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Small Study Finds that a Diet that Improves Cholesterol Levels May Reduce MS-Related Fatigue

August 16, 2019

  • In a small pilot study, researchers found that a specific diet that improved participants’ lipid profile (levels of blood fats, including cholesterol and triglycerides) and reduced body weight also led to reductions in MS-related fatigue.
  • If results are confirmed by larger studies, this may offer another strategy for treating MS fatigue. At least one follow-up study is underway.
  • Dr. Kelly Fellows Maxwell and others at State University of New York, Buffalo, and Dr. Terry Wahls and others at the University of Iowa published their findings in PLOS ONE (published online June 18, 2019).
Background: Fatigue -- a lack of physical or mental energy -- is a common MS symptom. MS-related fatigue has several possible causes, including central nervous system inflammation, heat, sleep disturbances, depression, stress, poor diet, and other underlying medical conditions. There are many approaches to treating MS fatigue, which have had mixed results.  Some dietary interventions have shown preliminary promise, and because cholesterol levels have been associated with disease progression in MS, the researchers wondered if a diet designed to improve cholesterol levels could impact fatigue.
The Study: In this pilot study, 18 people with progressive MS followed a diet that recommended high intake of vegetables, fruits, and nutritional supplements such as fish oil; encouraged consumption of animal and plant protein; and excluded foods with gluten-containing grains, dairy and eggs. In addition, exercise, neuromuscular electrical stimulation (NMES) and stress reduction programs were designed for each participant, who kept daily logs of their activities and food intake. The participants’ cholesterol and triglycerides were checked at the beginning of the study and 12 months later, and fatigue levels were evaluated every three months.
Results: The researchers found that improved blood lipid profiles, particularly triglycerides and HDL cholesterol, may contribute to reducing MS fatigue. They found improvements in participants overall -- in cholesterol and triglyceride levels, reduced body weight, and fatigue scores (measured on the Fatigue Severity Scale). The decrease in fatigue was most associated with eating more of the recommended foods and less of the excluded foods. The exercise, NMES, and stress reduction components did not seem to impact fatigue.
The limitations of the study include a small sample size and the lack of a control group for comparison. Another potential problem is that food logs are notably difficult to maintain accurately.
Dr. Kelly Fellows Maxwell and others at State University of New York, Buffalo, and Dr. Terry Walls and others at the University of Iowa published their findings in PLOS ONE (published online June 18, 2019).
Conclusions: The results of this small pilot study suggest that dietary approaches may have promise in reducing MS fatigue. A larger, controlled trial is underway by Dr. Wahls, with National MS Society funding, to compare the ability of two different diets to reduce MS fatigue.
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Multiple sclerosis is an unpredictable disease of the central nervous system. Currently there is no cure. Symptoms vary from person to person and may include disabling fatigue, mobility challenges, cognitive changes, and vision issues. An estimated 1 million people live with MS in the United States. Early diagnosis and treatment are critical to minimize disability. Significant progress is being made to achieve a world free of MS.

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