What we eat directly influences the functioning of our brain. 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 constitutes 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-hungry organ that requires specific nutrients. 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 resilient to stress, and maintains its cognitive abilities more effectively.

For people with MS, diet takes on particular importance as it can influence several aspects of the disease: the level of inflammation in the body, the health of myelin, the energy available for brain functions, and even potentially the composition of the gut microbiota that 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 and makes up about 30% of the brain's lipids. Adequate intake of omega-3s is associated with better cognitive function, reduced inflammation, and potentially better myelin health.

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

Food sources of omega-3s

• Fatty fish: Salmon, mackerel, sardines, herring, anchovies are the best sources of DHA and EPA that can be directly utilized by the body
• Flaxseed oil: Rich in ALA (precursor of omega-3s), to be consumed raw as a dressing
• Walnuts: Particularly English walnuts, an excellent plant source of omega-3s
• Chia and hemp seeds: To be added to smoothies, yogurts, or salads
• Canola oil: A good source of ALA for cooking at moderate temperatures

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 a 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 as obesity can worsen the progression of MS.

Pillars of the Mediterranean diet

• Fresh fruits: Consumed daily, preferably whole rather than juiced
• Whole grains: Whole grain bread, brown rice, quinoa, oats rather than refined grains
• Legumes: Lentils, chickpeas, dried beans several times a week
• Nuts and seeds: A handful daily for good fats and minerals
• Herbs and spices: Used generously 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 champions of antioxidants 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 one more element 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 low vitamin D levels are associated with more active disease. Vitamin D plays a role in regulating the immune system and may have neuroprotective effects.

Although vitamin D is primarily synthesized by the skin in response to sunlight, diet can help maintain adequate levels. However, for people with MS, supplementation is often necessary as dietary intake alone is rarely sufficient to reach the recommended optimal levels.

Food 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 strong taste
• Egg yolk: Modest intake but useful in the context of 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 conversely 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: Found in ultra-processed foods, fried foods, industrial pastries
• Excess red meat: High consumption is associated with more inflammation
• Ultra-processed foods: Rich in additives, salt, sugar, and bad fats
• Alcohol: To be consumed with 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 gut microbiota, the billions of bacteria that populate our intestines, in brain health and the functioning of the immune system. 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 individuals and may play a role in the disease. Nourishing a healthy and diverse microbiota through diet is therefore a potentially interesting strategy, although this area of research is still young.

Foods for a healthy microbiota

• Prebiotic fibers: Garlic, onion, leek, asparagus, banana nourish 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 nourish beneficial bacteria
• Legumes: Excellent source of fermentable fibers

Diet 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 better able 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 powers 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 small nutritional attentions can optimize your performance and cognitive progress.