Dietary factors to reduce MS risk and progression

Dr Lucinda Black

Curtin University, WA

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


MS is a chronic, inflammatory condition that affects the brain and spinal cord, causing lesions and affecting muscle strength and movement. Loss of the myelin sheath around the nerves in the brain and spinal cord (demyelination) impairs the conduction of nerve impulses. Certain lifestyle factors, such as low sun exposure, low vitamin D levels and smoking have been shown to increase the risk of developing MS. Although nutritional factors have long been of interest in MS, the link between diet and MS remains unclear.

This project used dietary intake information and blood samples from people with early signs and symptoms of MS, available through studies in Australia and in the US, to investigate whether specific foods or nutrients can help reduce the risk of disease onset and progression in MS. The impacts of dietary factors such as following a Mediterranean diet, consuming foods with anti-inflammatory properties, blood levels of omega-3 polyunsaturated fatty acids and other fats, ultra-processed foods and dairy foods were assessed.

Progress to Date

To examine the relationship between diet and MS risk, the researchers studied the first clinical diagnosis of demyelination in the brain and spinal cord (FCD), which is a common precursor to MS. They found that a healthy dietary pattern (high in poultry, fish, eggs, vegetables, legumes) and a Mediterranean diet, including unprocessed red meat, was associated with reduced likelihood of FCD. In contrast, and ultra-processed food intake was associated with higher likelihood of FCD, and a more pro-inflammatory diet was associated with higher likelihood of FCD in women. Total intake of dairy foods was not associated with FCD, but higher consumption of yoghurt was associated with lower risk of FCD.

The researchers also looked at the association of diet with the risk of relapse in early MS, and with disability. A healthy dietary pattern was associated with lower relapse risk in the 5 years following FCD. There was no association between a Mediterranean diet and relapse rate, and no association between dairy consumption and relapse rate or disability. A proinflammatory diet was associated with an increased relapse rate and size of MS lesions in early MS. Higher consumption of ultra-processed foods was also associated with higher relapse rate. These findings suggest that diet may play a role in MS onset and disease progression.

The team also explored the challenges faced by adults with MS when making dietary decisions, and their perceived dietary education needs. People with MS are highly motivated to make dietary changes and improve their health. Interestingly, in this vein, the team looked at associations between omega-3 polyunsaturated fatty acids in the blood, fish oil supplement use and fish consumption, and first clinical diagnosis of central nervous system demyelination (FCD). Having an FCD is associated with increased use of fish oil supplements, suggesting a behaviour change in response to this health event.

Results from this project so far provide new insights into the role of diet in the risk of MS onset. Going forward, further research could also provide evidence that could lead to the development of a clinical trial to test appropriate dietary strategies to reduce progression in the early stages of the disease. The results of this study could also potentially lead to evidence-based dietary recommendations for people with MS and those at high risk of MS.


  • Tiller C, Black LJ, Ponsonby AL, Taylor B, van der Mei I, Clarke MW, Lucas RM; Ausimmune Investigator Group. Vitamin D metabolites and risk of first clinical diagnosis of central nervous system demyelination. J Steroid Biochem Mol Biol. 2022 Apr;218:106060. doi: 10.1016/j.jsbmb.2022.106060.
  • Russell RD, Black LJ, Begley A. Nutrition Education Programs for Adults with Neurological Diseases Are Lacking: A Scoping Review. Nutrients. 2022 Apr 10;14(8):1577. doi: 10.3390/nu14081577.
  • Dieu DYR, Dunlop E, Daly A, Lucas RM, Probst Y, Black LJ. Total Dairy Consumption Is Not Associated With Likelihood of a First Clinical Diagnosis of Central Nervous System Demyelination. Front Neurol. 2022 May 13;13:888559. doi: 10.3389/fneur.2022.888559.
  • Saul A, Taylor BV, Blizzard L, Simpson-Yap S, Oddy WH, Probst YC, Black LJ, Ponsonby AL, Broadley SA, Lechner-Scott J, van der Mei I. Associations between diet quality and depression, anxiety, and fatigue in multiple sclerosis. Mult Scler Relat Disord. 2022 Jul;63:103910. doi: 10.1016/j.msard.2022.103910.
  • Mannino A, Lithander FE, Hoare S, Shivappa N, Daly A, Pereira G, Sherriff J, Lucas RM, Ponsonby AL, Hebert JR, Ausimmune Investigator Group, Black LJ* (2021) A proinflammatory diet is associated with central nervous system demyelination in women. Mult Scler Relat Disord 57:103428
  • Daly A, Martin C, Sherriff J, Mori TA, Pereira G, Lucas RM, Ponsonby AL, Taylor B, van der Mei I, Ausimmune Investigator Group, Black LJ* (2021) Omega-3 Index, fish consumption, use of fish oil supplements and first clinical diagnosis of central nervous system demyelination. Mult Scler Relat Disord 55:103210
  • Russell R, Black LJ, Begley A* (2021) Navigating dietary advice for multiple sclerosis. Health Expect (in press)
  • Black LJ*, Hetherton S, Forkan M, Gonzales EG, Smith JB, Daly A, Lucas RM, Langer-Gould A (2021) An exploratory study of diet in childhood and young adulthood and adult-onset multiple sclerosis, Mult Scler doi: 10.1177/1352458520986964.
  • Dunne J, Chih HJ, Begley A, Daly A, Gerlach R, Schütze R, Castell E, Byrne J, Black LJ (2020). A randomised controlled trial to test the feasibility of online mindfulness programs for people with multiple sclerosis Mult Scler Relat Disord 48:102728.
  • Simpson S, Oddy W, Taylor B, Lucas R, Black L, Ponsonby A-L, Blizzard L, Dwyer T, van der Mei I*. (2020) High Prudent diet factor score predicts lower relapse hazard in early multiple sclerosis. Mult Scler
  • Russell R, Black LJ, Begley A*. (2020). The unresolved role of the neurologist in providing dietary advice to people with multiple sclerosis. Mult Scler Relat Disord
  • Russell R, Black LJ, Pham NM, Begley A*. (2020) The effectiveness of emotional wellness programs on mental health outcomes for adults with multiple sclerosis: a systematic review and meta-analysis. Mult Scler Relat Disord 44:102171.
  • Russell R, Black LJ, Begley A*. (2020) Dietary education programs for adults with neurological diseases: a scoping review protocol. JBI Database Syst Rev Implement Rep 18:1-7.

Updated: 31 March 2022

Updated: 04 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

  • Postdoctoral Fellowship

Total Funding

  • $120,000


  • 3 years

Funding Partner

  • MSWA
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Ms Alice Saul

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Dietary factors to reduce MS risk and progression