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A study published in the Journal of Neurology, Neurosurgery and Psychiatry looks at fish intake and slowed disability progress in Multiple Sclerosis (MS).
Dr Emma Gray, Director of Research at the MS Society, said:
“This study builds on previous research that suggests adopting a healthy diet could improve quality of life and may reduce disability progression among people with multiple sclerosis. However, we’d like to see further research to confirm the findings, and understand what is going on in the body to produce these benefits. Additional factors like the impact of other dietary choices and socioeconomic status could also be taken into account. Over 150,000 people live with MS in the UK and due to the unpredictability of the condition no ‘one’ diet works for all – it’s a personal choice. Ultimately a healthy balanced diet can help people with MS to stay in the best health possible and guard against other issues, like heart disease and strokes.”
Dr Shelly Coe, Senior Lecturer in Nutrition Science, Oxford Brookes University, said:
“It is great to see more research into MS and diet approaches for managing symptoms and disability progression, with the current research showing that higher lean and oily fish consumption is associated with a reduced risk of MS disability progression. Benefits of this study include the high sample size and that people with MS have a confirmed diagnosis and are recruited from clinics throughout Sweden.
“Fish consumption is assessed with a 4-point scale for oily or lean fish intake, and therefore this could result in some limitations; however considering the study design this is overall a suitable method for assessing diet in this population.
“Those with higher lean and oily fish intake overall showed an association with lower disability progression. More benefits were found in those who consistently had a higher fish consumption over time, however those who increased their fish consumption over time also had an associated reduced disability progression, although less pronounced. This therefore highlights that even if someone with MS changes their diet later in their condition to a diet richer in oily and lean fish, there is still a beneficial association with disability progression to some extent. Overall, analysis seems thorough considering all aspects of the data.”
Dr Aravinthan Varatharaj, Clinical Lecturer in Neurology, University of Southampton, said:
“This is a well-conducted study with robust findings. Sweden has an excellent registry where most people with multiple sclerosis include their data. Using this data, the researchers found that people eating more fish were relatively protected against worsening of their disability.
“There could be lots of reasons for this. All fish contain important nutrients and amino acids which are beneficial for health. Oily fish contain essential omega-3 fatty acids which cannot be otherwise produced by the human body. UK guidelines recommend we eat at least two portions of fish per week, with at least one of oily fish. However, most people in the UK eat less than this, and only a minority regularly eat oily fish. People with multiple sclerosis already know the importance of a healthy balanced diet, and this study is another bit of evidence to say that eating more fish is good for you.
“The study also showed that for people who didn’t each much fish and were diagnosed with multiple sclerosis, if they started eating more they still benefited. This goes to show that making a lifestyle change after diagnosis can have a positive impact.
“However, previous studies done in the 1970s looking at fish oil supplementation did not show a strong benefit for people with multiple sclerosis. Dietary studies can be at risk of confounding by hidden factors. One thing this study didn’t look at is whether people who ate less fish were also less well-off. Fish can be expensive, so this could be a factor. We know that people with lower incomes have worse health outcomes (for multiple sclerosis and many other conditions).”
Dr Ruth Dobson, Clinical Senior Lecturer in Neurology (Multiple Sclerosis), Queen Mary University of London (QMUL), said:
“The Swedish EIMS study has done a lot to enhance our understanding of MS epidemiology. The question about fish consumption playing a role in MS susceptibility and/or severity is one that has been hypothesised for some time from a biological basis. Diet is of significant interest to people living with MS, and high quality studies to investigate the effect of diet are hard to do; this study provides a really useful avenue for investigation.
“There appears to be a consistent dose-response relationship between fish consumption and MS severity, the first time this has been reliably described. Notably, the same is true for physical activity and smoking behaviour, which has been shown before.
“I don’t think this fully answers the question about whether it is fish consumption directly that influences MS (although this is completely plausible), whether it is synergistic with other lifestyle traits (I think this is most likely), or whether it is purely acting as a surrogate for other lifestyle traits (less likely). They do adjust for some of these but residual confounding remains a concern in all studies like this. But the paper as presented is fair and does discuss this.”
‘Impact of fish consumption on disability progression in multiple sclerosis’ Eva Johansson et al. was published in Journal of Neurology, Neurosurgery and Psychiatry at 23:30 hours UK time Tuesday 25 February 2025.
DOI: 10.1136/jnnp-2024-335200
Declared interests
Dr Aravinthan Varatharaj: I am involved in trials of disease-modifying treatments for progressive multiple sclerosis. I am also an investigator on the UK MS Register. I have received funding from Roche who make pharmaceuticals for MS.
Dr Ruth Dobson: No COIs relating to this research.
For all other experts, no response to our request for DOIs was received.