Diet, Lifestyle Come Into Focus for Managing Multiple Sclerosis: Rebecca Spain, MD

Although drug development and immune system research have long dominated the field of multiple sclerosis (MS), growing evidence points to the powerful role that diet and wellness can play in improving quality of life for people with the condition. In this interview, Rebecca Spain, MD, MSPH, FAAN, associate professor of neurology at Oregon Health & Science University and codirector of MS Center of Excellence–West at the Portland Veterans Affairs Medical Center, discusses how nutrition, exercise, and mind-body practices can help manage symptoms, support overall health, and enhance long-term outcomes. Spain presented a session at the Institute for Value-Based Medicine event hosted by The American Journal of Managed Care^® in Portland, Oregon, on October 21, 2025, titled “Management of Patients with Multiple Sclerosis.”

This transcript has been lightly edited; captions were auto-generated.

Transcript

What do we know about the role of diet and wellness in managing MS?

Well, we know diet and wellness is incredibly important; it's incredibly important for all of us, but it can have real impacts on people with MS. It hasn't been a real focus of research for quite some time. Researchers have been very focused on the immune system and drug development, but particularly the National MS Society—and I'll give a shout-out to them—has shown a real spotlight on the need for research and education around diet and wellness and the need for rigorous investigation of these. They have sponsored, and investigators have conducted some great research into, diet and wellness approaches. These are difficult studies to do. As you can imagine, it's hard to control diet, it's hard to even record diet and remember what you've had. But there are a number of studies that really have shown that diet improves quality of life, particularly improves fatigue, which is one of the hardest symptoms to tackle in people with MS.

We do know that people who are generally healthier—so fewer comorbid conditions like diabetes, hypertension, and heart disease—they do better with MS. They have less disability; they have a higher physical function. These diseases are also impacted by diet and lifestyle. We know it's important. I think behavioral change is difficult to do, and that's a whole other science on how to take this knowledge and move it into long-standing behavioral change. There are other wellness approaches as well to addressing symptoms of MS, maybe even underlying pathology in MS. And some of those are exercise, mind-body wellness activities like Tai Chi or Qigong, some other practices like acupuncture, and other sorts of stress management practices. I know I'm missing some others, but all of these really have a role in the 360 care of a person with MS, or really any chronic disease that is meaningful and helps them thrive in.