In a nutshell, positive lifestyle choices in people with MS can prevent relapse, promote and preserve brain function, slow disease progression, improve symptoms and efficacy of treatment, as well as provide people with a sense of control and agency, which in turn instils hope, impacts mood and improves quality of life.
Healthy brains, minds and bodies support emotional, physical and mental health and improve perceived quality of life. Preserving brain function in people with MS is essential [1], whilst supporting positive mental and emotional health can reduce the impact of symptoms like pain and fatigue, and improve mood and cognition. Read more about how a healthy lifestyle can:
We know that outcomes for people with MS and the burden on health services are both worsened by comorbidities whilst some comorbidities [2] are associated with worsened disease progression and increased relapses [3]. Metabolic syndrome, for example, has been linked with increased disability, worsened progression and reduced disease-modifying treatment efficacy [4]. By encouraging healthy lifestyle choices as part of holistic management, we can reduce the likelihood of people developing comorbidities, or minimise their impact [5].
Research has found that positive lifestyle choices can directly impact disease activity such as reduced relapses or slowed disease progression. For example, smoking cessation has been found to slow the rate of motor disability deterioration [6] whilst regular participation in exercise may impact relapse rate [7].
There is some evidence to suggest that people with MS who have certain comorbidities are at risk of greater disease progression and may have less positive treatment outcomes [8] [9]. People with MS and metabolic syndrome have been found to have an increased rate of both relapse and disease progression and reduced health-related quality of life, as well as to see the success of disease-modifying treatment impacted [10] [11] [12].
Symptom management can be optimised through a multi-pronged approach of lifestyle change, therapeutic interventions and medication and this is clearly established in the updates to the MS NICE guidance [13] [14]. Positive changes like improving sleep or nutritional quality, better stress management or physical movement have been found to improve symptoms like fatigue, pain, mood and cognition [15], whilst exercise has been found to be more efficacious in managing fatigue than medications [16], [17].
Self-management is a key focus for the NHS in meeting the growing health needs of our society, yet it can be challenging to encourage patients to be motivated to self-manage. Sharing the evidence for lifestyle as a meaningful form of treatment and management when combined with therapeutic interventions and optimised medication is an incredible message of hope. This can motivate self-management and improve quality of life [18], reduce burden on healthcare services [19], and encourage people with MS to make positive lifestyle choices for the long-term [20].
