The evidence for diet in reducing fatigue associated with multiple sclerosis (MS) is growing but remains preliminary and somewhat mixed. Fatigue is one of the most common and disabling symptoms of MS, and many people with MS seek dietary strategies to help manage it alongside medical treatments.
One of the most promising dietary approaches studied recently is the **ketogenic diet**, which is very low in carbohydrates and high in fats. This diet shifts the body’s energy source from glucose to ketones, a state called ketosis. Several small studies over the past few years have found that people with MS who follow a ketogenic diet for several months often report **reduced fatigue**, improved neurological function, better sleep, and enhanced quality of life. Some also experience improvements in mood and physical abilities like walking and hand dexterity. These benefits may be linked to the diet’s potential to reduce inflammation, alter gut bacteria positively, and lower body fat. However, these studies have been limited by small sample sizes and short durations, so while the ketogenic diet shows promise as a sustainable adjunctive intervention for MS fatigue, larger and longer-term trials are needed to confirm its effectiveness and safety.
Another dietary approach that has been explored is **fasting or intermittent fasting**, which may also have anti-inflammatory effects. Some research suggests fasting can improve metabolic health markers and possibly ease symptoms like depression, which can be intertwined with fatigue in MS. However, like ketogenic diets, fasting has not yet been shown to reduce the formation of new brain lesions or directly slow disease progression.
More broadly, general healthy eating patterns are recommended for people with MS to support overall well-being and potentially reduce fatigue. Diets rich in **fruits, vegetables, whole grains, lean proteins, and healthy fats**—especially omega-3 fatty acids found in fatty fish—are encouraged. These foods provide antioxidants, vitamins, and minerals that may help reduce systemic inflammation and support brain and nerve health. Avoiding processed foods, added sugars, and trans fats is also advised because these can promote inflammation and worsen fatigue.
Some specialized diets, like the **Wahls Protocol**, focus on nutrient-dense whole foods with an emphasis on vegetables and elimination of processed foods. Many individuals following such diets report increased energy levels and reduced fatigue, though rigorous scientific validation is still limited.
It is important to note that while dietary changes can help manage symptoms like fatigue, no specific diet has been conclusively proven to alter the course of MS or replace medical treatments. The evidence so far suggests diet can be a valuable complementary strategy to improve quality of life and reduce fatigue, but it should be personalized and undertaken with professional guidance to ensure nutritional adequacy and safety.
In summary, the current evidence points to several dietary strategies—especially ketogenic and anti-inflammatory diets—that may help reduce MS-related fatigue by improving metabolic health, reducing inflammation, and supporting neurological function. However, these findings are preliminary, and more extensive, well-controlled studies are needed to establish clear dietary recommendations for fatigue management in MS. Meanwhile, adopting a balanced, nutrient-rich diet while avoiding processed foods appears to be a sensible approach for those seeking to reduce fatigue and enhance overall health.
