Active lifestyles help support better mobility, mood in people with MS
Five-year study shows exercise offers the strongest benefits across outcomes
- Regular physical activity is tied to lower disability, fatigue, and depression over time in people with multiple sclerosis.
- A healthier diet and not smoking are also tied to better long-term outcomes.
- Combining multiple healthy lifestyle factors offers cumulative benefits for multiple sclerosis.
Regular physical activity was independently linked to lower disability, fatigue, and depression over time in people with multiple sclerosis (MS), a new study found.
Other lifestyle factors also supported better outcomes. For example, eating a higher-quality diet was independently associated with less disability, while not smoking was independently tied to lower depression scores, the data showed.
People who practiced three or more lifestyle habits — such as being physically active, eating well, or not smoking — saw the greatest overall benefits.
“These insights may guide personalised and sustainable lifestyle strategies for pwMS [people with MS] to mitigate specific clinical outcomes,” the researchers wrote.
The study, “Healthy lifestyle is associated with reduced fatigue, depression, and disability over 5 years in people with multiple sclerosis,” was published in Multiple Sclerosis and Related Disorders.
Why researchers examined multiple lifestyle habits together
Lifestyle habits — such as being physically active, eating well, managing stress through meditation, not smoking, and getting enough vitamin D — have all been associated with better health outcomes in people with MS.
Most past studies looked at these habits one at a time. To get a clearer picture, researchers in Australia examined five lifestyle habits together in a large group of MS patients.
“Comparing lifestyle factors with the aim of understanding which factors have the strongest association with outcomes presents the opportunity to implement personalised lifestyle modifications based on symptoms relevant to the individual,” the researchers wrote.
The analysis included 839 adults with MS (83% women) who took part in an international observational study called Health Outcomes and Lifestyle in a Sample of pwMS. Participants completed an online survey at the start of the study, and again at 2.5 and five years, reporting demographics, clinical information, and five lifestyle habits.
Diet quality was measured using a modified Dietary Habits Questionnaire, where higher scores reflected healthier eating patterns. Physical activity was assessed through the International Physical Activity Questionnaire Short Form, a seven-day recall of walking frequency and duration, and moderate-to-vigorous activity. Regular activity meant doing at least 30 minutes of activity per day at any intensity, three or more days each week.
The other lifestyle habits assessed were meditation, smoking status, and vitamin D intake, which included supplement use and intentional sun exposure.
How the team measured disability, fatigue, and depression over time
Researchers assessed three main health outcomes: disability, fatigue, and depression. Disability was measured using the Patient-Determined Disease Steps, fatigue using the Fatigue Severity Scale, and depression using the Patient Health Questionnaire-2.
At baseline, a higher-quality diet and greater physical activity were independently associated with lower disability, fatigue, and depression scores. Not smoking and higher vitamin D intake were significantly associated with lower depression scores. Meditation did not show relationships with any of the health outcomes.
Over time, greater physical activity was significantly associated with lower fatigue and disability at both 2.5 and five years, and lower depression at 2.5 years. At five years, not smoking was significantly tied to less depression, while a higher-quality diet was connected with less disability. Meditation and vitamin D intake were not prospectively associated with any outcomes.
Engaging in multiple healthy lifestyle factors had cumulative benefits up to 5-years follow-up.
When the researchers looked at lifestyle factors together, they found that people who engaged in three or more of the healthy habits at the start of the study reported less disability, fatigue, and depression.
At the 2.5-year mark, having two or more healthy lifestyle factors was significantly linked to less fatigue, and having three or more was significantly linked to lower depression and disability. The biggest improvements were seen in people who used four of the five healthy habits.
By five years, significant benefits remained only for people who maintained four or five healthy lifestyle habits. Those with three showed trends toward lower depression and disability. Overall, the effects were stronger at 2.5 years than at five years.
“Physical activity was independently associated with all three clinical outcomes at 2.5-years,” and “therefore ought to be encouraged,” the researchers wrote. Also, “engaging in multiple healthy lifestyle factors had cumulative benefits up to 5-years follow-up.”
“Interventional studies are needed to better define and quantify these individual and cumulative effects,” the team concluded.
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