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14 January 2022

“When it comes to MS, one size does not fit all.”

New research from the University of Melbourne shows how the associations between lifestyle behaviors and quality of life differ based on multiple sclerosis phenotype.

As anyone with MS can tell you, this condition exists on a spectrum. One person can have a mild run for years with limited apparent disability, the next person could have the opposite experience.  

When it comes to MS, one size does not fit all. 

Regardless of that, the recommendations around what to do when you’re diagnosed remain consistent: 

  • get regular physical activity 

  • eat a healthy diet 

  • take supplements, vitamin D, omega 3, or both 

But does that actually work for everyone with MS? 

MS and quality of life

If you read any MS research, you’re likely to come across the term ‘quality of life,’ QoL for short. Basically, it means that if you have lots of MS symptoms (fatigue, pain, disability, depression, cognitive impairment) and/or those symptoms are severe, your QoL is worse.  

That’s what makes QoL the MS holy grail. If your QoL is high and stays high in the decade following diagnosis, the PwMS (person with MS) probably has little fatigue, pain, disability, depression, or cognitive impairment, and that means they’re probably living a pretty normal life. 

There are several subdomains of QoL that are in three groups: physical, mental, social. 

The three paths of MS

At the time of diagnosis, most of us will be told what our MS phenotype is, i.e., what flavour of MS have you got.  

More than 8 in 10 of us will be told we have relapsing-remitting MS (RRMS) – which looks like an attack, followed by a break, rinse and repeat. The remainder will be told they have primary-progressive MS (PPMS) where symptoms are present and continue to deteriorate. 

The third type of MS, secondary-progressive MS (SPMS), is what awaits up to three quarters of the RRMS group. With SPMS, RRMS converts to a gradual worsening of neurological functioning. 

It all sounds grim, but a group of researchers asked whether these three types mean that there are three (or more) different options for preserving QoL. 

In short, they found the answer is probably yes. Which is why it’s important to understand the right path for your type. 

Physical activity is a win

There’s no dodging this one. Whether your phenotype is RRMS, SPMS or PPMS, doing regular physical activity is associated with better QoL.  

For some PwMS, physical activity is limited by disability, but this group of researchers looked more broadly at wellness activities too, like Tai Chi, meditation, and relaxation. PwMS who have RRMS and participate in these kinds of activities report benefits for both physical and mental health. 

Aerobic forms of physical activity (i.e., ones that make you huff and puff) have the best evidence of benefit for every PwMS, but whatever you can do regularly is great. 

Quality eating habits for QoL

Another area that was a positive for all the MS phenotypes was a high-quality diet, specifically an anti-inflammatory or MS-specific diet, like the one recommended by Overcoming MS. 

PwMS who followed these types of diet reported that they had better physical and mental QoL than PwMS who haven’t undertaken a change in diet. 

Importantly, the research showed that certain diet types have negative associations for PwMS who have RRMS, but positive associations for PwMS who have PPMS. For more information on this, please click here to access the full paper. 

The researchers thought that this difference might reflect the greater age of people with PPMS. They thought being older meant that these PwMS had more comfort and confidence in how to best handle their MS, and better ability to ignore people who might think their diet is strange. 

Supplements have asterisks

While most of us, myself included, have a bottle of supplements on hand, the research had more mixed reports on the benefits of vitamin D and omega 3 supplements. 

Their research showed that for people who had a low initial reading for vitamin D (less than 30ng/ml) and took more than 5000 IU daily, PwMS reported improved QoL.  

There is less known about omega 3 supplements and MS. The researchers found one large study that showed benefits for QoL for PwMS who self-reported frequent fish consumption and omega 3 supplementation. 

Overall, though, this particular study found no association between vitamin D or omega 3 supplements and QoL for PwMS. 

Living your best life

Achieving a good quality of life, like living with MS, looks different for everyone, but this study has some guidance on how best to pursue your best QoL based on your MS phenotype.  

The research showed that – for everyone who has MS – diet, wellness and especially physical activity have positive associations with QoL.  

They also showed that this looks different for those of us with RRMS and for those of us with PPMS. When you are figuring out how best to achieve your own quality of life, your MS phenotype does make a difference.

Find more information on physical activitydiet recommendations and taking vitamin D supplements with the OMS program. 

You can read the full paper here.