MS Patients Generally Able to Maintain Healthy Lifestyle Changes, Study Shows

In general, multiple sclerosis (MS) patients are able to make and sustain healthy lifestyle changes associated with a better quality of life, a study shows.

The study, “Health outcomes and adherence to a healthy lifestyle after a multimodal intervention in people with multiple sclerosis: Three year follow-up,” was published in the journal PLOS ONE.

The consensus is that MS is caused by an interplay of genetic and environmental risk factors. While many studies have uncovered genetic drivers of MS progression, there is also strong evidence for the role of modifiable lifestyle factors — such as smoking and low vitamin D levels — in the evolution of MS.

Modifiable risk factors, including regular physical activity, stress reduction, healthy weight, and normal blood lipid (fat) levels, have been shown to be associated with important health outcomes, such as quality of life, in MS patients.

These studies suggest that changing these behaviors provides a promising strategy for the prevention and management of MS progression. While many patients are motivated to make these lifestyle changes, few trials have actually measured adherence to these changes and outcomes beyond one year.

Researchers have now conducted a study in MS patients to assess the adoption and adherence to healthy lifestyle recommendations, and health outcomes three years after patients made a lifestyle change.

A total of 95 MS patients were enrolled in the study; 73% of them had relapsing-remitting MS (RRMS). They completed baseline surveys, and then participated in five-day MS lifestyle risk-factor modification workshops. One year later, 76 participants completed the follow-up surveys, and three years later, 78 patients completed the surveys.

Results showed that a number of modifiable risk factors — including participants’ healthy diet score, the proportion spent meditating one hour or more a week, supplementing with at least 5,000 IU of vitamin D daily, and supplementing with omega-3 flaxseed oil — improved at one-year follow-up and were sustained (although slightly lower) after three years.

This suggests that these lifestyle changes are sustainable over time in MS patients.

“The intervention successfully changed behaviours but, more importantly, maintained these healthier behaviours over time,” the researchers wrote.

Furthermore, compared with the start of the study, participants reported clinically meaningful increases in both their physical and mental health quality of life at both the one-year and three-year follow-ups.

There was also a small decrease in disability from the start to the one-year and three-year follow-ups, but this change was not clinically meaningful.

RRMS patients had fewer relapses during the year before the first follow-up and three-year follow-up — suggesting a particular benefit for these patients.

Unfortunately, there was no evidence for a change in physical activity and not enough smokers among the participants to make any meaningful comparisons.

Medication use increased at both the one-year and three-year follow-ups, indicating that lifestyle changes are not associated with a direct decrease in MS medication use.

“The results provide evidence that lifestyle risk factor modification is feasible and sustainable over time, in a small self-selected and motivated sample of people with MS,” the team concluded.

They emphasized that “given the enormous potential for improvement in health outcomes,” efforts should be made to implement management strategies centered around modifiable lifestyle factors in MS patients.