The role of diet in Multiple Sclerosis

Ms Alice Saul

Ms Alice Saul

University of Tasmania, TAS

| Better treatments | Social And Applied Research | Scholarship | 2019 | Investigator Led Research |


There is great interest in the effects of dietary factors and their influence on MS disease progression. Many people with MS modify their diets to align with diets promoted as being beneficial for MS. However, there is a lack of solid evidence on the impact of many diets on disease progression of MS.

This PhD project aims to generate more evidence on the effect of dietary factors on MS progression. Ms Alice Saul is focusing on dietary patterns and diet quality, to determine whether MS outcomes including disability progression, relapses and symptom severity are impacted by diet.

Project Outcomes

Ms Saul has examined the role of diet in MS using the AusLong study. This is a study of a group of people who were recruited soon after they had initial symptoms suggesting they would go on to develop MS. This group was then followed annually for 10 years. 

Specifically, Ms Saul has examined whether diet quality, diet inflammatory index and dietary acid load are associated with fatigue, anxiety and depression.  

The dietary inflammatory index assesses the potential of a diet to cause chronic inflammation. It includes examination of omega-3 and vitamin D intake, to which a higher intake of both has been consistently associated with benefitting MS activity and progression in observational research. The dietary acid load refers to acid-inducing foods, which has been linked to worsening mental health.  

Ms Saul found that there are some associations between higher diet quality and lower levels of depression and anxiety. She also found that a pro-inflammatory diet is associated with higher levels of depression and anxiety, but not fatigue.  Additionally, a high dietary acid load potentially has a long-term influence on the level of depression in people with MS. The evidence is less convincing for anxiety and fatigue.  

Ms Saul has also analysed diet quality and compared it with magnetic resonance imaging (MRI) outcomes over 10 years. She has found that a pro-inflammatory diet in people with MS is associated with an increased rate of relapse and increased lesion volume on MRI in early MS.   

This research has been presented at the world’s largest annual international conference in MS, ECTRIMS/ACTRIMS, in 2020 and 2021 in addition to national conferences, and the work has been published in esteemed journals. 

The data generated in this project has provided novel insights into the role of diet in MS progression and inflammatory outcomes over a 10-year disease period, starting at the earliest manifestation of MS. The findings, together with other observational studies will be useful to guide the design choices for future randomised clinical trials of diet in MS and will contribute to the development of evidence-based dietary advice for people with MS to enhance their quality of life. 


  • A Saul, BV Taylor, L Blizzard, WH Oddy, YC Probst, LJ Black, AL Ponsonby, SA Broadley, J Lechner-Scott, I van der Mei (2022) Associations between diet quality and depression, anxiety, and fatigue in multiple sclerosis. Mult Scler Relat Disord. Jul; (63) 10390
  • Alice M Saul, Bruce V Taylor, Leigh Blizzard, Steve Simpson-Yap, Wendy H Oddy, Nittin Shivappa, James R Hébert, Lucinda J Black, Anne-Louise Ponsonby, Simon A Broadley, Jeanette Lechner-Scott, Ingrid van der Mei, Ausimmune/AusLong Investigators (2023) A pro-inflammatory diet in people with Multiple Sclerosis is associated with an increased rate of relapse and increased FLAIR lesion volume on MRI in early multiple sclerosis, a prospective cohort study. Mult Scler. May; (6) 13524585231167739
  • Saul A, Taylor BV, Blizzard L, Simpson-Yap S, Probst YC, Black LJ, Ponsonby AL, Broadley SA, Lechner Scott J, van der Mei I (2023) Long-term dietary acid load is associated with depression with fatigue and anxiety in multiple sclerosis. Mult Scler Relat Disord. Jan; 69:104415

Updated 31 March 2023

Updated: 03 January, 2019

Stages of the research process

Fundamental laboratory

Laboratory research that investigates scientific theories behind the possible causes, disease progression, ways to diagnose and better treat MS.

Lab to clinic timeline: 10+ years

Research that builds on fundamental scientific research to develop new therapies, medical procedures or diagnostics and advances it closer to the clinic.

Lab to clinic timeline: 5+ years
Clinical Studies
and Clinical Trials

Clinical research is the culmination of fundamental and translational research turning those research discoveries into treatments and interventions for people with MS.

Lab to clinic timeline: 1-5 years


Grant Awarded

  • Postgraduate Scholarship

Total Funding

  • $78,000


  • 3 years

Funding Partner

  • The Penn Foundation
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The role of diet in Multiple Sclerosis