The power of healthy habits for people living with multiple sclerosis

By Dr Shireen Kassam

Multiple Sclerosis (MS) is an autoimmune condition affecting the brain and the spinal cord. Conventional pharmaceutical treatments slow the progression but rarely reverse or cure it. Patients living with MS often explore diet and lifestyle interventions as a means of managing their symptoms and reducing reliance on medication, yet these approaches are rarely discussed with or supported by their physicians. There is consistent evidence that a healthy diet and lifestyle may not only be protective against getting MS but can also play an important role in managing the condition. Programs such as ‘Overcoming MS’, which support people to adopt healthy lifestyle habits have been hugely valuable.

To raise awareness of the power of healthy habits, we published two case histories highlighting the remarkable potential of lifestyle changes, including a whole food plant-based diet, to improve symptoms and quality of life, allowing for the discontinuation of medication. This is not the first report of such successes. Dr Saray Stancic, a US-based physician has also previously charted her experience of reversing severe disability from MS using a whole food plant-based diet and lifestyle approach. We fully appreciated that not all people living with MS can expect to have such positive results but these same lifestyle habits are key for reducing the longer term risk of cardiovascular disease and cancer, conditions with a higher incidence in people living with MS.

My personal interest is in the role of a whole food plant-based diet for improving health outcomes. We know that people living with MS can benefit from increasing the proportion and variety of healthy plant foods in the diet i.e. fruit, vegetables, whole grains, beans, nuts and seeds, whilst limiting or avoiding animal-derived and processed foods. Dr Roy Swank, a pioneer of dietary approaches in MS, used a diet low in saturated fat that limited meat consumption and emphasised fruit and vegetable consumption. His observational study is the longest ever reported on diet and MS, following his patients for up to 34 years. The results suggested that patients adhering to his dietary protocol had significantly less neurological disability and longer lives. Subsequent studies have shown that these positive results are likely to be explained by the fact that a plant-based diet is rich in nutrients that reduce inflammation and thus leading to improvements in symptoms. In contrast diets high in meat and saturated fats promote inflammation and in general worsen symptoms and quality of life.

Growing evidence suggests that the health of the gut microbiome is a key factor in the development and progression of MS, especially given its importance in maintaining a healthy immune system. Diet is the main determinant of gut health, with a fibre and polyphenol-rich plant-based diet being essential. Meat heavy diets reduce the number of favourable bacteria in the gut and thus adversely affect the immune system. In contrast plant-based diets support the growth of a variety of healthy gut bacteria, which are associated with better immune health and lower levels of inflammation. A recent randomised study has demonstrated that the adoption of a plant-rich, anti-inflammatory diet led to reduced levels of inflammation in the gut of people with MS and that this was also associated with improvements in visual symptoms.

There is little doubt that a healthy diet and lifestyle is key for preventing a number of our commonest chronic conditions. Evidence is emerging that people living with MS can also benefit from adopting healthy habits, including a whole food plant-based diet. We hope the cases we have described inspire patients and researchers alike to explore this under-utilised treatment strategy.