Multiple Sclerosis diets

Multiple Sclerosis manifests itself over time with increasing muscle weakness and fatigue, which are for the majority the most disabling aspects of this condition. There are an number of interventions based on both natural therapies and drugs that have been found to help. Here I look at some of the natural therapies.

Diet and exercise regimes

Many people have been able to alleviate symptoms by adopting various restrictive diets and physical therapies. These include:

The Autoimmune protocol(1) 

The Autoimmune protocol as espoused by Dr Sarah Ballantyne (Paleo Mom) is based mainly around a modified Paleo diet, that is stricter than a standard Paleo diet. It makes reference to other lifestyle factors such as sleep, activity and stress, but does not stipulate how they should be achieved.

Foods that you can eat include:

  1. Major protein and fats sources such as organ meats, meat and poultry, fish and shellfish.
  2. Vegetables such as leafy greens, cruciferous vegetables, root vegetables and alliums such as onions and garlic.
  3. Fruit such as berries, citrus fruit, olives, avocadoes and coconuts as well as most other fruit.

Foods that you are urged to avoid include:

  1. Legumes such as most lentils, peas, beans including soy products and dried beans. Given that soy products are used in many processed foods you need to inspect food labels for such things as soy lecithin.
  2. Dairy such as butter, cheese, cream, milk, kefir and yoghurt.
  3. Eggs, especially the egg whites.
  4. Nuts and seeds including cumin and coriander.
  5. Nightshade vegetables including peppers, aubergine, goji berries, ordinary potatoes (sweet potatoes are OK), and tomatoes.
  6. Grains such as oats, wheat, barley, quinoa, chia and corn, thus eliminating bread, pasta and rice. This includes most products in gluten free sections of supermarkets.
  7. Coffee, cocoa and alcohol. The first two are derived from beans.
  8. Processed foods including industrial seed oils such as sunflower oil, vegetable oil and rapeseed oil, most additives, marmite and virtually all sweet products and artificial sweeteners including stevia and xylitol.
  9. Some drugs are specifically to be avoided if possible including non-steroidal anti inflammatories (NSAIDs) such as Aspirin, Ibuprofen, Naproxen, Diclofenac, Indomethacin and Celecoxib. The birth control pill is also to be avoided.

The Autoimmune protocol has some research evidence backing it up, especially in the area of gastrointestinal illness(2). It is thought likely to be effective by correcting gastrointestinal dysbiosis, reducing inflammation and avoiding any allergic reactions.

If you intend to follow the Autoimmune protocol then there are some useful A4 sheets you can print out of the foods to eat and those to avoid here.

The Wahl's protocol(3)

The Wahl's protocol was invented by Dr Terry Wahls, an MS sufferer from Iowa in the USA. It features a diet based around the consumption of plenty of meat, fish, leafy green vegetables, brightly coloured fruits and a number of key supplements. It involves the elimination of a number of commonly consumed food groups including sugar, dairy, eggs, grains, legumes and vegetables of the nightshade family. In addition to the diet: stretching, strength exercises, electrical stimulation, meditation and massage are used.

Foods that you can eat include:

  1. Green, leafy vegetables.
  2. Sulphur rich vegatable such as cabbage, onion family, asparagus and mushroom.
  3. Colourful fruit and vegetables such as beetroot, carrots and berries.
  4. Omega 3 rich fish and meat such as salmon, sardine and grass fed meat.
  5. Organ meats such as liver.
  6. Seaweed.

Foods to avoid include:

  1. Gluten containing grains such as bread, pasta and couscous.
  2. Dairy produce such as milk, butter, cheese and cream.
  3. Eggs.
  4. Legumes such as peanuts, beans and peas.
  5. Nightshade vegetables such as potatoes, tomatoes, peppers, aubergines, goji berries and tobacco.

Dr Wahl's protocol is very similar to the autoimmune protocol, but places particular emphasis on non dietary interventions as well. Some such as electrical stimulation of muscles are not normally mentioned as part of an autoimmune protocol.

A preliminary study using the Wahl's protocol on around 10 subjects(4) found that symptoms of perceived fatigue decreased for the majority of subjects by nearly 2 points on a scale that has 6 points in total. This represents a significant drop and suggest the protocol is worth trying if adherance to the strict nature of the protocol is possible. Successful adherence may neccesitate an adult helper to be present to administer electrotherapy, and potentially for cooking and other daily tasks.

The study results also point to the fact that most progress is likely in the first 3 months of the protocol. To get up to speed with the Wahl's protocol I recommend watching this video

The Swank diet

This is not an approach that I would encourage for MS as it misses out the on the main understanding we have for autoimmune conditions. It encourages whole grains and reduces saturated fat which are almost certainly the wrong things to be doing if you have MS.

Should I try a dietary protocol?

I think for most people with MS the answer will be yes if you have adequate assitance. MS is a multifactorial disease with a number of features such as nutritional deficiencies, psychological issues and physical disabilities. No one pill or single therapy is likely to reduce symptoms as much as a complete change in lifestyle and this by its nature is likely to require help from others to implement successfully.

However care should be taken if this diet is significantly different from your current diet and the best approach is to include a 1-2 month elimination phase before you reach full compliance with the diet. This should help you avoid adverse reactions to increases in the fibre content of your diet as well as avoiding the possibility that some of the elements of the diet that are new to you could cause intolerance reactions.

Causes

There are a number of factors that make Multiple Sclerosis more likely. One of these is previous episodes of viral infection. In particular glandular fever (the Epstein Barr virus - EBV) which in one study was found in 90% of the brains of MS patients compared with only 24% in those without MS(5). EBV most often affects young children and produces no symptoms. If it occurs during adolescence it is often produces fever, sore throat and swollen glands that lasts a month of more.

The high presence of EBV in the brains of MS patients suggests that previous infection with glandular fever makes MS more likely in certain people. Indeed some studies have suggested that it is virtually impossible to get MS unless there has been previous infection with EBV, whether with or without symptoms.

The DrDobbin approach

My approach for most people with MS is based on the Autoimmune protocol with additional advice on exercise, sleep and meditation approaches. The process of adopting an MS compliant diet usually takes from 4-6 weeks to achieve and so 2-3 follow up consultations are normally necessary to ensure that the transition and ongoing maintenance periods runs smoothly.

The reason these types of dietary approach can work is that they reduce the inflammation that stimulates our immune systems to attack the myelin proteins that help sheath the nerve fibres in our brain and spinal cord.

There is some scope to reintroduce certain foods after a few months and this needs to be staged and monitored to avoid an increase in symptoms.

References:

  1. https://www.thepaleomom.com/start-here/the-autoimmune-protocol/ AI protocol
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5647120/ AIP for GI diseases
  3. https://www.webmd.com/multiple-sclerosis/wahl-diet-ms Wahl's protocol
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4011484/ 2014 Wahl's study
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5796799/ EB virus