Currently, multiple sclerosis (MS) lacks a definitive treatment, emphasizing the need for research that prioritizes the investigation of modifiable environmental risk factors such as diet associated with MS development or the manifestation of its symptoms. Therefore, we designed a narrative review to investigate the role of dietary interventions on multiple sclerosis symptoms.
Swank is one of the oldest dietary interventions in MS. In 1948, swank started utilizing low fat diet, supplemented by cod liver oil. After 34 years follow-up, the survival rate was higher in swank diet group and patients were still ambulatory and otherwise healthy.
Modified Paleo diet (Wahl’s protocol), recommends green leafy and sulfur-rich vegetables, as well as intensely colored fruits and vegetables, encourages eating omega-3 sources, animal and plant protein, nutritional yeast, plant-based milk, and kelp and spirulina, and excludes gluten, dairy, and eggs. A 12-month multimodal intervention it resulted in improvement in anxiety, depression, cognitive function, and executive function (self-reported).
Sand et al 2019 investigated the effects of a modified Mediterranean dietary program in MS patients in a 6 months intervention. They reported a significant improvement in fatigue scores.
The ketogenic diet is a high-fat and low-carbohydrate diet. Benton et al, in 2019 investigated the effects of the 6-month intervention of a modified Atkins diet as a type of ketogenic diet (KDMAD) in MS patients. No subject experienced worsening disease on diet. Body mass index and total fat mass decreased. Fatigue and depression improved and leptin declined after 3 months.
Data on the effects of dietary interventions in MS is limited and the available studies are not methodologically strong. Based on the beneficial effects of some investigated diets and modifiable characteristics of diet, it seems that there is a need for more investigation with a better methodology to prove the effects of each dietary pattern.