Multiple sclerosis and sugar

 Can cutting down on sugar improve MS symptoms? Nutritionist Jenna Cox explains the science

While “a spoonful of sugar” might help the medicine go down (thanks Mary Poppins), it could have the opposite effect on multiple sclerosis (MS) symptoms. High sugar consumption can contribute to inflammation, gut health issues, obesity, and an increased risk of diabetes – all factors that may exacerbate MS. Here I am going to explore the possible impact of sugar on MS and offer practical tips for naturally sweetening your diet while supporting better health.

Inflammation

Inflammation is a central feature of MS, driving the immune-mediated attacks on the central nervous system that lead to the disease’s characteristic symptoms. A diet high in sugar and unhealthy fats may exacerbate this inflammation, potentially worsening the disease course. In experimental animal models of MS, high-glucose and high-sucrose diets have been shown to increase the proportion of pro-inflammatory immune cells, CD4+ T cells, and exacerbate neuroinflammation in the brain and spinal cord.

Gut microbiome

The gut microbiome plays a pivotal role in regulating immune function and maintaining overall health. In MS, the composition of the gut microbiome has been shown to influence disease progression. Diet, particularly one high in sugar and unhealthy fats, can lead to gut dysbiosis – an imbalance in the microbial population in the gut. This dysbiosis is associated with increased gut permeability, allowing harmful substances to enter the bloodstream and potentially cross the blood-brain barrier, contributing to neuroinflammation and autoimmunity in MS.

Animal model studies have found that high-sugar diets can alter the gut microbiome in ways that promote the differentiation of Th17 cells, a type of immune cell that plays a key role in the pathogenesis of MS. These diets can exacerbate inflammation in the brain and spinal cord, worsening MS symptoms.

Weight management and MS

While there are many factors influencing weight management, there is a trend between sugar overconsumption and obesity which is a concern when looking at the Western diet. A 2019 review reported that the US population consumes more than 300 per cent of the recommended daily amount of sugar.

Obesity at the onset of MS has been linked to higher disability levels not only at diagnosis but also during subsequent follow-up assessments. This suggests that managing weight from the time of diagnosis could be crucial in mitigating disease severity and improving long-term outcomes.

Diabetes as a comorbidity

People with MS are at a heightened risk of developing metabolic disorders, including diabetes. This comorbidity poses significant challenges, as diabetes can exacerbate the progression of MS.

Although clinical studies have yet to establish a definitive link between high sugar intake and MS progression, the available evidence suggests that reducing sugar consumption might be beneficial in managing both MS and diabetes. For instance, one study found that people with MS with a high intake of sugar-sweetened beverages had a greater risk of severe disability compared to those with a lower intake. This highlights the importance of dietary choices in managing comorbidities and overall health in people with MS.

Stay sweet while avoiding refined sugars

Here are some easy and delicious ways to keep your meals sweet without relying on refined sugars or common sweeteners like honey and maple syrup.

1. Frozen banana ‘Nice-cream’

For a sweet treat, freeze chopped bananas and then blend them into a creamy “nice-cream.” This dairy-free dessert is naturally sweet and can be flavoured with cocoa powder or berries for a healthy alternative to ice cream. Download my free ebook, ‘How to go dairy-free on your MS journey’ for a nice-cream recipe, and other delicious dairy-free swaps. Find it at www.jennacox.co.uk.

2. Apple sauce in baking

When baking muffins, cakes, or biscuits, replace half the sugar with unsweetened apple sauce. This swap not only cuts down on sugar but also adds moisture and natural sweetness.

3. Medjool dates with almond or cashew butter

Medjool dates stuffed with nut butter make a delicious, naturally sweet snack. Dates are rich in natural sugars, fibre, and nutrients, while nut butter adds protein and healthy fats.

4. Cocoa powder for a chocolate hit

Add a spoonful of unsweetened cocoa powder to smoothies, porridge, or even yoghurt to get a rich chocolate flavour without the need for added sugars. Cocoa powder is low in sugar and high in antioxidants, making it a great way to satisfy chocolate cravings in a healthier way.

5. Fruit purée with soaked dates

Soak dates in warm water until soft, then blend them into a smooth purée. This date purée can be used as a sweetener in sauces, dressings, or baking recipes, offering a natural and fibre-rich alternative to sugar.

6. Energy balls with dried fruits and nuts

Make your own energy balls by blending dried fruits like dates, apricots, or raisins with nuts and seeds. Roll them into bite-sized snacks for a quick energy boost that’s packed with natural sweetness and nutrients.

7. Berries in yoghurt

Skip the flavoured yoghurt with added sugars and mix in a handful of fresh or frozen berries. Strawberries, blueberries, and raspberries not only sweeten your yoghurt but also add a dose of antioxidants and vitamins.

8. Sweet potatoes in pancakes

For a naturally sweet and nutrient-packed breakfast, try adding mashed sweet potatoes to your pancake batter. They bring a subtle sweetness and a boost of vitamins and fibre.

9. Cinnamon in coffee

Instead of sugar or flavoured syrups, sprinkle a little cinnamon into your coffee. Cinnamon adds a warm, sweet flavour and can help regulate blood sugar levels.

10. Bananas in your porridge

Instead of drizzling honey over your morning porridge, mash a ripe banana and stir it in. Bananas add natural sweetness and a creamy texture, plus they’re full of fibre and potassium.

Don’t be bitter

These natural sweetening options allow you to enjoy delicious flavours while keeping your sugar intake in check. By making these simple swaps, you can enhance the sweetness of your food naturally while staying on the path to better health.

Jenna Cox is a registered nutritional therapist, supporting people with MS to 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 a range of free resources from her website ranging from a seven-day meal planner, a probiotic foods shopping guide, and an ebook on how to go dairy-free on your MS health journey. Visit www.jennacox.co.uk, and follow her on Instagram @jennacoxnutrition