Can You Beat MS With the Paleo Diet?

Some evidence suggests that the Paleo diet can improve or reverse symptoms of multiple sclerosis.

Can eating like a Stone Age hunter-gatherer ease symptoms of multiple sclerosis (MS)? One doctor who has MS, Terry L. Wahls, MD, clinical professor of internal medicine at the University of Iowa Carver College of Medicine in Iowa City, says the answer is yes and that she's living proof.

The Paleo diet, of which there are multiple versions, consists only of those foods that were available to humans during the Paleolithic era, such as lean meats and fish, fruits, vegetables, nuts and seeds, and certain types of oils and fats. Foods that are not part of the diet include grains, dairy products, refined sugar, and other processed foods.

Much of the enthusiasm for a Paleo-like diet as a treatment for MS comes from Dr. Wahls, who was diagnosed with MS in 2000 and by 2003 had to rely on a wheelchair to get around. Today, after changing her diet and making some other lifestyle changes, she can jog on a treadmill.

She chronicled her journey in a 2011 independent TEDx Iowa City talk and has published several books on the topic, including The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles.

The Paleo Diet for MS

In her TEDx talk, Wahls recommends consuming the following on a daily basis:

• 3 cups of green, leafy vegetables
• 3 cups of sulfur-rich vegetables, such as those from the cabbage family, the onion family, mushrooms, and asparagus
• 3 cups of deeply colored vegetables or fruits, such as beets, carrots, and berries
• Omega-3 fatty acids from wild fish and grass-fed meat

She also recommends consuming the following on a weekly basis:

• Organ meats, which are high in vitamins and minerals, including coenzyme Q10, or CoQ10, an antioxidant that may have heart-health benefits
• Seaweed, a good source of iodine

Wahls’s version of the Paleo diet does not include gluten (a protein found in wheat, barley, and rye), dairy, or eggs. It does allow nuts and seeds and some oils.

“Most Westernized diets are lacking in vitamins, nutrients, and fat that support brain health,” Wahls says. Also, many people with MS have a genetic tendency toward an aggressive immune response to gluten, casein (a protein in milk), and egg protein, she says.

A number of studies have found an association between celiac disease (gluten intolerance) and MS. Both are autoimmune diseases, and celiac disease sometimes causes neurological symptoms that may resemble symptoms of MS.

What to Expect When You Start the Paleo Diet

“People have the most success when they do it as a family unit,” says Wahls, warning that you'll probably feel worse during the first week of the diet but better by week two. Within a month, she says, you'll have more energy, more mental clarity, and less fatigue, and "will start to see how you're turning the corner on the disease.”

She cautions that following the diet will cost more than the groceries you are likely buying now, but that the payoff will be better health and fewer doctor's bills.

Research on the Paleo Diet

A small study from Wahls's lab published in the Journal of Alternative and Complementary Medicine in May 2014 showed that people with secondary-progressive MS who followed Wahls’s version of the Paleo diet, took nutritional supplements, and participated in an exercise and meditation program — among other interventions — were less fatigued at the end of 12 months. But the study involved only 10 people, of which 8 completed the study and 6 adhered to the diet and other parts of the study for the full 12 months.

A study that examined the use of alternative and complementary medicine among people with MS, published in the Journal of Community Health in February 2015, found that the study subjects following the Paleo diet did not meet the estimated average requirement for vitamins D and E set by the Food and Nutrition Board of the Institute of Medicine. But again, the number of people studied was very small.

In August 2016, the National Multiple Sclerosis Society (NMSS) announced it had committed more than $1 million to support a clinical trial at the University of Iowa, to be led by Wahls, to compare the ability of two popular diets to treat multiple sclerosis-related fatigue.

Study investigators planned to recruit 100 people with relapsing-remitting MS who experienced fatigue to enroll in the 36-week clinical trial. Participants would follow their usual diet for 12 weeks, then be randomly assigned to follow a low-saturated-fat diet (called the Swank diet) or a modified Paleolithic diet (the Wahls diet), for 24 weeks. Their health and activities would be extensively monitored during the study.

The Swank diet was created by the late Roy Swank, MD, PhD, a former head of the division of neurology at Oregon Health & Science University, in 1950, after he observed a higher incidence of MS in geographic areas that consumed more foods high in saturated fat. While there is no scientific proof that the Swank diet controls MS, some people who have followed it say it makes them feel better.

Should You Try the Paleo Diet?

Not everyone believes the Paleo diet is the “right” diet for everyone with MS. Many critics point out that there is limited scientific evidence that the diet alleviates MS symptoms or progression. And some people who have tried it have not seen their symptoms get better.

Lori S. Chong, RD, a nutritionist at Ohio State University's Wexner Medical Center in Columbus, says that the Paleo diet can have health benefits for anyone, including people with MS.

“Cutting out sugars and processed foods, reducing refined oils, and returning to natural sources of fats is smart," she says. "The diet is rich in fish, nuts and seeds, fruits, and vegetables, which are known to have health benefits.”

The typical American diet doesn’t hold a candle to the Paleo diet, she says, because “it contains very few fruits and vegetables, all grains are stripped of minerals and fiber, and processed foods are the norm.”

Rosalind Kalb, PhD, vice president of the NMSS's professional resource center and coauthor of Multiple Sclerosis for Dummies, says trying the Paleo diet is a case of “first do no harm.”

“Try it and see what happens," she says. "We have no evidence that the Paleo diet will affect the disease itself, but it does not appear to cause any harm.”