Many members of MyMSTeam ask each other about the impact of diet and lifestyle on multiple sclerosis (MS). Can changing how you eat and live actually improve MS symptoms? One prominent figure in this field is Dr. Terry Wahls, a clinical professor of medicine. In the early 2000s, she was diagnosed with secondary progressive MS and required a wheelchair. To supplement her treatment plan and support her brain health, she designed the Wahls Protocol — a diet and lifestyle program.

Today, Dr. Wahls no longer needs a wheelchair. She bicycles to work at the University of Iowa and leads clinical trials on her protocol — including the Wahls Protocol diet — for many chronic (long-term) conditions, including MS. Recent research suggests that the Wahls Protocol diet may help improve MS-related symptoms, including fatigue and reduced quality of life, even compared with other MS-related diets.

MyMSTeam interviewed Dr. Wahls about her program, asking how she uses it for herself and the people she treats. Based on that conversation, here are some tips for following the Wahls Protocol diet and lifestyle program.

1. Avoid Sugar

On the Wahls Protocol diet, refined carbs, sugar, and artificial sweeteners should be avoided. Limiting sugar helps prevent inflammation. Artificial sweeteners can damage the gut microbiome (helpful bacteria in your digestive system) and are linked to hunger and weight gain, which can worsen MS symptoms such as fatigue (extreme tiredness that doesn’t improve with rest).

If you have a sweet tooth, this adjustment can take time. “Our brains crave sugar, salt, fat, and inactivity,” Dr. Wahls explained. “Processed foods have been designed by food scientists to make products that are incredibly tasty — addictive — and that create cravings that may result in some withdrawal symptoms if you stop.” To manage these cravings, Dr. Wahls said, “we have to rewire part of our brains — rewire some automatic activities.”

Reducing your intake of processed foods is a good first step toward eating less sugar. If you drink a lot of soda or juice, switching to water should be a top priority. Reading food labels, being mindful of your choices, and experimenting with recipes on the Wahls’ Diet App will help you find ways to fill your plate with ingredients that are naturally low in sugar.

2. Get Rid of Gluten

The Wahls Protocol recommends avoiding gluten, a protein found in wheat, barley, and rye. Gluten-free diets have been associated with improved brain and nerve health for people with MS. Dr. Wahls’ advice: “No gluten-containing grains. Eat nonstarchy vegetables. Rice is OK if you have to have grains, but cauliflower rice or cabbage would be better.”

Although there are naturally gluten-free grains and flours, the Wahls Protocol diet doesn’t include these. Legumes (like beans and lentils) are also off-limits. Instead, choose sprouted nuts and seeds. Dr. Wahls also mentioned fresh or frozen riced cauliflower as an option.

Keep in mind that not everyone with MS reacts the same way to gluten, legumes, or other excluded foods. Some people may benefit from cutting them out completely, and others may tolerate these foods without worsening symptoms. A phased elimination plan, guided by a registered dietitian, can help you identify your triggers without unnecessary restrictions.

3. Replace Dairy With Healthy Fats

Studies show that cow’s milk may raise the risk of new or progressing MS. “Swap out dairy and use coconut milk or almond milk,” Dr. Wahls advised. Try cooking with other fats like coconut oil, ghee (clarified butter), and animal fats from sources other than cows.

Avoid foods such as ice cream, cheese, and sour cream, which are high in saturated fat and can contribute to inflammation. Instead, aim to eat foods rich in healthy fats, like avocados, which support overall health.

4. Choose More Colorful Produce

After cutting out sugar, gluten, and dairy, you might wonder what’s left to eat. The Wahls Protocol Diet allows plenty of veggies. Studies show that eating more fruits and vegetables — while cutting back on gluten and dairy — can quickly improve mood for people with MS.

Dr. Wahls encouraged focusing on leafy greens and sulfur-rich vegetables — “more cabbage, onion, garlic, and mushrooms.”

“I discovered that I could not get enough leafy greens,” she said. “Within three months, my pain [from trigeminal neuralgia, which causes severe facial pain in some people with MS] was gone. My brain fog was gone. My fatigue — gone.”

Choosing “deeply pigmented vegetables and berries like carrots, beets, blueberries, and blackberries” is an important step, she said: “My preference is to remove the foods that are most inflammatory, and then be sure that you have the foods that give you the building blocks your brain needs to make myelin, turn off the inflammation, and fuel the mitochondria.”

Dr. Wahls recommended eating about nine daily servings of fruits and vegetables — the bulk of your diet.

5. Include Enough Protein

Animal proteins may be important for health, but processed meats like hot dogs and cold cuts aren’t allowed on the Wahls Protocol diet. To get enough protein, Dr. Wahls advised eating “6 to 12 ounces of grass-fed meat or wild-caught fish for protein per day,” adding that “organ meats like liver are good two days per week.”

Can You Eat Eggs on the Wahls Protocol?

Eggs are also a good source of protein, but they’re not included in the Wahls Protocol. Eggs are considered to promote inflammation and potentially worsen MS symptoms. Since avoiding eggs and other foods in this diet can increase your risk of a vitamin B12 deficiency, Dr. Wahls suggested taking a daily B12 supplement.

If you’re worried about getting enough protein and vitamins, it’s a good idea to speak with your healthcare provider or a nutritionist.

6. Build Healthy Habits

“It’s more than a diet — it’s a diet and lifestyle,” said Dr. Wahls. She does not suggest that people with MS stop taking their medications and rely only on her diet. Although she has been off all disease-modifying drugs since 2008 (with her neurologist’s approval), Dr. Wahls still takes low-dose gabapentin (Neurontin) for trigeminal neuralgia.

There is strong clinical evidence that people with MS who consistently take disease-modifying medications have better health outcomes. However, more neuroscientists and neurologists (doctors who specialize in the brain and nervous system) agree that improving lifestyle habits, including diet, is key for brain health and overall longevity.

In her interview with MyMSTeam, Dr. Wahls encouraged everyone living with MS to ask their healthcare providers to support their efforts to make lifestyle changes. Big changes can feel overwhelming, so it helps to focus on one habit at a time. Small, steady steps — such as adding a fruit or vegetable to your diet, cutting back on sugary drinks, or walking for five minutes a day — can build momentum and help you avoid burnout.

If you think the Wahls Protocol could help you manage your MS, talk with your provider.

7. Consider Participating in a Clinical Trial

Dr. Wahls credited diet and lifestyle changes with significantly improving her MS symptoms. She said she hopes that clinical trials studying the Wahls Protocol and other diet and lifestyle interventions — including one funded by the National Multiple Sclerosis Society — will help make these options part of standard treatment for MS and other chronic conditions.

Although the benefits of the Wahls Protocol are promising, new studies are emerging to better understand exactly how much these lifestyle changes may improve MS symptoms. For example, Dr. Wahls announced that an upcoming systematic review will gather current findings on how dietary changes affect inflammation in people with MS. The connection between diet and MS is an active field of research, with more to learn in the future.

You can find more information about the Wahls Protocol at TerryWahls.com. You can also sign up for emails and a downloadable cheat sheet of the diet. If you’re living with other inflammatory conditions like fibromyalgia or long COVID, consider learning more about joining a current clinical trial through the Wahls Lab. If you have questions, you can also email the study team.

Talk With Others Who Understand

On MyMSTeam, the social network for people with multiple sclerosis and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Have you made changes to your diet or lifestyle to control your MS symptoms? If you’ve tried the Wahls Protocol, what did you think of it? Share your experience in the comments below, or start a conversation by posting on your Activities page.