Diet and Multiple Sclerosis: Nourishing Your Brain to Support Cognitive Functions

What we eat directly influences our brain's functioning. For people with multiple sclerosis, adopting a neuroprotective diet is a concrete lever to support cognitive functions and potentially influence the progression of the disease. Without claiming to replace medical treatments, an adapted diet is a valuable complement to the overall management of MS and cognitive stimulation with programs like EDITH and JOE.

The link between diet and brain health

The brain is an extraordinarily energy and nutrient-hungry organ. Although it represents only 2% of body weight, it consumes about 20% of the body's total energy. This significant energy demand means that the quality of our diet directly impacts brain performance. A well-nourished brain functions better, is more resistant to stress, and maintains its cognitive capacities more efficiently.

For people with MS, diet is of particular importance as it can influence several aspects of the disease: the level of inflammation in the body, the health of the myelin, the energy available for brain functions, and even potentially the composition of the intestinal microbiota, which communicates with the brain via the gut-brain axis.

Omega-3s: essential fats for the brain

Omega-3 fatty acids, particularly DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid), are absolutely essential nutrients for the brain. DHA is a major structural component of brain cell membranes, representing about 30% of brain lipids. Adequate omega-3 intake is associated with better cognitive function, a reduction in inflammation, and potentially better myelin health.

Studies on omega-3s in MS are promising. Several researches suggest that omega-3 supplementation could reduce inflammation, decrease relapse rate in some patients, and improve certain symptoms. Although these results require confirmation by larger studies, increasing omega-3 consumption is a risk-free and potentially beneficial nutritional strategy.

Dietary sources of omega-3s

• Fatty fish: Salmon, mackerel, sardines, herring, anchovies are the best sources of DHA and EPA directly usable by the body
• Flaxseed oil: Rich in ALA (omega-3 precursor), to be consumed raw as dressing
• Nuts: Particularly walnuts, excellent plant source of omega-3s
• Chia and hemp seeds: To be added to smoothies, yogurts, or salads
• Canola oil: Good source of ALA for moderate-temperature cooking

The Mediterranean diet: a protective nutritional model

The Mediterranean diet is regularly cited as one of the most beneficial dietary models for brain health. Characterized by a high consumption of fruits, vegetables, whole grains, legumes, olive oil, fish, and moderate consumption of red meat, this diet has shown protective effects against cognitive decline in many studies.

For people with MS, the Mediterranean diet offers several advantages: it is naturally anti-inflammatory due to its richness in antioxidants and omega-3s, it promotes a healthy gut microbiota, and it is associated with better weight control, an important factor because obesity can worsen MS progression.

The pillars of the Mediterranean diet

• Fresh fruits: Consumed daily, preferably whole rather than in juice
• Whole grains: Whole bread, brown rice, quinoa, oats rather than refined grains
• Legumes: Lentils, chickpeas, dry beans several times a week
• Nuts and seeds: A daily handful for good fats and minerals
• Herbs and spices: Generously used for their antioxidant properties
• Limited red meat: Occasional, preferring poultry and fish

Antioxidants: protecting the brain from oxidative stress

Oxidative stress, caused by an excess of free radicals, is involved in many neurological diseases including MS. Free radicals can damage brain cells and myelin. Antioxidants present in the diet help neutralize these free radicals and protect brain structures. A diet rich in antioxidants is therefore particularly relevant for people with MS.

Main sources of antioxidants

• Red fruits: Blueberries, raspberries, blackberries are antioxidant champions with their anthocyanins
• Colorful vegetables: Spinach, kale, broccoli, peppers, tomatoes are packed with antioxidant vitamins
• Dark chocolate: Rich in flavonoids, to be consumed in moderation (minimum 70% cocoa)
• Green tea: Excellent source of catechins, powerful antioxidants
• Turmeric: Curcumin has remarkable anti-inflammatory and antioxidant properties
• Garlic and onion: Rich in sulfur compounds with protective properties

Since I adopted a more colorful and varied diet, rich in vegetables and good fats, I feel a difference in my energy and mental clarity. It's not a miracle, but it's another tool in my toolbox for living better with my MS.

Marie-Pierre, 47 years old, MS for 10 years

Vitamin D: a particularly important nutrient

Vitamin D occupies a special place in the context of MS. Numerous studies have shown that people with MS often have lower levels of vitamin D than the general population, and that a low vitamin D level is associated with more active disease. Vitamin D plays a role in regulating the immune system and could have neuroprotective effects.

While vitamin D is mainly synthesized by the skin under the effect of sunshine, diet can help maintain adequate levels. However, for people with MS, supplementation is often necessary because dietary intake alone is rarely sufficient to reach the recommended optimal levels.

Dietary sources of vitamin D

• Fatty fish: Salmon, mackerel, herring are the best dietary sources
• Cod liver oil: Very rich in vitamin D but with a pronounced taste
• Egg yolk: Modest contribution but useful in a balanced diet
• Sun-exposed mushrooms: Some mushrooms synthesize vitamin D
• Fortified foods: Some milks, yogurts, and cereals are fortified with vitamin D

Foods to limit or avoid

While some foods support brain health, others can promote inflammation and potentially worsen MS symptoms. Without falling into obsession or guilt, it is wise to limit the consumption of certain pro-inflammatory foods.

Pro-inflammatory foods to reduce

• Added sugars: Sodas, candies, industrial pastries promote inflammation and blood sugar spikes
• Trans and saturated fats: Present in ultra-processed foods, fried foods, industrial pastries
• Excessive red meat: High consumption is associated with more inflammation
• Ultra-processed foods: High in additives, salt, sugar, and bad fats
• Alcohol: To be consumed in great moderation as it can interact with treatments and affect the nervous system

The gut-brain axis: the role of the microbiota

A major discovery in recent years is the importance of the intestinal microbiota, these billions of bacteria that inhabit our intestines, in brain health and immune system functioning. The microbiota communicates with the brain via the gut-brain axis and influences inflammation, mood, and even cognitive functions.

In MS, research suggests that the microbiota of affected individuals differs from that of healthy people and could play a role in the disease. Feeding a healthy and diverse microbiota through diet is thus a potentially interesting strategy, although this research field is still young.

Foods for a healthy microbiota

• Prebiotic fibers: Garlic, onion, leek, asparagus, banana feed the good bacteria
• Fermented foods: Yogurt, kefir, sauerkraut, kimchi provide natural probiotics
• Plant diversity: Aim for 30 different plants per week to diversify the microbiota
• Whole grains: Their fibers feed beneficial bacteria
• Legumes: Excellent source of fermentable fibers

Healthy eating and cognitive stimulation: a winning synergy

Healthy eating and cognitive stimulation form a complementary duo to protect the brain in MS. A well-nourished brain is more apt to benefit from cognitive training with programs like EDITH and JOE. Conversely, cognitive stimulation can amplify the protective effects of a good diet by strengthening neural connections and cognitive reserve.

Think of your diet as the fuel that feeds cognitive training sessions. A balanced breakfast before a morning session of JOE, a healthy snack of nuts for an omega-3 boost before your exercises with EDITH: these little nutritional attentions can optimize your performance and cognitive progress.