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Multiple Sclerosis (MS) is an autoimmune disease where the immune system attacks the myelin sheath - a protective covering - around nerve fibres, and causes communication problems between the brain and the rest of your body. Eventually, the disease can cause permanent damage to or deterioration of the nerves.

While there is no evidence that diet by itself can prevent or treat MS, the higher incidence of MS in western countries compared with the developing world lends credence to the notion that diet has a role to play. Taking a healthy and balanced diet may not only lead to fewer relapses, but also help manage the complications of the disease, and improve the overall quality of life.

  1. Nutrients to improve the condition of Multiple sclerosis
  2. Managing common problems during Multiple Sclerosis with diet
  3. Food to avoid in Multiple Sclerosis
  4. Indian Diet Plan for Multiple Sclerosis recovery
Doctors for Multiple Sclerosis Diet

Here are some essential nutrients that should be included in an MS patient’s diet:

A good balance of essential fatty acids

Omega 3 and Omega 6 fatty acids play an important role in keeping the nervous system healthy. A good balance of both omega 3 and 6 is more important for people with MS than the total amounts of each. To add these nutrients in a balanced manner to your diet, have fatty fish, flax seeds, chia seeds, safflower oil, sunflower oil, corn oil, soybean oil, sunflower seeds, walnuts, and pumpkin seeds.

MS and Antioxidants

Some research has suggested that oxidative activity in the central nervous system may be linked to the damage that occurs in MS. However, more studies on the use of antioxidants for people with MS are still needed.

Antioxidant therapy might also carry a risk for people with this disease, as some antioxidants have a stimulating effect on the immune system. So before starting any antioxidant or supplement, please discuss with your doctor first.

MS and Vitamin B12

Vitamin B12 is needed for the body to make myelin that gets damaged in MS. Because of the importance of vitamin B12 in the nervous system, and because a vitamin B12 deficiency can lead to symptoms similar to those found in MS, some studies have suggested it can help treat or prevent the disease. To maintain a sufficient amount of this nutrient in your body, add milk and milk products, egg, chicken, fish, fermented food to your diet.

(Read more: Vitamin B12 Test)

MS and Vitamin D

There are a lot of studies that have shown that higher levels of vitamin D are associated with reduced risk of developing multiple sclerosis and with reduced clinical activity in established MS, including decreased risk of relapse and reduction in disease activity on brain MRI. You can obtain vitamin D through your diet and exposure to sunlight. For diet, you can have cod liver oil, mushrooms, and egg yolk.

(Read more: Vitamin D deficiency symptoms and Vitamin D test)

MS presents and progresses differently for each patient. However, some complications of the disease have been observed quite commonly. The correct diet can help you alleviate these to a certain extent, or even keep them at bay.

Multiple Sclerosis and weight management

Both weight loss and weight gain can be a problem for people with Multiple Sclerosis, but this can be managed with a customized diet plan. A dietitian can help you develop a plan that adjusts as your needs change, ensuring you always get a healthy balance of nutrients.

  • How to manage weight loss during MS: If someone is underweight they may become malnourished and weak, which can make MS symptoms like fatigue, muscle weakness, or spasms worse. There are many reasons people with MS might not eat as much as they need. Problems with posture, swallowing, fatigue and tremors can all make shopping for, preparing, or eating food more difficult.

    Appetite can also be affected by stress, anxiety, and depression, as well as certain drug treatments. In these conditions, try to include energy-dense and healthy food such as sandwiches, milkshakes, homemade energy bars, and nuts. (Read more: How to gain weight)

  • How to manage weight gain during MS: Keeping generally fit and healthy can make it easier to cope with the symptoms of MS. But having MS may mean you are less active than you once were, so you might find that you have put on weight. Appropriate exercise and a healthy, balanced diet can help you return to your healthy weight. In addition to that, you can do a few things to speed up weight loss, like drink an adequate amount of liquids. However, stay away from fruit juices or sugary drinks, and instead opt for water or low-sugar versions such as plain lemon water, or buttermilk.

    Sugary and fatty snacks are sometimes ‘comfort food’ at times of stress and worry. If you are eating a lot of comfort food, and think you may be depressed, discuss this with your doctor as depression is treatable. (Read more: How to lose weight)

Diet for MS and bladder problems

Bladder related problems are very common during MS. Some people with bladder problems drink less water to reduce their need to use the toilet. However, this can mean you have more concentrated urine, which can irritate the bladder and increase the chances of getting urinary tract infections. Drinking six to eight glasses of water per day is generally recommended. It is best to avoid large quantities of caffeine and alcohol as these will irritate the bladder.

Dietary changes for constipation

Dietary changes are often suggested as the first line of treatment for people with MS who experience constipation. Adequate fluid intake can help get regular bowel function, as can a diet with plenty of insoluble fiber. This fiber cannot be digested and passes straight through the gut, helping the digestion of other foods and removal of waste. A well-balanced diet, with plenty of fruit and vegetables, can provide fiber. Oranges, guava, whole grain, and leafy vegetables are particularly good sources of insoluble fiber.

(Read more: How to get rid of constipation)

Swallowing problems (Dysphagia)

Difficulties with swallowing or dysphagia can be a stressful symptom, especially if not managed properly. But there are a number of ways to modify your eating habits or diet that can help:

  • If chewing is difficult, try to avoid tough or dry food.
  • If big meals are a problem, take small and frequent meals.
  • Calorie-rich drinks can help ensure you get enough calories.
  • A change in your seating position may make swallowing easier.
  • Soften food with a fork, spoon, or blender to minimize chewing and make swallowing easier.

Some people find it harder to drink enough fluid through the day when drinks have been thickened. To avoid dehydration, sip a little but often. If swallowing difficulties are causing weight loss, nutritional supplements might be helpful. These ways of eating and drinking might also help if you experience facial pain, which can make opening the mouth and chewing difficult.

Diet to treat fatigue

Fatigue can sometimes be helped by adjusting the diet. For those who get tired quickly, eating large, hot meals can be difficult. So, smaller, more frequent snacks can be better.

Proteins with all meals or snacks or complex carbohydrates such as a whole grain can help keep energy levels up. Relying too much on sugary foods for energy can make fatigue

worse, as they cause energy peaks followed by lows. Dehydration can lead to tiredness, so aim to drink six to eight glasses of fluids per day. Drinks that contain a lot of caffeine, such as tea, coffee, and cola can dehydrate you. Try to avoid them.

How to manage tremors

Tremors can affect your nutritional needs or your approach to eating. Constant tremors use stored calories, so high-energy foods and drinks between meals might be necessary to avoid weight loss or worsening fatigue. If tremor affects holding or reaching for things, certain foods may be easier to eat than others. A sandwich, for example, is easier to manage than a paratha. You can also use specially designed cutlery, crockery, and kitchen utensils.

Take good care of your bone health

Osteoporosis causes bones to become fragile and increases the risk of breaking. Several factors may increase the risk of osteoporosis for people with MS:

  • Extensive use of steroids to treat relapses
  • Lack of weight-bearing exercise
  • Reduced mobility
  • Avoiding sunlight because of heat sensitivity or fatigue, leading to lower vitamin D intake

(Read more: Exercises for osteoporosis)

To help reduce this risk, it is important to maintain good levels of both vitamin D and calcium in the diet, as they help keep bones strong and healthy. Good sources of vitamin D include oily fish, liver, and eggs.

Milk and dairy products are the richest sources of calcium. Eggs and green leafy vegetables are also good sources. Skimmed milk contains as much calcium as full-fat milk, so cutting down on fat need not mean losing out on calcium. Fortified soy products and juices are non-dairy alternatives.

(Read more: Osteoporosis diet)

Some food options can increase inflammation in the body and worsen an MS patient’s condition. Try to avoid such foods:

  • Processed meats: Sausages, bacon, canned meat
  • Refined carbs: White bread, white rice, pasta, biscuits, all-purpose flour, sugar, sweets.
  • Fried foods: French fries, samosa, kachori
  • Junk foods: Fast food, potato chips, and ready to eat food
  • Trans fats: Margarine, dalda, butter, packaged food products, and partially hydrogenated vegetable oils.
  • Sugar-sweetened beverages: Energy and sports drinks, soda, and sweet tea
  • Alcohol: Stop consumption of all alcoholic beverages

Here is a sample Indian diet plan for multiple sclerosis patients that combines all the advice given above. You can follow this, or create a customized diet plan with your nutritionist:

  • Early morning: milk (1 cup) + walnut (4-6)
  • Breakfast: methi paratha (2) + curd (1 bowl) + papaya (1 small bowl)
  • Mid meal: apple (1 small sized)
  • Lunch: chapati (2)/ brown rice (1 bowl) + toor dal/ cucumber raita (1 bowl) + bottle gourd curry (1 bowl) + grated salad (1 bowl)
  • Evening tea: turmeric tea (1 cup) + roasted makhana (1 bowl) / boiled egg (1)
  • Dinner: vegetable soup (1 big bowl) + chapati (2) + paneer curry (6-7 pieces) / fish curry (1-2 piece)
  • Bedtime: turmeric milk (1 glass)
Dt. Akanksha Mishra

Dt. Akanksha Mishra

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Surbhi Singh

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Dr. Avtar Singh Kochar

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