Scientists tested three different eating plans on people with multiple sclerosis (MS) - fasting, ketogenic (very low carb), and anti-inflammatory diets. After 18 months, they found that all three diets helped reduce inflammation in the body and improved some MS symptoms. The ketogenic diet showed the most promise for reducing brain inflammation markers. While the results are encouraging, this was a small study and more research is needed to confirm these benefits for MS patients.

The Quick Take

  • What they studied: Whether special diets (fasting, very low carb, or anti-inflammatory eating) could help people with multiple sclerosis by reducing inflammation in their bodies
  • Who participated: Adults diagnosed with multiple sclerosis who were randomly assigned to follow one of three different eating plans for 18 months
  • Key finding: All three diets appeared to reduce inflammation markers in the blood, with the ketogenic diet showing the strongest effects on brain-related inflammation
  • What it means for you: If you have MS, working with your doctor to try one of these eating approaches might help reduce inflammation, but don’t change your medical treatment without professional guidance

The Research Details

This was a randomized controlled trial, which is considered the gold standard for testing treatments. Researchers randomly assigned MS patients to follow one of three different diets for 18 months. They measured inflammation markers in blood samples and tracked MS symptoms throughout the study. The three diets were: intermittent fasting (eating only during certain hours), ketogenic diet (very low carbohydrates, high fat), and anti-inflammatory diet (focusing on foods that fight inflammation like fish, vegetables, and whole grains).

Random assignment helps ensure that any improvements seen were likely due to the diets themselves, not other factors. The 18-month follow-up period was long enough to see meaningful changes in inflammation and symptoms, since dietary changes often take months to show their full effects.

The study used objective blood tests to measure inflammation rather than relying only on how patients felt. However, the sample size appears to be relatively small, which means the results need to be confirmed in larger studies before making strong recommendations.

What the Results Show

All three diets led to reductions in inflammatory markers in the blood compared to baseline measurements. The ketogenic diet showed the most dramatic changes, particularly in markers related to brain inflammation that are important in MS. Participants following the ketogenic diet had significant decreases in inflammatory proteins that are known to worsen MS symptoms. The anti-inflammatory diet also showed benefits, with steady improvements in multiple inflammation markers over the 18-month period. Intermittent fasting produced more modest but still meaningful reductions in overall body inflammation.

Beyond inflammation markers, some participants reported improvements in energy levels and overall well-being. The ketogenic diet group showed the best adherence rates, meaning people found it easier to stick with long-term. There were no serious adverse effects reported from any of the three diets, though some participants experienced initial adjustment periods with fatigue or digestive changes.

These findings align with previous smaller studies suggesting that dietary interventions can influence MS progression. However, this appears to be one of the longest follow-up studies comparing multiple dietary approaches head-to-head in MS patients, providing stronger evidence than previous research.

The study size was relatively small, making it harder to draw definitive conclusions. Participants knew which diet they were following, which could influence their reported symptoms. The study also didn’t compare these diets to standard MS medications, so it’s unclear how dietary changes stack up against proven medical treatments.

The Bottom Line

People with MS may benefit from discussing these dietary approaches with their healthcare team, particularly the ketogenic or anti-inflammatory diets which showed the strongest effects. However, these diets should complement, not replace, standard MS treatments. Start with small changes and work with a nutritionist familiar with MS if possible.

MS patients looking for additional ways to manage their condition should pay attention to these results. People with other autoimmune conditions might also find this relevant, though the research was specific to MS. Those with eating disorders or certain medical conditions should be cautious about restrictive diets like ketogenic eating.

Based on this study, meaningful changes in inflammation markers appeared within 3-6 months, with continued improvements over 18 months. Don’t expect immediate results - dietary changes for chronic conditions require patience and consistency.

Want to Apply This Research?

  • Track daily carbohydrate intake if trying ketogenic approach, or log anti-inflammatory foods like fatty fish, leafy greens, and berries consumed each day
  • Start by replacing one processed food daily with an anti-inflammatory option like nuts, olive oil, or colorful vegetables, and gradually build more structured eating patterns
  • Log energy levels, mood, and any MS symptoms daily to identify patterns with dietary changes over 3-6 month periods, sharing data with healthcare providers

This information is for educational purposes only and should not replace medical advice. People with multiple sclerosis should consult their healthcare provider before making significant dietary changes or altering their treatment plan.