Specific diets for multiple sclerosis

Many people living with multiple sclerosis are interested in diets specific to the disease.  Some people have found that by making appropriate changes to their diet some of their symptoms have been relieved, and in some cases the time between relapses has increased.
Similar themes occur in many of the multiple sclerosis diets. Some recommend the restriction or complete elimination of various foods, while others recommend taking supplements, particularly Vitamin D.  Many encourage more frequent consumption of foods containing Omega 3 fats and significantly reducing foods high in saturated fats.  Some of the multiple sclerosis-specific diets are evidence-based; while others are based on personal experience and observation.
Before making significant changes to your diet, or deciding to take supplements or not, seek the advice of your GP, nutritionist or dietitian to ensure you achieve a healthy weight and are obtaining all of your essential nutrients.  Also take the time to consider what is right for you, your health, your budget, and how you would like to manage your health in the long term.

The following is a brief summary of some of the more well-known multiple sclerosis diets with links to further information.

Swank Diet

Credentials: Professor Roy Laver Swank, Professor and Head of Neurology at University of Oregan Medical School.
Research: Professor Swank identified that more people had multiple sclerosis in geographical areas where saturated fat consumption (particularly dairy products) was highest.  Correspondingly in areas where fish (high Omega 3 content) was eaten, multiple sclerosis was lower[i].  He followed 144 people living with multiple sclerosis for 34 years while they ate a very low saturated fat diet.  Those people who followed the diet rigorously and were experiencing mild symptoms when they started the diet had slower disability progression than those who had not stuck strictly to the diet[ii] [iii] [iv].
Swank also conducted a 50 year follow up.[v]
Swank Diet basics: Dr Swank believed a low fat and high grain, fruit and vegetable diet would help to slow the progression of disability.  Swank's study showed that benefits occurred for people who managed to reduce saturated fat to 16gm/day on average.  The study participants who could not adhere to such a strict low saturated fat diet were consuming on average 38gm of saturated fat/ day (which is still very low).This indicates that for the Swank diet saturated fat must be completely avoided if possible.
  • Saturated fat should not exceed 15gm/day.
  • Unsaturated fat (oils) should be kept to 20-50gms/day.
  • Fruit and vegetables permissible in any amount.
  • Wholegrain breads, rice and pastas encouraged.
  • No red meat for the first year, including pork.
  • After the first year 85gm of red meat allowed once per week.
  • White meat poultry (skinless) and white fish permissible.
  • Limit fatty fish to 50gm/day.
  • Egg whites ok, no egg yolks.
  • Dairy products must contain 1% or less butterfat.
  • No processed foods containing saturated fat.
  • Cod liver oil (1tsp or equivalent capsules) and a multivitamin supplement recommended daily.
Further Reading: The Multiple Sclerosis Diet Book, Dr. Swank and Barbara Dugan

Professor George Jelinek, The Overcoming Multiple Sclerosis Diet

Credentials: Professor George Jelinek, Professor and Head | Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne,  First Professor of Emergency Medicine in Australiasia, Founding Editor of the Journal of Emergency Medicine Australasia, Professorial posts at University WA, University of Melbourne and Monash University.  Professor Jelinek was diagnosed with multiple sclerosis in 1999; he remains symptom free.

Research: After being diagnosed with multiple sclerosis in 1999 Professor Jelinek applied his expertise in medicine and as an editor of an academic journal to review the data regarding multiple sclerosis and diet.  He has published numerous studies showing that people with multiple sclerosis who increase their consumption of omega 3s through fish and flaxseed oils have significantly better quality of life, lower relapse rates and less disability.[vi] [vii] [viii] Professor George Jelinek’s approach is inspired by the research of Professor Swank, his own research and current research, meta analysis and epidemiological data.  The Overcoming Multiple Sclerosis diet is evidence-based.
Jelinek/ OMS Recovery Program basics:. The program focuses on:
  • A plant-based whole food diet plus seafood, with no saturated fat as far as is practical.
  • Omega 3 supplements in the form of fish, fish oil and flaxseed oil.
  • Optional B group vitamins or B12 supplements if needed.
  • Vitamin D via sunlight and supplements.
  • Foods to avoid: Meat, egg yolk, dairy except low fat yoghurt, biscuits, pastries, cakes, muffins, doughnuts, margarine, lard, chocolate, coconut oil, palm oil, fried food.
  • The Overcoming Multiple Sclerosis diet is part of a whole program that also includes supplements, vitamin D, exercise and meditation.
Further Reading:
Overcoming Multiple Sclerosis, Prof G. Jelinek

The Wahls Protocol

Credentials: Dr Terry Wahls is a Clinical Professor of Medicine at the University of Iowa.  In 2000 she was diagnosed with relapsing-remitting multiple sclerosis. A diagnosis of secondary progressive multiple sclerosis followed in 2003.  By 2007 Dr. Wahls was in a tilt recline wheelchair.  She changed her diet in 2007 and by October 2008 was able to cycle 18 miles.

Research: Dr Wahls has designed a diet called the Wahls Protocol™. This diet is based on key elements of the ‘hunter-gatherer’ diet.

Dr Wahls diet basics:
  • Dr Wahls recipes are gluten, dairy and egg-free.
  • 3 cups of leafy greens per day.  Especially recommended kale and parsley.
  • 3 cups of sulfur-rich vegetables / day, eg. cabbage, onions, garlic, mushrooms, asparagus.
  • 3 cups of brightly coloured vegetables and fruits, eg. carrots, beets, capsicums, berries, peaches and oranges.
  • Grass-fed meats as they are rich in Omega 3s.
  • Organ meats such as brain, liver and tongue.
  • Seaweed.
Further reading:

Ashton Embry’s Best Bet Diet

Credentials: Ashton Embry Ph D is a Canadian research scientist.  He is a graduate of the University of Manitoba who has a PhD in geology/stratigraphy from the University of Calgary.  When his son developed multiple sclerosis in 1995, Dr. Embry researched the scientific literature and developed the Best Bet Diet.

Research: Embry has based his diet on the theory that an autoimmunity process is ignited by undigested food proteins escaping through the gut wall and into the circulatory system. This causes the immune system to attack tissue in the central nervous system (CNS) due to similarities between the food proteins and the CNS tissue. This process is known as Leaky Gut Syndrome.[ix] [x]
Best Bet Diet basics: The Best Bet Diet says that stopping, or restricting the consumption of foods that have a molecular structure similar to myelin, reduces the autoimmune response.  Foods that are said to have a similar structure to myelin are thought to be dairy, gluten and legumes.  Food intolerances, bacterial imbalance, infectious agents (viruses, bacteria and protozoa), non steroidal antiinflammatory drugs and refined sugar are thought to make the leaking of food proteins through the leaky gut wall into the blood stream worse. 
  • Avoid all dairy, gluten, legumes.
  • Avoid all foods individuals may have a sensitivity/intolerance to.  This involves testing to determine.
  • Avoid sugary foods.
  • Reduce saturated fat, omega 6 oils, alcohol.
  • Increase skinless chicken breast, grass fed game meat, Omega 3’s in fish such as salmon and mackerel, vegetables and fruit.
  • Take up to 17 specific supplements aimed at reducing the autoimmune reactions, repairing the leaky gut and strengthening the blood brain barrier.
Further Reading:
[i] Swank RL. Multiple sclerosis: a correlation of its incidence with dietary fat. Am J Med Sci 1950; 220:421-430.
[ii] Swank RL. Dugan B. Effects of a low saturated fat diet in early and late cases of multiple
sclerosis. Lancet 1990; 336(8709):37-39.
[iii] Swank RL, Dugan BB. The Multiple Sclerosis Diet Book: A low fat diet for the treatment of MS. New York: Doubleday, 1987
[iv] Swank RL. Multiple Sclerosis: fat-oil relationship. Nutrition 1991; 7:368-376
[v] Swank RL, Goodwin J. Review of MS patient survival on a Swank low saturated fat diet. Nutrition 2003; 19:161-162
[vi] Jelinek GA, Hadgkiss EJ, Weiland TJ, Pereira NG, Mark CH, van der Meer DM. Association of fish consumption and omega 3 supplementation with quality of life, disability and disease activity in an international cohort of people with multiple sclerosis. Int J Neurosci, 2013 Nov; 123(11):792-800
[vii] Hadgkiss EJ, Jelinek GA, Weiland TJ, Pereira NG, Marck CH, van der Meer DM. The association of diet with quality of life, disability, and relapse rate in an international sample of people with multiple sclerosis. Nutr Neurosci. 2015 Apr;18(3):125-36. doi: 10.1179/1476830514Y.0000000117. Epub 2014 Mar 17.
[viii] Taylor KL, Hadgkiss EJ, Jelinek GA, Weiland TJ, Pereira NG, Marck CH, van der Meer DM. Lifestyle factors, demographics and medications associated with depression risk in an international sample of people with multiple sclerosis. BMC Psychiatry. 2014 Dec 3;14:327. doi: 10.1186/s12888-014-0327-3.
[ix] Embry AF. The Multiple Factors of Multiple Sclerosis: a Darwinian
Perspective. Journal of Nutritional & Environmental Medicine (2004) 14(4), 1–11
[x] M C ArrietaL Bistritz, and J B Meddings. Alterations in Intestinal Permeability. Gut. 2006 Oct; 55(10): 1512–1520


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