lectins can cause autoimmune symptoms or disorders like MS, but there’s no evidence to support those beliefs.
In addition, most lectins in foods are inactivated by cooking, particularly when the food is cooked in a large quantity of liquid. Since whole grains and beans are almost never eaten raw, and are often boiled in water, the likelihood of anyone eating large amounts of active lectins this way is very low.
Beans are inexpensive, readily available, versatile to cook with, and high in dietary fiber, protein, B vitamins, and various other vital nutrients. They may also help lower blood sugar levels, improve cholesterol levels, and maintain a healthy gut.
Whole grains are a great source of complex carbohydrates, fiber, B vitamins, and minerals like iron and magnesium. What’s more, one analysis of researchsuggested that a low intake of whole grains was a leading dietary risk factor for death and disability.
RELATED: 10 Nutritious Family Dinners to Make With Beans
4. Do Nightshade Vegetables Ramp Up MS-Related Inflammation?
Some people believe that nightshade vegetables — white potatoes, peppers, tomatoes, and eggplant — cause inflammation because they contain a compound called solanine. This substance is toxic in high concentrations, but it is not dangerous in small doses, such as the amount in a serving of tomatoes in a salad or eggplant in a sautéed dish.
There’s no conclusive evidence to suggest that nightshade vegetables have any impact at all on the MS disease course. These foods are rich in nutrients, making them worthy additions to your diet.
That said, it’s worth remembering that MS is a complex disease. And if you have MS along with another chronic disease (known as a comorbidity), it becomes even more complex — meaning inflammation and pain can arise from a variety of causes. A nightshade food may (or may not) be the culprit.
If you find that eating specific nightshade vegetables causes pain symptoms for you, don’t eat them. But consider each nightshade vegetable individually. Just because one kind triggers pain doesn’t mean they all will.
And be sure to speak with your doctor to rule out other potential health problems before removing foods from your usual eating pattern.
What Science Tells Us About MS and Diet
According to the NMSS, there’s no scientific evidence that any particular diet alters the MS disease course or that certain foods are harmful to all people with MS.
That said, some evidence suggests that making certain dietary changes may yield overall health benefits for people with MS, when practiced over time.
According to one study, following a diet rich in plant foods and low in fat may be tied to improvements in fatigue, cholesterol levels, and body mass index. These are dietary changes anyone can make.
A growing body of evidence also indicates that the most effective way to maintain good health when living with MS may be indirect:?by managing (or preventing) chronic comorbid health conditions, such as diabetes, and by maintaining good glucose control, fat levels in the blood, and blood pressure.
A?review article found that poorly managed comorbidities are associated with an increase in disability and a decrease in quality of life among people with MS.
So, eating well is an essential part of living well with MS. But it doesn’t mean eliminating foods unnecessarily or following unproven diets because you have MS?is a good idea.
RELATED: Healthy Eating Habits for Multiple Sclerosis
How to Eat Well if You Have MS
Low-fat dairy products, whole grains containing gluten, beans and other legumes, and nightshade vegetables are quite nutritious, and unnecessarily removing them from your meals can result in nutritional deficiencies.
Eating for good health generally can help you improve your quality of life and decrease your risk of disability.
When planning your meals, opt for a balanced and flexible eating pattern that consists of the following foods:
- Colorful Fruits and Vegetables When picking your produce, variety matters. Different colors of fruits and vegetables bring different nutrient profiles to your plate. Leafy greens, blueberries, and strawberries are great additions to anyone’s diet.
- Lean Proteins Chicken and fish are both good choices to incorporate consistently into your diet. And for meatless dishes, consider trying tempeh.
- Beans, Legumes, Nuts, and Seeds Some worthy additions to any eating pattern are black beans, lentils, walnuts, and chia seeds.
- Whole Grains Oatmeal, brown rice, and quinoa are all nutrient-packed options worth incorporating into your daily meals.
- Calcium-Rich Foods Low- or nonfat dairy sources of calcium include skim milk and nonfat, plain yogurt. Some dairy-free options are collard greens, cooked spinach, canned salmon, and tofu with calcium sulfate.
- Foods Containing Vitamin D Fortified low-fat milk and dairy products, as well as fatty fish like salmon and albacore tuna, are great sources of vitamin D. Experts believe that taking vitamin D supplements may be beneficial for people with MS, but more research is needed to confirm this, the Mayo Clinic reports. Be sure to talk with your doctor before trying a supplement.
- Monounsaturated Fatty Acids?Foods containing these heart-healthy fats include olive oil, avocados, almonds, cashews, and nut butters.
- Polyunsaturated Fatty Acids?Another form of heart-healthy fats, these are found in foods like flax and soybean oil, salmon, albacore tuna, and walnuts.
Be sure to limit saturated fats, sodium, added sugars, and highly refined foods. And avoid trans fats entirely.
If you need help planning a healthy diet, I recommend consulting your doctor or a registered dietitian nutritionist who is well-versed in MS.
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Resources
- Ulven SM, Holven KB, Gil A, Rangel-Huerta OD. Milk and Dairy Product Consumption and Inflammatory Biomarkers: An Updated Systematic Review of Randomized Clinical Trials. Advances in Nutrition. May 2019.
- Stefferl A, Schubart A, Amini A, et al. Butyrophilin, a Milk Protein, Modulates the Encephalitogenic T Cell Response to Myelin Oligodendrocyte Glycoprotein in Experimental Autoimmune Encephalomyelitis. Journal of Immunology. September 1, 2000.
- Bazelier MT, van Staa TP, Uitdehaag BMJ, et al. Risk of Fractures in Patients With Multiple Sclerosis: A Population-Based Cohort Study. Neurology. June 12, 2012.
- Vitamin D and MS: Is There Any Connection? Mayo Clinic. April 19, 2023.
- Dietary Guidelines for Americans, 2020–2025 [PDF]. U.S. Department of Agriculture and U.S. Department of Health and Human Services. December 2020.
- Salt, Gluten and Dairy in MS. National Multiple Sclerosis Society.
- Shmerling RH. Ditch the Gluten, Improve Your Health? Harvard Health Publishing. April 14, 2022.
- Lectins. Harvard T.H. Chan School of Public Health. January 2022.
- Afshin A, Sur PJ, Fay KA, et al. Health Effects of Dietary Risks in 195 Countries, 1990–2017: A Systematic Analysis for the Global Burden of Disease Study 2017. The Lancet. May 11, 2019.
- Diet and Nutrition. National Multiple Sclerosis Society.
- Yadav V, Marracci G, Kim E, et al. Low-Fat, Plant-Based Diet in Multiple Sclerosis: A Randomized Controlled Trial. Multiple Sclerosis and Related Disorders. September 2016.
- Moss BP, Rensel MR, Hersh CM. Wellness and the Role of Comorbidities in Multiple Sclerosis. Neurotherapeutics. October 2017.
Jason Paul Chua, MD, PhD
Medical Reviewer
Mona Bostick, RDN
Author
When she is not working with clients, keeping up-to-date with current MS research, or writing, you will find her walking her dog, working in her "yarden" (much less fancy than a garden), or watching the Chicago Cubs play baseball.