If you google ‘diet’ and ‘MS’, it is likely that you have come across a number of different diets, with punchy names and promising results. The reality is however, there is no overwhelming evidence that there is one ideal diet that people with MS should follow.

We eat for many reasons: to celebrate, for enjoyment, for nutrition. And our own personal diets are influenced by social calendars, cultural background, and what is available to us. Diet is often linked to a person’s wellbeing, and so many people with MS are motivated to make dietary changes to support their MS journey.

What does the evidence say?

While there are many MS specific designed diets, there is not enough evidence to recommend them for long term use.

These include:

• Swank diet (restricted saturated fat)
• Wahls modified paleolithic diet (high in meat, vegetables and fruit; no dairy, eggs, legumes or grains
• Overcoming MS diet (low in saturated fat; moderate in seafood, avocado and nuts, no meat, dairy, egg yolks or refined foods)
• McDougall diet (vegan, high-starch, low saturated fat)
• Ketogenic (low carbohydrate, moderate protein, high fat)

Mediterranean diet

A Mediterranean diet consists of high levels of vegetables and fruits, whole grains, legumes, nuts, olive oil, and moderate to low intake of lean meats, fish, dairy and eggs.

Mediterranean and plant-based diets have been shown to have some benefits. A meta-analysis of 11 studies found that modified Mediterranean diets improved fatigue and quality of life compared to control diets. Another study found that Mediterranean diet adherence was linked to less objective disability in people with MS. Whilst more research is needed, this diet focuses on everyday whole foods which are easily accessible.

Dairy-free diet

A dairy-free diet means excluding all dairy products such as milk, cheese, and yogurt. Studies are not conclusive on the benefits of a dairy free diet, unless you have a cow’s milk allergy.

Gluten free diet

A gluten free diet eliminates all sources of gluten which can be found in any wheat products, often leading to substitution. There is limited evidence on benefits on this diet for people with MS, unless you are coeliac.

Key Takeaways

• Mediterranean dietary patterns show the most consistent benefits for people with MS
• Higher diet quality is associated with better quality of life and reduced disability
• Most specific “MS diets” lack strong evidence from large clinical trials
• Simple, affordable dietary improvements matter more than expensive supplements or extreme restrictions

Overall diet quality matters most

Diet quality, is defined as a diet pattern rich in vegetables, fruit, legumes, wholegrain cereals, fish and fibre. This is consistent with Australian Dietary Guidelines and recommends adults eat:

• Plenty of vegetables, (different colours and types)
• Legumes and beans
• Fruit
• Wholegrain breads, cereals or pasta, polenta, oats, quinoa and barley
• Lean meats and poultry, fish, eggs, tofu, nuts and seeds
• Milk, yoghurt and cheese
• Drink plenty of water
• Limit intake of highly processed foods. These include white bread, many packaged foods, frozen meals, biscuits, chips, snackfood

Studies have shown that diet quality was positively associated with greater quality of life and reduced disability in people with MS.

Practical, Affordable Steps

Based on the evidence, these approaches show genuine promise:

1. Emphasise whole foods: Vegetables, fruits, whole grains, legumes, nuts, and olive oil
2. Include fish regularly: Aim for 2-3 servings weekly of fatty fish
3. Limit ultra-processed foods: These may promote inflammation and gut dysbiosis. These include white bread, many packaged foods, frozen meals, biscuits, chips
4. Moderate alcohol: Research suggests higher intake worsens MS severity
5. Ensure adequate folate: From leafy greens, legumes, or supplements

References

1. Russell, R.D., et al. (2024). “Diet and multiple sclerosis – development and mixed methods feasibility testing of a comprehensive nutritional information resource (NUTRIMS).” Disability and Rehabilitation, 46(5), 1988-1999.
2. Martinez Solsona, E., et al. (2024). “Associations between diet and disease progression and symptomatology in multiple sclerosis: A systematic review of observational studies.” Multiple Sclerosis and Related Disorders, 87, 105636.
3. Mandato, C., et al. (2023). “Multiple sclerosis-related dietary and nutritional issues: An updated scoping review with a focus on pediatrics.” Nutrients, 10(6), 1022.
4. Katz Sand, I.B. (2018). “The role of diet in multiple sclerosis: mechanistic connections and current evidence.” Current Nutrition Reports, 7(3), 150-160.
5. Cassard, S.D., et al. (2023). “High-dose vitamin D3 supplementation in relapsing-remitting multiple sclerosis: a randomised clinical trial.” eClinicalMedicine, 59, 101957.
6. Beckett, J.M., et al. (2024). “Vitamin D3 as an add-on treatment for multiple sclerosis: A systematic review and meta-analysis of randomized controlled trials.” Multiple Sclerosis and Related Disorders, 83, 105433.
7. Costenbader, K.H., et al. (2024). “Vitamin D and marine n-3 fatty acids for autoimmune disease prevention: Outcomes two years after completion of a double-blind, placebo-controlled trial.” Arthritis & Rheumatology, 76(6), 973-983.
8. Babaei, E., et al. (2024). “Omega-3 fatty acids supplementation and neuroprotection, inflammation, fatigue, and physical activity in multiple sclerosis: A randomized controlled trial.” PMC.
9. Liu, Y., et al. (2024). “Causal effects of dietary composition on multiple sclerosis risk and severity.” Frontiers in Nutrition, 11, 1410745.
10. Titcomb, T.J., et al. (2023). “Editorial: Diet and multiple sclerosis.” Frontiers in Neurology, 14, 1347478.
11. Elgenidy, A., et al. (2025). “From prevention to management: Exploring the impact of diet on multiple sclerosis.” PMC.
12. Katz Sand, I., et al. (2023). “Mediterranean diet is linked to less objective disability in multiple sclerosis.” Multiple Sclerosis Journal, 29(2), 248-260.