People following the Overcoming MS Program (OMSers) should find this very reassuring, but it doesn’t mean that we can rest on our laurels and patiently wait for the medical community to suddenly “come around” to our view of managing MS. Whilst ever increasing numbers of neurologists are now advocating our approach, we realise that it is going to take more research and an even higher quality of evidence before we change the hearts and minds of the medical majority and reach even further into the global MS community.
New Study that supports Overcoming MS (OMS)
Fortunately, a study has just been published in the "Journal of Neurology” that adds another important piece to the jigsaw puzzle that supports lifestyle modification in MS. Researchers in Buffalo, New York took 175 people with MS or clinically isolated syndrome (CIS), and 42 “healthy controls”. Over a period of 5 years, they aimed to test whether factors known to be associated with cardiovascular disease; such as obesity, smoking, poor diet, lack of exercise and the presence of other health conditions such as diabetes or high blood pressure, might also have an effect on MRI findings and clinical progression rates in MS.
In a well-conducted study, using extremely robust and widely-accepted computing models and statistical analyses to establish cardiovascular risk and diet quality (Healthy Heart Score and Framington Coronary Heart Disease Risk Score), the team found some very interesting results regarding the effects of diet and lifestyle on MS.
Outcomes of study
One of their key outcome measures was that of brain atrophy rates. This refers to the amount of shrinkage of the brain over time due to loss of tissue, which is an area of increasing interest for MS researchers and pharmaceutical companies. As we age it is normal to lose between 0.25 and 0.4 percent brain tissue annually, but in MS this can be increased by two to three times. It is felt that much of the disability accumulation could be due to these accelerated rates of brain atrophy, and this is now a key measure in monitoring disease activity and testing the effectiveness of various new drug treatments.
MRIs were performed at the beginning and end of the 5-year follow-up period, and specifically looked for new MS lesions and several markers of central brain atrophy (white matter volume, grey matter volume and lateral ventricular volume). They found that those with MS who had the least healthy lifestyles had significantly more brain atrophy, and significantly more new lesions over the 5-year period than those with MS leading a healthier lifestyle.
Interestingly, brain atrophy rates were even worse in the healthy control group than the MS group when they were matched for diet and lifestyle. So someone without MS had more brain atrophy if living an unhealthy lifestyle. This means that the partners and supporters of OMSers that also follow the program have much to gain in terms of disease prevention. We know that conditions such as Alzheimer’s disease and other forms of dementia are closely related to brain atrophy. It also alludes to the fact that there are likely to be other factors at play in the neurodegeneration seen with MS, other than just someone’s diet. The importance of the holistic Overcoming MS approach then, and the need for further research into the disease process, are paramount.
In conclusion, this research again demonstrates how lifestyle-based factors and cardiovascular health contribute to brain atrophy rates in people with MS, and also that unhealthier diets are associated with greater MS lesion accumulation over time. The authors deduced that lifestyle-based modifications may provide a beneficial effect on reducing brain atrophy in people with MS. If atrophy rates relate to long-term disability in the way that it is currently thought, then this should be viewed as hugely important to the health of all people with MS – just as well then that Overcoming MS’ mission is to reach all 2.5 million around the world!
Dr Jonathan White MBChB MRCOG
- Jakimovski, D., Weinstock-Guttman, B., Gandhi, S. et al. J Neurol (2019) 266: 866. https://doi.org/10.1007/s00415-019-09208-0
- Establishing pathological cut-offs of brain atrophy rates in multiple sclerosis