7 Diet and Exercise Tips to Improve Multiple Sclerosis Symptoms

Have you ever eaten extra healthy for a few days? Meals consisted of green leafy vegetables, lots of fruit, lean protein, wholesome grains, and heart-healthy fats. After following a nutrient-dense diet for several days, you may have noticed improved energy levels, less brain fog, and better sleep. This is because the foods you eat have a significant impact on overall health, especially in patients with multiple sclerosis. 

Multiple sclerosis is a neurodegenerative autoimmune disease. The body mistakenly attacks healthy myelin cells around the spinal cord and brain. This results in symptoms like fatigue, changes in vision, mobility issues, pain, cognitive dysfunction, and even depression. 

Ongoing research and patient experience show that specific diets accompanied by a balanced exercise program can relieve many multiple sclerosis symptoms. For some, making a few changes to food choices is enough to feel some sense of improvement. For others, a new diet strategy may be a better option to reduce existing symptoms and prevent new ones from popping up. 

Specialty Diets for Multiple Sclerosis

Nutrition plays an important role in regulating and improving health. When you have a chronic condition like multiple sclerosis, diet is key in managing symptoms and preventing episodes. For many years, researchers have found a connection between diet, inflammation, and chronic illness. Studies show that following an anti-inflammatory diet can help reduce disease symptoms and prevent illness. 

Ketogenic Diet

The ketogenic diet is a low-carb, high-fat eating plan that has historically been used to help treat different neurological, metabolic, and mental health conditions. In recent years, the keto diet has gained special attention as a weight-loss method. While people can lose weight while following a keto diet, its roots began in the medical field. This type of dieting was originally used in the 1920s to treat epilepsy. After seeing such success with the diet, it was then tested on patients with diabetes, cancer, and Alzheimer’s disease. Now, keto is widely used as a supplemental treatment method for other diseases like multiple sclerosis.

The keto diet structures food intake by percentages. To follow the diet, about 70-80% of daily calories should come from fat, 10-20% from protein, and 5-10% from carbohydrates. By consuming very low amounts of carbs, the body is deprived of glucose which is one of the main energy sources. Ketosis is the process that occurs when the body doesn’t have enough carbs to use for energy. It burns fat into energy called ketones, which the body uses for fuel in place of carbs. 

Studies show that keto is safe for people with multiple sclerosis and may help reduce some symptoms associated with the condition. A 2022 study found that MS patients who followed a keto diet experienced less fatigue, improved symptoms of depression, and improved quality of life. They also found that patients had reduced levels of inflammatory markers. 

Researches believe the keto diet can help patients with multiple sclerosis because it can reduce inflammation and can help with weight loss and management. They also believe that people with MS may respond better to ketones as an energy source compared to glucose. Multiple sclerosis is a neurodegenerative disease, meaning never cells lose function over time. While they don’t know exactly why, one theory is that the mitochondria aren’t working correctly and don’t utilize glucose well. Instead, they function better using ketones. A 2021 study found that MS patients on a keto diet had lower levels of neurodegeneration compared to those not on a keto diet.  

Paleo Diet

The Paleolithic diet, or paleo diet, focuses on the idea that eating like our ancestors did in the paleolithic era aligns with our genetics and promotes good health. The theory suggests that both acute and chronic diseases common in society today are associated with the food revolution. Eating grains, dairy, processed foods, and foods high in sugar, sodium, and fat can lead to disease. 

Instead of focusing on a certain macronutrient count or daily percentage, the paleo diet suggests eating a mix of foods that can only be hunted, fished, or gathered. This means the diet consists of meats, fish, fruits, vegetables, and some nuts and seeds. 

A small 2016 study analyzed the impact of a modified paleo diet in addition to exercise, stretching massage, meditation, and electric stimulation of muscles in patients with secondary progressive MS over a 12-month period. They found a significant improvement in fatigue scores and mood. Another small study of 34 randomized relapse remitting MS patients found similar outcomes. They found that patients who followed a paleo diet saw improvements on the Fatigue Severity Scale, Multiple Sclerosis Quality of Life-54, and on time to complete the 9-hole Peg Test. Those who didn’t follow a paleo diet showed no improvements on any of the scales or tests.  

Wahls Diet

The Wahls diet is one of the most popular among the MS community. It was created by Terry Wahls, a clinical professor of medicine at the University of Iowa. Dr. Wahls was diagnosed with relapse remitting multiple sclerosis in 2000 and by 2003 had transitioned to secondary progressive multiple sclerosis. After years of research, Dr. Wahls was able to redesign a diet that allowed her to get the nutrients needed to support brain function and motor skills. 

She discovered that a nutrient-rich paleo diet, that is also high in specific vitamins, minerals, antioxidants, and essential fatty acids can reduce MS symptoms. This particular diet recommends focusing on:

  • Deeply pigment vegetables
  • Green leafy vegetables
  • Sulfur-rich vegetables like mushrooms and asparagus
  • Berries, especially wild blueberries
  • Meats and fish
  • Healthy fats from plants and animals, like beef and coconut

A recent study looked at the impact of the Wahls or Swank diet in 77 relapse remitting MS patients over the course of 36 weeks. Both groups were similar in characteristics like age, gender, and weight, but had clinically significant differences in fatigue levels. 

After the 12 and 24-week mark, patients in the Wahls groups saw a significant reduction in fatigue levels using the Fatigue Severity Scale. They also saw an improved mental and physical quality of life (68.4% and 60.5% respectively). 

When considering the Wahl’s diet, or any diet, it’s important to recognize any limitations that come along with the diet. This includes any potential vitamin or mineral deficiencies, which can happen when cutting out or limiting any one food group. Speak with your doctor about a carefully planned and well-balanced diet to ensure you are getting all the nutrients you need for your body.  

Types of Exercise for Multiple Sclerosis

Multiple sclerosis often leads to a variety of physical symptoms. Some common physical symptoms in MS patients include:

  • Muscle weakness
  • Gait abnormalities
  • Balance problems
  • Spasticity
  • Numbness and tingling
  • Pain

There are times when symptoms become so debilitating, that daily activities like doing the laundry or grocery shopping can be nearly impossible. When symptoms are exacerbated, patients will often decrease physical activity for the fear of making them worse. But lack of exercise can actually lead to increased frequency and more severe symptoms. 

Over exercise or exercise that is too intense can cause too much inflammation and stress on the body, which can also make symptoms worse. It’s important to choose the right type of exercise to make sure your body is getting the amount and intensity of exercise to help it heal.

Weight Training

Weight training has long been studied as one of the most beneficial forms of exercise to improve overall health. It’s described as any physical movement that uses weight, either body weight or with equipment like dumbbells and resistance bands, to build muscle, strength, and endurance. 

Some benefits of weight training include:

  • Improved strength 
  • Increased metabolism 
  • Decreased body fat
  • Decreased risk of falls
  • Lower risk of injury
  • Improved heart health
  • Improved mobility and flexibility

While patients with MS may think they can’t do weight training because of their symptoms and limitations or that the benefits don’t apply to them, science proves otherwise. Research shows that patients with MS who follow a conventional weight training program saw a significant increase in strength, better walking abilities, and less fatigue and disability.

A small 2004 study looked at the impact of weight training in 8 multiple sclerosis patients during an 8-week, progressive resistance training program. Participants trained twice a week and increased the number of repetitions and resistance per exercise every week. Researchers used MRI images of the thigh, walking speed, and self-reported fatigue and disability to measure the progress of the participants. After the 8 weeks, they found that both strength and walking speed significantly increased. Patients reported feeling much less fatigued and disabled.  

Low-Impact Exercises

Low-impact exercise is a group of gentle exercises that are easy on the joints, muscles, and cardiovascular system. Specific low-impact exercises that have been shown to be beneficial to patients with MS focus on mobility, flexibility, and balance. 


Pilates is a series of movements and exercises based on whole-body synchronization. It aims to strengthen the muscles while improving postural alignment and flexibility. While it generally targets the core, it works the entire body because everything is connected to the core. Specific exercises are used to target different areas of the body and can be performed with or without equipment.

Studies have found that pilates has multiple benefits for MS, these include

  • Strengthened muscles that support the joints
  • Improved balance, stability, and flexibility
  • Increased Body awareness
  • Improved walking distance
  • Reduced pain and fatigue
  • Decreased risk of falls

2018 study looked at how pilates affected walking distance and Timed Up and Go test. The study included 30 MS participants who were not restricted to a wheelchair or scooter. Participants were randomized to receive pilates twice a week and once-weekly massage therapy, or once-weekly message therapy.  At the end of the 12 weeks, the pilates group saw a 15% increase in mean walking distance and a decrease in the Timed Up and Go test. 


Yoga is similar to pilates in that it focuses on whole-body movement, but it emphasizes the mind and body practice. It revolves around movement, meditation, and breathing techniques to improve physical mental, and physical well-being. Some benefits of yoga include:

  • Increased strength
  • Greater flexibility
  • Improved breathing 
  • Reduced stress, anxiety, and pain
  • Better sleep

Studies show that 8-week yoga programs and mindfulness interventions can significantly improve multiple sclerosis symptoms and quality of life. One study looked at the impact of yoga on cortisol levels in MS patients. At the end of the 8 weeks of yoga, researchers found participants saw an increase in adrenocorticotrophic hormone (ACTH) levels and a significant decrease in cortisol, a stress hormone. Another study found that MS patients who followed an 8-week yoga program saw improvements in muscle strength, balance, walking ability, and concentration. 

While any type of yoga can be beneficial for MS, it’s important to recognize there are some types of yoga that may not be safe for some patients. Hatha, Restorative, Kundalini, and Iyengar are generally the safest types because they are less strenuous on the body. Bikram or hot yoga may be dangerous because of the high heat, which can make it difficult to breathe deeply. When deciding what type of yoga to do, it’s important to discuss it with a health care professional so you choose the type that is going to be most beneficial for you

Aerobic Exercise

Cardiovascular exercise, or aerobic exercise, is often referred cardio. This type of exercise gets your heart pumping quickly. As a result, the blood pumps to the rest of your body faster delivering more oxygen to your lungs. The harder and more intense the exercise, the more oxygen your body needs to keep up with the activity. Your body also uses stored nutrients like carbohydrates, proteins, and fats, to help keep you energized throughout the duration of the exercise session. 

Some common types of aerobic exercise include:

  • Running or jogging
  • Biking
  • Swimming
  • Rowing
  • Dancing 
  • Sports like basketball, soccer, and hockey

Studies show that MS patients who do cardio regularly had improved emotion regulation, better bladder and bowel function, reduced fatigue, and more flexibility. A 2013 study examined how aerobic exercise affected 9 individuals for a course of 5 months. For the first 2 months, MS participants performed aerobic activity twice a week for 30 minutes at a time, followed by 3 months of instructed physical activity. They then returned for a follow-up evaluation. Researchers found that participants experienced significant improvements in mood and quality of life after 2 months of structured exercise. 

Finding the Right Balance

Being mindful of diet and physical activity is vital in every person’s life and has been proven to be even more so for those who have multiple sclerosis. Before making any lifestyle changes, please consult your doctor to determine if it is the right change for you. Some diets may cause vitamin deficiencies if not supplemented properly, which can make symptoms worse. Others may be more difficult to follow for the long term. Your doctor can help monitor your health as you implement a new diet and exercise schedule to ensure you are progressing forward. 

It’s important to remember that these changes may take time to have an effect. If you don’t notice improvements in a few days, be patient with yourself. It may take a few weeks to feel a significant effect. Remember, you are not alone on your MS journey. If you are struggling with symptom relief, connect with PatientsLikeMe members to learn about what they have done to improve their symptoms and boost their overall health. 

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