Diet And Multiple Sclerosis – The Paleo Mom


Dr. Terry Wahls is an Institute for Functional Medicine Certified Practitioner and conducts clinical research using functional medicine principles in the setting of multiple sclerosis.  In 2018 she was awarded the Institute for Functional Medicine’s Linus Pauling Award for her contributions in research, clinical care, and patient advocacy. Dr. Wahls has secondary progressive multiple sclerosis, which confined her to a tilt-recline wheelchair for four years. Dr. Wahls restored her health using a diet and lifestyle program she designed specifically for her brain and now pedals her bike to work each day. She is the author of The Wahls Protocol: How I Beat Progressive MS Using Paleo Principles and Functional Medicine, The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles (paperback), and the cookbook The Wahls Protocol Cooking for Life: The Revolutionary Modern Paleo Plan to Treat All Chronic Autoimmune Conditions. Learn more about the current study Efficacy of Diet on Quality of Life in Multiple Sclerosis at Pick up a one-page handout for the Wahls™ Diet. Follow her on Instagram @drterrywahls, and on Facebook/Twitter at @TerryWahls. Sign up to receive her weekly research updates.

Does your doctor tell you food has no impact on multiple sclerosis (MS)? Do they tell you there is no research showing that diet makes a difference for people with MS? They are wrong!

I have been conducting clinical research testing the effects of diet in people with MS for over a decade. The good news is that the tide is finally turning in favor of using diet to help control MS symptoms. Our research lab has investigated the modified Paleolithic diet, ketogenic diet, and the low saturated fat diet.1-7 We have consistently observed that improving diet leads to reductions in fatigue,1,2,6-8 anxiety,4 and depression,4 and improved quality of life.1,2,4,6,7 I have conducted 7 clinical trials and have published over 70 peer-reviewed scientific papers, abstracts, and posters. Our MS diet studies have been cited by other researchers hundreds of times.

Save 80% Off the Foundations of Health

Expand your health knowledge on a wide range of topics relevant to you, from how to evaluate scientific studies, to therapeutic diet and lifestyle, to leaky gut and gut microbiome health, to sustainable weight loss, and much more!!!

More people are doing dietary intervention studies in the setting of MS. There have now been 12 published randomized, controlled, dietary intervention studies in people with MS. There was even a recent editorial in Neurology, the highest impact and most widely read journal that publishes MS research, stating there is now evidence that diet can reduce fatigue and improve quality of life for people with MS. This is huge. If your physicians are telling you that diet does not matter, your physician is not keeping up with the latest research!

We are currently inviting people with relapsing-remitting MS to be in our new study, “Efficacy of Diet on Quality of Life in Multiple Sclerosis.” I will tell you how to sign up for this study later in this article.

Diet studies in MS findings

Regardless of what your physician(s) may say, we now have strong scientific evidence that diet matters.

The strongest evidence that an intervention is helpful (or harmful) is when multiple studies are combined and analyzed together. This type of analysis is called a meta-analysis. A network meta-analysis combines and compares all known studies to identify which treatments are the most effective. This is much stronger evidence than looking at a single study. We now have enough published studies on the role of diet on fatigue and quality of life to conduct these important meta-analyses.

The paper, Efficacy of Diet on Fatigue and Quality of Life in Multiple Sclerosis: A Systemic Review and Network Meta-analysis of Randomized Trials,was a network meta-analysis. A network meta-analysis allows the investigator to rank the interventions from most effective to least effective. The paper was published in Neurology, the most widely read journal by neuroscientists and practicing neurologists, in January 2023. Dr. Linda Snetselaar examined randomized dietary intervention studies in MS that lasted at least 12 weeks and had either fatigue or quality of life as an outcome. The authors found 12 studies that investigated 8 diets: Mediterranean, Paleolithic, ketogenic, anti-inflammatory, low saturated fat, fasting, calorie restriction, and control diet (the participant’s usual diet). A total of 608 participants were enrolled in these 12 studies. The standardized mean difference (SMD) was calculated for improvements in measures of fatigue, mental health quality of life, and physical health quality of life for the intervention diets and control diet. The 95% confidence interval (CI) was also calculated for the intervention diet and control diet. If both the SMD improvements and the 95% confidence interval are entirely on the side of the intervention, then scientists can safely state the intervention is effective for reducing fatigue or improving quality of life. That was how Dr. Snetselaar determined whether any of the diets were effective at reducing fatigue or improving quality of life. It is also how she ranked the effectiveness of all 8 diets for reducing fatigue or improving quality of life.

When comparing each dietary intervention to the control diet, three diets had confidence intervals that were entirely on the side of reducing fatigue. The other five diets were not significantly better than the control diet. The magnitude of change for reducing fatigue severity in descending order, was Paleolithic (SMD -1.27; 95% CI -1.81, -0.74), low saturated fat diet (Swank diet) (SMD -0.90; 95% CI -1.39, -0.42), and Mediterranean diet (SMD -0.89; 95% CI -1.15, -0.64). When comparing each diet to usual diet for improving quality of life, there were two diets that were associated with significant improvement in quality of life. In descending order, those two diets were the Paleolithic (also known as the Wahls™ diet) (SMD 1.01; 95% CI 0.40, 1.63) and Mediterranean diet (SMD 0.47; 95% CI 0.08, 0.86) diets. All of the Paleolithic diet studies cited in the network meta-analysis and half the low-fat diet (Swank diet) studies were from our lab. Thus the Paleolithic diet that was reported was really the modified Paleolithic diet, also known as the Wahls™ diet.

What diet to follow if you have MS

The three best diets for reducing fatigue and/or improving quality of life are the Mediterranean, modified Paleolithic (Wahls™ diet) and low saturated fat (Swank diet).

The Mediterranean encourages more vegetables and fruits, whole grains, legumes, fish, nuts, and seeds and reduces or eliminates added sugars, processed foods, fast foods, white breads, and white rice. It also reduces dairy and red meat intake.

The low saturated fat (Swank) diet encourages more vegetables, fruits, whole grains, fish, and white poultry, restricts saturated fat to less than 15 grams per day, restricts red meat, dark poultry meat, dairy fat, and saturated fat, and reduces or eliminates added sugar, processed foods, and fast foods.

The modified Paleolithic diet (Wahls™ diet) encourages more vegetables (target is 6 to 9 servings per day), 6 to 12 ounces of meat or fish per day, and some fermented foods, nuts, and seeds each day. It excludes gluten-containing grains, dairy, and eggs and reduces or eliminates added sugars, processed foods, and fast foods.

Sit down and have a family conversation about this research. Which of these diet plans do you want to try?