• The Mediterranean, low-carb, and fasting-mimicking diets — when combined with exercise — have a positive effect on people with multiple sclerosis (MS), a new study found.
• People on traditional Western diets may experience more inflammation than those on other diets.

When combined with exercise, diets such as Mediterranean, low-carb, and fasting-mimicking appear to have a positive impact on people with MS, a new study suggests.

Scientists at Italy’s University of Palermo recently analyzed data from more than 160 scholarly articles regarding diet and physical activities that produce the most optimal health effects for people with multiple sclerosis.

The study authors found that even though individuals with MS may be consuming a normal level of calories, their macronutrients (carbohydrates, fats, and protein) may be imbalanced. Macronutrients are the food components the body needs for energy and to maintain its structure.

For example, a diet high in saturated fats has been associated with higher MS risk. Consuming too many foods with saturated fats has been shown to increase relapse rates in children with relapsing-remitting multiple sclerosis.

The authors of the new study noted that certain diets can lead to abdominal obesity, higher body mass index [BMI], and a higher fat percentage, which can lead to increased inflammation and high serum levels of cytokines linked with MS pathogenesis and severity. They added, “Western diet, which is characterized by a high intake of highly saturated fats and carbohydrates, may lead to the activation of pro-inflammatory immune pathways and is therefore not recommended.”

The researchers found that only low-carbohydrate, Mediterranean, and fasting-mimicking diets showed a positive effect on MS disease course and in patient-reported outcomes — when used in association with disease-modifying drugs and physical activity.

Learn more about healthy eating and exercise and their impact on MS.

Drilling Down Into Diets

A fasting-mimicking diet is a low-calorie diet that “tricks” the body into a fasting state, according to the University of Southern California. The study authors noted that there are various types of fasting-mimicking diets, all of which involve prolonged periods of little or no caloric intake. Calorie-restriction diets and intermittent-fasting diets are types of fasting-mimicking diets. According to the study, fasting-mimicking diets have been shown to have anti-inflammatory benefits and to reduce demyelination — the nerve damage caused by MS.

Mediterranean diets were found to reduce the chances of developing long-term MS disability. These diets are high in omega-3 polyunsaturated fats from fish or seafood and monounsaturated fats from olive oil, as well as fruits, vegetables, bread, cereals, red wine, eggs, legumes, and nuts,

Finally, low-carb diets include ketogenic diets and paleolithic meal plans. The study authors emphasized how ketogenic and paleolithic diets are associated with enhanced memory and motor skills, quality of life, and lower scores on the disability status scale.

The authors warned, however, that eliminating cereals in these diets may lead to deficiencies in folic acid, thiamine, calcium, and vitamins B, D, and E. The National Multiple Sclerosis Society notes that going on a low-carb diet can lead to fatigue, which is already a common problem in people with MS.

Physical activity showed a positive effect on disease course and patient-reported outcomes. “Training with combined exercises is considered the more effective approach,” concluded the authors.