Navigating Nutrition with Multiple Sclerosis

Many diets claim to help manage Multiple Sclerosis (MS) by reducing inflammation, but the research behind them is often mixed. This post explores common MS diets, their potential benefits and drawbacks, and how to approach nutrition with flexibility and self-compassion.

I want to start by acknowledging that I’m not a multiple sclerosis (MS) expert and I don’t live with MS. What I do know is how chronic illnesses profoundly impact relationships with food and body image. This post is based on research, insights from colleagues, and my work with many resilient clients navigating MS.

In this post, we’ll explore common dietary interventions for MS and assess how they may fit your unique situation. While this post centers on MS, the principles of evaluating dietary advice are relevant to anyone managing a chronic illness.

Nutrition Interventions and Chronic Illness

With chronic conditions, it’s easy to focus on what I refer to as “nutritional extras”—supplements, niche diets, or food eliminations. Pursuing these strategies can offer a sense of control and hope when a diagnosis feels overwhelming, and there’s no judgment in exploring them.  However, it’s essential to proceed with caution and self-compassion. I always encourage building a secure nutritional base of consistent, adequate, and varied foods before exploring the ‘nutritional extras’. 

When working with clients newly diagnosed with MS, they’re often overwhelmed by conflicting advice from doctors, online searches, and well-meaning friends. We’ll explore some of the most common diet recommendations in the MS space below.

Gluten Free Diet

Research regarding a gluten free diet for MS is convoluted, with some studies supporting a gluten-free diet to manage MS symptoms while other studies show no connection between gluten and MS(1). Eliminating gluten without a celiac diagnosis or clear intolerance offers little benefit and adds unnecessary complexity. 

Dairy-Free Diet

Dairy is often labeled as inflammatory, but evidence linking it to MS symptoms, such as fatigue, is inconclusive(2). Some studies even support milk as protective from MS development. For those with lactose intolerance—a condition that affects a significant portion of the population(3) —avoiding dairy makes sense. Otherwise, dairy can be a convenient, nutrient-dense protein source.

Swank Diet

Developed in the 1950s by Dr. Roy Swank, this very low-fat diet was based on his observations of lower MS rates in fishing communities(4). While some studies suggest it may reduce fatigue or relapse risk, the extreme fat restriction is unsustainable for most and could lead to nutrient deficiencies(5,6). Swank also recommended high doses of omega-3 supplements, which are expensive and may cause side effects. I often suggest exploring a more gentle heart-healthy approach to eating before trying the Swank diet. 

 Wahls Protocol

This modified paleo diet emphasizes high meat intake while minimizing grains and is based on the personal experience of Dr. Terry Wahls, who lives with MS. Research on this protocol is limited, with most studies being small, short-term, and also incorporating non-nutritional interventions like meditation and stretching. While the Wahls Protocol may work for some, the lack of conclusive research and the risks associated with high-meat diets, such as elevated cholesterol, warrant caution. It's important to remember that individual success stories don't equate to universal effectiveness.

Questions to Ask Before Trying a New Diet

The evidence behind these diets is intriguing but not definitive. If you’re considering experimenting with dietary changes, ask yourself these key questions:

1. Is it worth the effort? What potential benefits do you hope to gain, and are they significant enough to justify the effort required?

2. Is it sustainable? Can you consistently follow this diet long-term without sacrificing important aspects of your life, like social events or food enjoyment?

3. Is it safe for me? Strict diets can increase the risk of disordered eating, such as obsessive thoughts, feelings of deprivation, or bingeing (7). They may also lead to nutrient deficiencies if not carefully planned. Always check in with your healthcare team before trying out any major dietary interventions. 

Building a Foundation

My goal when supporting clients with chronic illness is to create the least restrictive eating pattern possible while managing symptoms. This ensures nutritional adequacy, sustainability, and a reduced risk of disordered eating — all without diminishing the joy and social connection that food brings.

If you are struggling with your relationship with food and body image, reaching out for support is one of the most empowering things you can do. McArtney nutrition offers specialized support for those navigating eating disorder recovery or living with chronic illnesses. Georgia coaches many clients with MS as they build healthier relationships with food. Reach out for a discovery call to chat about finding food peace and body acceptance! 

Disclaimer: the information provided in this blog is for educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.

Sources

1. Thomsen, H. L., Jessen, E. B., Passali, M., & Frederiksen, J. L. (2019). The role of gluten in multiple sclerosis: A systematic review. Multiple Sclerosis and Related Disorders, 27, 156–163. https://doi.org/10.1016/j.msard.2018.10.019

2. Dieu, D. Y. R., Dunlop, E., Daly, A., Lucas, R. M., Probst, Y., & Black, L. J. (2022). Total dairy consumption is not associated with likelihood of a first clinical diagnosis of central nervous system demyelination. Frontiers in Neurology, 13, Article 888559. https://doi.org/10.3389/fneur.2022.888559

3. National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Definition & facts for lactose intolerance. National Institute of Health. Retrieved March 20, 2025, from https://www.niddk.nih.gov/health-information/digestive-diseases/lactose-intolerance/definition-facts#:~:text=In%20the%20United%20States%2C%20about,of%20people%20have%20lactose%20malabsorption

4. Swank MS Diet Foundation. (n.d.). The Swank diet. Swank MS Diet Foundation. Retrieved March 20, 2025, from https://www.swankmsdiet.org/the-diet

5. Swan, D. L., & Smith, J. (2016). Low-fat, plant-based diet in multiple sclerosis: A randomized controlled trial. Multiple Sclerosis Journal, 22(13), 1734–1742. https://doi.org/10.1177/1352458516671592

6. Zhang, Y., Chen, D., Xu, X., & Wang, Z. (2021). Change in micronutrient intake among people with relapsing-remitting multiple sclerosis adapting the Swank and Wahls diets. Journal of the Academy of Nutrition and Dietetics, 121(10), 1834–1842. https://doi.org/10.1016/j.jand.2021.03.018

7. Hilbert, A., Pike, K. M., Goldschmidt, A. B., Wilfley, D. E., Fairburn, C. G., Dohm, F. A., Walsh, B. T., & Striegel Weissman, R. (2014). Risk factors across the eating disorders. Psychiatry research, 220(1-2), 500–506. https://doi.org/10.1016/j.psychres.2014.05.054