Many members of MyMSTeam ask each other about the Wahls Protocol — a diet and lifestyle program created and used by Dr. Terry Wahls, a clinical professor of medicine who has multiple sclerosis (MS). Dr. Wahls was diagnosed with secondary progressive MS in 2000 and would require a tilt-recline wheelchair. She supplemented her treatment plan with a program she designed specifically for her brain health, known as the Wahls Protocol.

Dr. Wahls is now out of her wheelchair and rides her bike to work daily at the University of Iowa. She actively runs clinical trials on her protocol — including the Wahls Protocol diet — for many chronic conditions, including multiple sclerosis.

MyMSTeam interviewed Dr. Wahls about her program, discussing how she uses it for herself and her patients. Based on our conversation, here are some tips for following the Wahls Protocol diet and lifestyle program.

1. Avoid Sugar

People following the Wahls Protocol diet should avoid refined carbs, sugar, and artificial sweeteners. Limiting sugar helps prevent inflammatory blood sugar spikes. Additionally, artificial sweeteners have damaging effects on the gut microbiome (bacteria) and are associated with hunger and weight gain, which can worsen MS symptoms like fatigue.

If you have a sweet tooth, this adjustment can take time. “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.” To avoid acting on these cravings, Dr. Wahls said, “we have to rewire part of our brains, rewire some automatic activities.”

Reducing your intake of processed foods is a good first step toward eating less sugar. If you drink soda or juice regularly, transitioning to water should be a top priority. Additionally, being mindful of your choices, reading food labels, and experimenting with recipes on the Wahls’ Diet App will help you find ways to fill your plate with ingredients that are naturally low in sugar.

2. Get Rid of Gluten

The Wahls Protocol recommends staying away from gluten, a protein found in wheat, barley, and rye. Gluten-free diets have been associated with neurological improvements for people with MS. Dr. Wahls’ advice: “No gluten-containing grains. Eat nonstarchy vegetables. Rice is OK if you have to have grains, but cauliflower rice or cabbage would be better.”

Several naturally gluten-free grains and flours exist, but the Wahls Protocol diet doesn’t allow for grains, legumes, or soy, which limits your options. Instead, choose nuts and seeds that are soaked and sprouted. You can also find fresh or frozen “riced cauliflower,” which is diced into ricelike pieces.

3. Replace Dairy With Healthy Fats

Studies show that cow’s milk may promote disease progression in MS. “Swap out dairy and use coconut milk or almond milk,” Dr. Wahls advised. Cook with ghee (clarified butter) or coconut oil rather than butter. Avoid ice cream, cheese, and sour cream, which are high in saturated fat, but aim to eat some healthy fats, such as creamy avocado, which is rich in beneficial fatty acids.

4. Chose More Colorful Produce

After cutting out sugar, gluten, and dairy, you might be left wondering what to eat. Fortunately, you can have plenty of veggies on the Wahls Protocol Diet. Studies show that cutting back on gluten and dairy to make room for more fruits and vegetables offers fast and significant mood benefits for people with MS.

Dr. Wahls encouraged focusing on leafy greens and sulfur-rich vegetables and eating “more cabbage, onion, garlic, and mushrooms.”

Dr. Wahls shared that eating lots of leafy greens helped with her trigeminal neuralgia, a nerve disorder that causes debilitating facial pain in some people with MS. “I discovered that I could not get enough leafy greens,” she said. “Within three months, my pain was gone. My brain fog was gone. My fatigue — gone.”

Choosing deeply pigmented vegetables and berries — like carrots, beets, blueberries, and blackberries — is an important step, according to Dr. Wahls. “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,” she said.

The Wahls Protocol places “greens, sulfur, and color” categories at the base of its food pyramid. Dr. Wahls recommended working your way up to 3 cups of each category, making up the bulk of your diet. Eventually, you’ll be taking in up to 9 cups of vibrant produce per day, providing plenty of natural vitamins, antioxidants, and fiber.

5. Include Enough Protein

Dr. Wahls advised consuming “6 to 12 ounces of grass-fed meat or wild-caught fish for protein per day,” adding that “organ meats like liver are good two days per week.” If you’re a vegetarian or vegan, the diet plan suggests adding a B12 supplement.

Eggs are off-limits on the Wahls Protocol, as are processed meats, like hot dogs and cold cuts. But in addition to the natural proteins recommended above, the greens, nuts, seeds, and seaweed encouraged on the diet provide protein.

6. Maintain a Healthy Lifestyle

“It’s more than a diet. It’s a diet and lifestyle,” said Dr. Wahls, who does not suggest that people with MS replace their medication with her diet. Although she has been off all disease-modifying drugs since 2008 (with her neurologist’s approval), Dr. Wahls still takes low-dose gabapentin (Neurontin) for trigeminal neuralgia.

There is strong clinical evidence that people with MS who consistently take disease-modifying medications have better health outcomes, but more neuroscientists and neurologists (doctors who specialize in the brain and nervous system) agree that improving diet and lifestyle habits are key to brain preservation and overall longevity.

Dr. Wahls encouraged all people living with MS to ask their health care providers to support their efforts to incorporate a healthier diet such as the Wahls Protocol, physical therapy, and meditation into their treatment and wellness regimens.

7. Consider Participating in a Clinical Trial

Dr. Wahls credited dietary changes and lifestyle changes with significantly improving her MS symptoms. She said she hopes that the clinical trials involving the Wahls Protocol 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 other chronic conditions.

In an initial prospective clinical trial of the Wahls Protocol diet involving people with secondary and primary progressive MS, approximately 80 percent experienced a clinically meaningful reduction in fatigue severity and a better quality of life. Half the participants showed improvement in walking.

You can learn more about the Wahls Protocol at TerryWahls.com. You can also sign up for emails and a downloadable cheat sheet of the diet to post on your refrigerator. 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.

Talk With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 192,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Have you made dietary changes or lifestyle changes to control your MS symptoms? If you’ve tried the Wahls Protocol, what did you think of it? Share your tips and experiences in a comment below or on MyMSTeam.