General health advice in multiple sclerosis
No single diet has been shown in controlled trials to alter the course of multiple sclerosis (MS), but diet has been shown to improve body mass index and lipid profile, and possibly fatigue. Patients with MS often follow specific diets that are not supported by evidence. Encourage patients to eat a healthy, varied low-fat diet, to improve their general health.
A low serum vitamin D concentration has been associated with increased relapse frequency and magnetic resonance imaging activity in early MS. Check vitamin D at diagnosis and supplement if the serum 25-hydroxyvitamin D is lower than 50 nmol/L (see advice). It is uncertain whether supraphysiological doses of vitamin D are beneficial.
Smoking has been shown to increase the risk of developing MS, and to increase disease progression in patients with MS. Strongly advise patients with MS to stop smoking.
Encourage patients to increase exercise and moderate their alcohol intake—these changes were associated with lower disability in self-reported observational studies of MS1.