Does Lifestyle Affect Multiple Sclerosis? The Science Behind Diet, Exercise, Coffee, and More

 In recent years, medical science has increasingly focused on the role of lifestyle in chronic diseases such as multiple sclerosis (MS). Can changes in diet, physical activity, or other daily habits truly influence disease progression, relapse risk, and overall quality of life? This article provides evidence-based answers to five of the most frequently asked questions MS patients have—based on one of the most comprehensive and authoritative scientific reviews in the field.

All information is based on the peer-reviewed publication “Lifestyle-based modifiable risk factors in multiple sclerosis: review of experimental and clinical findings” (Neurodegenerative Disease Management, 2019), authored by a multidisciplinary team of researchers from the Jacobs School of Medicine & Biomedical Sciences at the University at Buffalo, USA. Leading contributors include Dr. Dejan Jakimovski, Dr. Yi Guan, Dr. Murali Ramanathan, Dr. Bianca Weinstock-Guttman, and Dr. Robert Zivadinov—world-renowned experts in neurology, pharmaceutical sciences, and clinical neuroimmunology. Their summary of findings from dozens of clinical and experimental studies outlines how patients can influence the course of MS through informed everyday decisions.

“Lifestyle changes—diet, exercise, weight management, and avoiding harmful habits—can significantly slow the progression of multiple sclerosis and improve quality of life.” 

Experts Weigh In

Multiple sclerosis (MS) is a complex autoimmune disease with a chronic course, primarily affecting young adults and often leading to long-term disability. In recent years, science has shed light on modifiable risk factors—those that patients can influence through lifestyle changes. Research suggests that controlling these factors can improve disease progression, reduce relapse risk, and support a better quality of life. Below are five expert opinions and scientific insights, each accompanied by explanatory subheadings and questions to guide patients and their loved ones toward informed decisions.

1. How important is physician involvement in lifestyle changes for MS?

“MS healthcare providers should participate in, engage with, and offer lifestyle-based behavioral change strategies as part of their routine clinical care.”

Explanation: Physicians should not limit their role to prescribing medications—they should actively support patients in making decisions related to nutrition, physical activity, weight control, and quitting harmful habits. Lifestyle modification is recognized by leading neurologists as a key element of modern MS treatment.

2. The impact of obesity and smoking on MS progression

“Active efforts to quit smoking and manage body weight can substantially improve long-term clinical outcomes and increase the benefit of current disease-modifying therapies.”

Explanation: Obesity and smoking are among the most dangerous modifiable risk factors associated with worse MS outcomes. Studies show that individuals with a higher body mass index (BMI) and active smokers face a greater risk of faster disability progression and more frequent relapses. Quitting smoking and reducing body weight are strongly associated with better prognosis.

3. What is the role of co-existing cardiovascular disease in MS?

“Managing co-morbid cardiovascular conditions such as hypertension, hyperlipidemia, diabetes, and heart failure will delay the accumulation of clinical and MRI-confirmed pathology in MS.”

Explanation: Cardiovascular conditions accelerate MS progression, lead to more brain atrophy, and increase neurological damage. Proper treatment of high blood pressure, cholesterol, and blood sugar is vital for better disease control and long-term health in MS patients.

4. The benefits of physical activity and rehabilitation

“Encouraging exercise and rehabilitation protocols can significantly impact physical and cognitive function in MS patients.”

Explanation: Regular physical activity improves not only physical abilities (walking, balance, strength) but also has proven positive effects on mood, cognitive function, and even brain structure (such as increased hippocampal volume and enhanced neural connectivity). Exercise should be tailored to individual capacity, but even minimal activity offers meaningful benefits.

5. Dietary changes – What foods are best for MS patients?

“A large study of nearly 7,000 MS patients showed that following healthy dietary guidelines is linked to lower reported disability and lower levels of depression. Higher intake of fruits, vegetables, legumes, and whole grains is beneficial, while red meat and added sugars are considered harmful.”

Explanation: There is no one-size-fits-all “MS diet,” but research strongly supports dietary patterns similar to the Mediterranean diet—rich in plant-based foods, fish, nuts, low in saturated fats, and limited in processed foods. Proper hydration and reduced salt intake are also important. Various dietary interventions are being actively studied, including low-fat, paleo, and ketogenic diets.

Questions and Answers

1. Does the type of fat I consume affect MS progression?

Answer: Yes, both the type and amount of fat matter. As early as the 1950s, studies showed that low intake of saturated fats (from animal sources like butter, meat, and dairy) could reduce relapse risk and even MS-related mortality. Later studies found that every 10% increase in total fat intake raises relapse risk by 56%, and every 10% increase in saturated fats triples that risk. Some research also shows benefits from combining fat reduction with omega-3 supplementation, which can improve both physical and mental health in MS patients.

2. Can calorie restriction or intermittent fasting help with MS?

Answer: Animal studies and early human trials suggest that calorie restriction and intermittent fasting may reduce inflammation, slow disease progression, and improve quality of life. In animal models, calorie-restricted diets significantly reduce the onset and severity of symptoms and increase survival. In humans, such diets are linked to better mood, weight loss, and fewer complaints—though more large-scale, long-term studies are still needed.

3. What are the effects of salt and salty foods on MS risk and activity?

Answer: In animal models, high salt intake increases disease risk and promotes inflammation by over-activating the immune system. In humans, the data is mixed: some MS studies associate high salt intake with more relapses and greater MRI lesion load, while other large studies find no significant link between salt consumption and MS activity or onset. Moderation is recommended, and excessively salty foods should be avoided.

4. Does coffee (or caffeine) affect MS risk or progression?

Answer: Yes, several studies suggest that coffee consumption has a protective effect: people who drink coffee regularly have a significantly lower risk of developing MS compared to non-drinkers. Among diagnosed patients, regular coffee intake is linked to slower progression to severe disability, especially in relapsing-remitting MS. Caffeine is believed to have anti-inflammatory effects and beneficial influence on certain immune pathways.

5. Does moderate alcohol consumption affect MS?

Answer: Yes, although findings are mixed, several epidemiological studies show that moderate alcohol use (especially red wine) is associated with a lower risk of developing MS and with slower progression of disability in already diagnosed individuals. Patients who consume alcohol moderately report higher quality of life and lower levels of depression and physical disability. However, excessive use is risky and not recommended as a treatment. Balance and moderation are key.

Conclusion 

Understanding and applying science-based insights on how diet, physical activity, salt, coffee, and alcohol affect multiple sclerosis can empower patients in their journey with the disease. As shown in the comprehensive review by the University at Buffalo team, while genetic and biological factors play a fixed role, scientifically grounded and sustainable lifestyle changes can bring real benefits for disease course, quality of life, and overall health. These decisions should be made in collaboration with a treating neurologist and adapted to the individual’s needs, abilities, and preferences.

Source: Jakimovski D, Guan Y, Ramanathan M, Weinstock-Guttman B, Zivadinov R. "Lifestyle-based modifiable risk factors in multiple sclerosis: review of experimental and clinical findings." Neurodegener Dis Manag. 2019;9(3):149–172. https://pubmed.ncbi.nlm.nih.gov/31116081