Many members of MyMSTeam have been asking each other about the Wahls Protocol^® — a diet and lifestyle program created and used by Dr. Terry Wahls, who has multiple sclerosis herself. Diagnosed with secondary progressive MS in 2000 and confined to a tilt-recline wheelchair for four years, Dr. Wahls supplemented her medical regimen with a program she designed specifically for her brain. Dr. Wahls is now out of the wheelchair and rides her bike to work each day at the University of Iowa. She is actively running clinical trials on her protocol — including the Wahls Protocol^® Diet — for many chronic conditions, including multiple sclerosis.

In this interview, MyMSTeam talked with Dr. Wahls about her program, how she uses it for herself and for her patients, and any tips she has for MyMSTeam members considering the Wahls Protocol^® Diet.

What Is the Wahls Protocol^®?

The Wahls Protocol^® involves three key elements, all of which are being tested or have shown results in clinical trials. Those three elements are:

• The Wahls Protocol^® Diet — Dr. Wahls is meticulous about what she eats. “Food is the most potent medicine,” she said.
• Physical Therapy — Dr. Wahls exercises and uses electrical stimulation therapy.
• Meditation — Dr. Wahls meditates twice a day.

“It’s more than a diet,” Dr. Wahls explained. “It’s a diet and lifestyle. Any time we’re trying to create new behaviors, and extinguish old, troublesome behaviors, [we] have to rewire part of our brains.” The program starts by asking you to improve your diet quality.

What’s on the Wahls Protocol^® Diet?

Dr. Wahls designed her diet to be high in nutrients that improve the common MS symptoms of fatigue, brain fog, and walking issues. It’s gluten- and dairy-free and gets rid of added sugar and processed foods. Dr. Wahls summarized her diet as follows:

• Get Rid of Sugar — “Eat berries instead.”
• Get Rid of Gluten — “No gluten-containing grains. Eat nonstarchy vegetables. Rice is OK if you have to have grains, but cauliflower rice or cabbage would be better.”
• Get Rid of Dairy — “Swap out dairy and use coconut milk or almond milk.”
• Ramp Up the Vegetables — Aim for 3 cups per day. “More greens, spinach, kale, chard.”
• Ramp Up the Colors — “Deeply pigmented vegetables and berries like carrots, beets, blueberries, and blackberries.”
• Ramp Up the Sulfur-Containing Veggies — “More cabbage, onion, garlic, and mushrooms.”
• Yes, You Can Have Meat — “Six to 12 ounces of grass-fed or wild-caught fish for protein per day, and organ meats like liver are good two days per week.”

You can download the Wahls Protocol^® Diet Cheat Sheet to see more details.

Getting Started on the Wahls Protocol^® Diet

“Our brains crave sugar, salt, fat, and inactivity,” Dr. Wahls explained. “Processed foods have been designed by food scientists to make products that are incredibly tasty, addictive, and that create cravings that may result in some withdrawal symptoms if you stop.” Examples include the obvious — like chips, soda, donuts, cookies — and the less obvious — like pasta, breads, white potatoes, dairy, and eggs. To stop acting on these cravings, Dr. Wahls said, “We have to rewire part of our brains, rewire some automatic activities.”

Changing these habits can be challenging. Dr. Wahls offered some ideas for staying motivated to make positive health decisions.

Do It For Someone or Something Special

Dr. Wahls likes to ask her patients if there’s something or someone they care about so deeply that they’d run into a burning building to save them — kids, grandkids, the ability to dance at your son’s wedding or attend your granddaughter’s graduation, etc. She asks her patients to link the new health behavior to being there for that special person or reaching that goal. “Now they will be ready to do the work,” Dr. Wahls said. ”If they don’t have anything they care about deeply, it’s going to be a huge struggle, and I’ll probably make a much smaller recommendation.”

Create a Conducive Food Environment

It’s particularly difficult to follow this diet if your social circle is not supportive and your food environment is not conducive to following a strict diet. Dr. Wahls explained, “My preference is to remove the foods that are most inflammatory, and then be sure that you have the foods that give you the building blocks your brain needs to make myelin, turn off the inflammation, and fuel the mitochondria.”

Commit 100 Percent for 100 Days

If you are willing to commit 100 percent for 100 days, you will be able to see if this diet is working for you. Of course, once you start seeing success and feeling better, the diet itself can become addictive. Dr. Wahls shared her own story: “I discovered that I could not get enough greens. Within three months my pain [from trigeminal neuralgia, which causes debilitating facial pain in some people with MS] was gone. My brain fog was gone. My fatigue, gone.”

Dr. Wahls had been in a tilt-recline wheelchair for four years at that point and found that after three months, she was able to start sitting up at the table to have supper with her family. She started walking around using walking sticks and then, after six months, she tried riding her bike. “That felt so miraculous,” she said. “My kids are crying, my wife’s crying, I’m crying. … It was such a momentous day in my life.”

Diet Is Not a Replacement for Medication, but an Important Part of Your Treatment Regimen

Dr. Wahls does not suggest people with MS stop taking their medication and replace it with her diet. Although she has been off of all disease-modifying drugs since 2008 (with her neurologist’s approval), Dr. Wahls still takes low-dose Gabapentin for trigeminal neuralgia.

Although there is strong clinical evidence that people with MS who are consistently on disease-modifying medications have better health outcomes, more neuroscientists and neurologists agree that improving diet and lifestyle are key to brain preservation. Dr. Wahls says that diet and lifestyle changes significantly improved her MS symptoms. She hopes the clinical trials done on the Wahls Protocol^® Diet and other diet and lifestyle interventions, including one funded by the National Multiple Sclerosis Society, will help diet and lifestyle changes become part of the standard treatment for MS and many other chronic conditions.

In an initial prospective clinical trial of the Wahls Protocol^® Diet in people with secondary and primary progressive multiple sclerosis, approximately 80 percent showed a clinically meaningful reduction in fatigue severity and improvement in quality of life. Half of the participants showed improvement in walking.

Dr. Wahls encourages all people facing MS to ask their neurologists and primary care physicians to support their efforts to incorporate a healthier diet such as the Wahls Protocol^® Diet, physical therapy, and meditation into their treatment and wellness regimens.

“Your [MS] specialist likely won't know anything about diet and lifestyle, but your primary care team should,” Dr. Wahls said. “If they can't be excited about your eating more vegetables and cutting out sugar and processed foods, fire them and get a different primary care person. If they can't be excited that you want to learn how to meditate, again, fire them and get someone else. If they aren't willing to give you a referral to physical therapy to help you design a home exercise program, fire them.”

People often ask Dr. Wahls about her personal self-care plan. She has been refining her routine over the last 20 years. Her current daily self-care ritual includes:

• Morning meditation and evening meditation
• A workout augmented by electrical stimulation
• A sauna (many people with MS following the Wahls Protocol^® are able to tolerate and enjoy heat again)
• Riding her bike to work (10 miles)
• Dinner with her family, where they take time to be grateful by sharing three joyful memories before eating

Clinical Trials

You can learn more about the Wahls Protocol^® at www.TerryWahls.com. Dr. Wahls is recruiting newly diagnosed patients with either relapsing-remitting multiple sclerosis or clinically isolated syndrome. Learn more about how to join a current clinical trial with the Wahls Lab. If you have questions, you can also email the study team.

Further Reading: Dr. Wahl’s Recommended Studies

• Review of Two Popular Eating Plans Within the Multiple Sclerosis Community: Low Saturated Fat and Modified Paleolithic — Nutrients
• A Multimodal, Nonpharmacologic Intervention Improves Mood and Cognitive Function in People With Multiple Sclerosis — Journal of the American College of Nutrition
• Randomized Control Trial Evaluation of a Modified Paleolithic Dietary Intervention in the Treatment of Relapsing-Remitting Multiple Sclerosis: A Pilot Study — Degenerative Neurological and Neuromuscular Disease
• Effects of a Multimodal Intervention on Gait and Balance of Subjects With Progressive Multiple Sclerosis: A Prospective Longitudinal Pilot Study — Degenerative Neurological and Neuromuscular Disease
• A Modified MCT-Based Ketogenic Diet Increases Plasma β-Hydroxybutyrate but Has Less Effect on Fatigue and Quality of Life in People With Multiple Sclerosis Compared to a Modified Paleolithic Diet: A Waitlist-Controlled, Randomized Pilot Study — Journal of the American College of Nutrition
• Beyond Rehabilitation: A Prevention Model of Reserve and Brain Maintenance in Multiple Sclerosis — Multiple Sclerosis Journal