Dairy and multiple sclerosis

What’s the deal with dairy? Nutritionist and MSer Jenna Cox examines the evidence 

Eliminating dairy from the diet is often encouraged by certain diets designed for people with multiple sclerosis (MS), but why is that and what does the research say?

The HOLISM (Health Outcomes and Lifestyle In a Sample of people with Multiple sclerosis) study last year found links between dairy and disability. This 2023 study looking at diet quality found that eating a high-quality diet was associated with a significant reduction in the risk of future disability progression. Participants with the highest scores for diet quality had more than a 50 per cent reduced risk over the seven and a half year study period. Consistently reported dairy consumption between the beginning of the study to five years later was associated with a greater risk of increased disability, independent of overall quality of diet. Researchers concluded that dairy may potentially increase disability progression risk.

Milk consumption and MS

A 1992 epidemiological study found a highly significant correlation between liquid milk consumption and MS prevalence. No significant correlation between cheese consumption and MS was found, however. Interestingly, in a follow up study, significant correlations were also found between cow milk production per country inhabitant and MS prevalence. Epidemiological studies are limited by the fact that cause and effect conclusions cannot be drawn, however they provide hypotheses to be tested in further research.

Milk and the central nervous system

Researchers investigated the concept of molecular mimicry in a year 2000 study on butyrophilin, a common protein found in cow’s milk. Molecular mimicry occurs when the immune system, while defending against harmful pathogens, mistakenly targets the body’s own proteins because they resemble the foreign protein chains found in food. When administered to rats, the researchers found that butyrophilin triggered inflammation in the central nervous system (CNS) and the same demyelinating response of MS.

It is hypothesised that exposure to butyrophilin in milk could potentially affect the development and progression of MS, as our immune system may confuse butyrophilin with our own myelin sheath proteins, thus causing inflammation. Myelin, a fatty substance insulating nerve fibres in the brain and spinal cord, plays a crucial role in MS as the immune system mistakenly attacks and damages the myelin sheath, disrupting nerve signals leading to various neurological symptoms.

Heightened reactions to dairy

A 2023 study looked at the prevalence of IgG antibodies against milk and milk antigens (antigens are substances that can induce the immune system to produce antibodies). Researchers analysed 35 MS patients and 20 control group individuals, assessing their immune reactions (IgG antibody responses) to various animal and plant-based milk alternatives, as well as to specific antigens within cow’s milk.

The findings revealed significantly heightened IgG antibody responses among MS patients, particularly to cow’s milk, compared to the control group. Correlations were noted between antibodies targeting certain cow’s milk antigens and antibodies targeting the structurally similar myelin antigens.

It is speculated that once tolerance to food antigens is lost, the cross-reactivity to self-antigens may exacerbate ongoing autoimmune activity and CNS inflammation in people with MS.

Contrasting evidence

In contrast, a two-year study published in 2023 involving 186 participants with MS found no association between dairy and gluten intake, and disease activity or quality of life scores. A strength of the study was that rather than relying on self-reported MS symptoms, it used three parameters to measure disease activity – no disability progression (as assessed by the Expanded Disability Status Scale), absence of clinical relapses, and no new MRI lesions. The researchers acknowledged that overall evidence in this field continues to be contradictory and that larger interventional studies are warranted to further explore the role of dietary interventions in MS.

What about calcium?

One concern that some people have regarding removing dairy from the diet is that they will become deficient in calcium. While you should always speak to a health professional before making any big changes to your diet, there are plenty of dairy-free calcium sources.

• Tinned fish with the bones such as tinned sardines and salmon. Try blending the fish (and the bones) with steamed sweet potato, spring onions, herbs and spices to make delicious fish cakes
• Sesame seeds and tahini (sesame seed paste)
• Almonds, hazelnuts, Brazil nuts, sunflower seeds and chia seeds
• Chickpeas and beans
• Calcium-set firm tofu
• Fortified dairy-free milks such as almond milk, soy milk and oat milk
• Leafy green vegetables such as kale, broccoli, watercress, spinach, cabbage and rocket

Dairy-free alternatives

The task of mimicking the qualities of dairy without venturing into the realm of highly processed foods brimming with saturated fats can be a challenge. Fortunately, there is an array of alternatives to explore. You can find my favourite dairy-free swaps for all of your favourite foods in my free eBook.

Conclusion

Autoimmune diseases are complex and there are many factors to consider with no specific diet known to work for everyone. Further studies are needed to determine the role of dairy in MS as the evidence to date is mixed. Removing dairy from the diet could potentially help to reduce the risk of ongoing autoimmune activity in MS and this may be an avenue worth exploring for some people.

Jenna Cox is a registered nutritional therapist, supporting people with MS navigate their journey to optimal health. Jenna has a personal understanding of the challenges MS can bring having been diagnosed with relapsing remitting MS in 2016. Download her free eBook ‘10 dairy-free swaps for all of your favourite foods‘ from www.jennacox.co.uk, and follow her on instagram @jennacoxnutrition