What can the Lifestyle in Multiple Sclerosis (LIMS) study tell us about lifestyle and MS?

New findings from the LIMS study suggest that taking a multidomain approach to lifestyle may support wellbeing for people living with multiple sclerosis (MS), with some benefits lasting up to two years. The findings add to growing evidence that introducing several healthy lifestyle behaviours together may be more useful than focusing on one behaviour in isolation.

What did the research look at?

When we look at research into lifestyle and MS, many studies focus on a single intervention – such as exercise, diet, sleep or stress management. The LIMS (Lifestyle in Multiple Sclerosis) study took a different approach, looking at what happens when several lifestyle behaviours are addressed together.

The study included 659 people living with MS, who took part in a three-month intensive, digital lifestyle programme, followed by a 21-month maintenance period. The programme focused on four areas: a Mediterranean-style diet, physical activity, stress management and sleep.

Researchers assessed participants at the start of the study, after the three-month intervention and at 6, 12, 18 and 24 months. They looked primarily at the impact of MS on people’s daily lives, as well as quality of life, general health, symptoms and lifestyle behaviours.

What did the study find?

The greatest improvements were seen during the initial three-month intervention. Participants reported reductions in both the physical and psychological impact of MS.

At 24 months, the improvement in psychological impact remained, while the initial improvement in physical impact was no longer as strong. Overall, the changes were modest, and not everyone experienced a meaningful improvement.

The study also found some lasting changes in lifestyle. Adherence to the dietary recommendations improved and remained partly improved over the longer follow-up period, alongside a modest reduction in body mass index. However, there was no significant long-term improvement in adherence to physical activity.

These findings are important because they highlight both the potential benefits and the challenges of making lifestyle changes.  Improvements may be possible, but maintaining changes over time isn’t always easy – and the impact can vary from person to person.

Why does this matter for people with MS?

For us at Overcoming MS, one of the most interesting aspects of LIMS is its multidomain approach.

Rather than asking whether one particular lifestyle behaviour can improve MS outcomes, the study considered several behaviours together. This is particularly relevant because most of us don’t experience our health in separate compartments. What we eat, how active we are, how we manage stress and how well we sleep can all be part of the bigger picture of wellbeing.

The findings also complement research from the ongoing HOLISM (Health Outcomes and Lifestyle In a Sample of people with Multiple sclerosis) study. HOLISM is an observational study that explores the relationships between multiple lifestyle behaviours and health outcomes in people with MS.

There are important differences between the two studies. LIMS was an intervention study, actively supporting participants to make changes in several areas, whereas HOLISM observes lifestyle behaviours in people living their everyday lives. However, they share an important feature: both look beyond individual lifestyle behaviours to consider a broader pattern of healthy living.

Research from HOLISM has found associations between engaging in multiple healthy lifestyle behaviours and better health outcomes. LIMS adds an important complementary perspective by exploring what happens when people are supported to make several lifestyle changes together.

Making healthy changes part of everyday life

At Overcoming MS, we believe that living well with MS involves looking at the bigger picture. This is reflected in our information and support, which brings together seven recommendations: diet, vitamin D, exercise, meditation, medication, family health, and making healthy lifestyle changes for life.

Several of these areas overlap with LIMS, particularly diet, physical activity and stress management. The LIMS study did not test the Overcoming MS recommendations, however its findings add to the evidence supporting a multidimensional approach to lifestyle and MS.

The LIMS study also differs from what we recommend at Overcoming MS. Whilst the LIMS lifestyle intervention was purely digital, we offer a range of digital, hybrid and in-person support. Previous research shows that quality of life improvements can be sustained up to five years following an in-person lifestyle retreat. 

If you’re looking to make lifestyle changes, you don’t need to change everything at once. A healthier diet, more movement, time for meditation or stress management, and prioritising sleep can all be considered as part of your own journey. What matters is finding changes that are realistic and sustainable for you.

At Overcoming MS, we don’t believe in perfection. We believe in progress, evidence-informed choices and healthy changes that become part of everyday life. LIMS reminds us that lifestyle change is a journey – and that taking a holistic approach may be a valuable part of living well with MS.

Read the full LIMS paper here.

Read more about the HOLISM study here.

Read more about the impact of lifestyle retreats for people with MS here.