Could the Paleo Diet Help in Multiple Sclerosis?

The so-called Paleolithic diet—one presumed to have been eaten during the Stone Age—might relieve multiple sclerosis symptoms. The diet consists mainly of of meat, fish, vegetables and fruit and excludes dairy and grain products while banning processed foods.

A small trial among patients with relapsing-remitting multiple sclerosis (RRMS) has found that a Paleolithic diet reduced patient fatigue and improves quality of life. The mechanism at play is believed to be avoiding foods that may trigger inflammation.

Investigators randomized 34 subjects to either their normal diet or a modified Paleolithic dietary intervention. Only nine control subjects (including only one man) and only eight Paleo-diet subjects (again, including only one man) finished the 3.5-month trial, but the outcomes were still significant.

Patients eating the Paleolithic diet experienced improvements in Fatigue Severity Scale scores, Multiple Sclerosis Quality of Life-54 (MSQOL) scores and time to complete (with dominant hand) 9-Hole Peg Tests. Blood tests also detected increased vitamin K serum levels in subjects who ate the Paleolithic diet. Control subjects, meanwhile, experienced no significant changes by any of these measures.

“These findings may support a Paleo diet as a potential treatment for patients with RRMS or as an addition to currently available therapies,” the study authors wrote. “The observed reductions of perceived fatigue, increases in serum vitamin K (a proxy for reductions in oxidative cell and mitochondrial damage), and improvements in exercise capacity, mental and physical QOL, and motor function suggest using a Paleo diet may improve overall well-being in individuals diagnosed with RRMS.”

Previous research has found that interventions entailing both a Paleolithic diet and some other lifestyle modification such as increased exercise can improve the mental and physical well-being of multiple sclerosis patients. The intention of the new study was to determine whether the diet alone would produce significant benefits.

Paleo-diet subjects agreed to eat nine cups of vegetables per day, along with some fruits and meat (including organ meat). They agreed to abstain completely from dairy, potatoes, legumes and all products containing gluten (wheat, barley, rye, etc.). They kept a food log throughout the three-month diet protocol and received one phone call per week for the first three weeks and one phone call every other week for the remainder of the study.

The mental component of the MSQOL score for intervention patients increased 16.2% over the course of the intervention while the same score decreased by 1.5% among control patients over the same period (P = 0.02). All the intervention subjects saw their scores increase by at least five points, but only five control patients experienced similar increases.

The physical component of the MSQOL score increased for all but one of the intervention patients but only three of the control subjects (P = 0.03).

The investigators speculated that the improvements experienced by patients who ate the Paleolithic diet may have stemmed from that diet’s lack of foods that are known to cause inflammation. A typical American diet, they noted, is high in inflammation-promoting foods, especially refined carbohydrates.

The study authors believe, however, that further trials will be necessary, both to confirm their results and to uncover whatever mechanisms might enable comprehensive dietary changes to influence the symptoms of multiple sclerosis. They hope that such research might lessen reliance upon the current generation of pharmaceutical treatments, which have "limited benefit and serious side effects."

"Randomized controlled trial evaluation of a modified Paleolithic dietary intervention in the treatment of relapsing-remitting multiple sclerosis: a pilot study" appeared in Degenerative Neurological and Neuromuscular Disease.

Related Coverage:

Mixed Signals in Ongoing Research for a Multiple Sclerosis Diet

Diet and Gut Microbiome Influences Multiple Sclerosis Disease Activity

Fasting Cycle Could Reduce Multiple Sclerosis Symptoms