Digital lifestyle program linked to some lasting benefits in MS patients
Study participants maintained dietary and sleep quality gains for two years
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A digital lifestyle program promoting a balanced diet and regular physical activity was associated with improvements in several measures reported by people with multiple sclerosis, a study found. (Photo from iStock)
- A digital lifestyle program was associated with improvements in several measures in people with multiple sclerosis, a study found.
- A healthier diet proved the easiest lifestyle change to maintain, and sleep scores continued to show improvement.
- Physical gains gradually faded in the maintenance period, while pyschological gains persisted.
A digital lifestyle program promoting a balanced diet, regular physical activity, better sleep, and stress management was associated with improvements in several measures and behaviors reported by people with multiple sclerosis (MS), a study found.
Most gains emerged during the intensive three-month program. Over the next 21 months, improvements slightly faded, but most outcomes remained better than before the intervention took place.
Participants also maintained some of the lifestyle changes encouraged by the program. A healthier diet proved the easiest lifestyle change to maintain, and sleep scores and stress levels continued to be lower than before the intervention. The proportion of participants meeting physical activity recommendations did not significantly change.
“These findings support a complementary role for lifestyle interventions in long-term MS management,” researchers wrote, while cautioning that the study had no control group, meaning it cannot prove the program itself caused the observed improvements.
The study, “Sustained Benefits of a Multidomain Lifestyle Intervention in Multiple Sclerosis in the LIMS Study,” was published in Neurology.
Can lifestyle changes complement medical treatment?
MS is an autoimmune disease marked by inflammation and damage in the brain and spinal cord. Disease-modifying therapies can target this inflammation and slow the gradual accumulation of disability, but the disease will continue to progress in most patients despite treatment.
As a result, interest in whether lifestyle changes could complement medical treatment has grown. Emerging evidence suggests that a well-balanced diet, regular physical activity, restorative sleep, and psychological well-being may influence MS symptoms and biological processes relevant to disease progression. But many of these programs require in-person attendance, which can pose challenges and limit participation.
In this study, researchers in the Netherlands examined the impact of a digital lifestyle intervention focusing on multiple aspects of a healthy lifestyle.
Psychological gains persisted at two years
A total of 659 adults with MS were recruited into the LIMS study (NCT05402501) between 2021 and 2022. After a three-month observation period, participants entered an intensive three-month online program promoting a Mediterranean-style diet, regular physical activity, and strategies to improve sleep and manage stress. They received guidance from lifestyle coaches, dietitians, and other experts. A less intensive 21-month maintenance period followed to help participants sustain the changes.
Both the physical and psychological impact of MS on daily life improved during the intensive program, meeting the study’s primary goal. Physical gains gradually faded in the maintenance period and were no longer significant at two years, while psychological gains persisted.
Some MS-related symptoms also eased during the intensive phase, including fatigue, anxiety, and depression. Anxiety remained significantly lower at two years, while improvements in fatigue and depression weakened over time — though these symptoms remained significantly lower than before the intervention. Cognitive complaints changed little.
General health measures also improved. Body mass index and waist circumference, two measures of body composition, fell during the intensive phase and, despite some loss of benefit, remained significantly lower at two years than before the intervention.
The modest effects observed suggest that lifestyle interventions alone are unlikely to yield large symptomatic improvements in people with MS. Nevertheless, they may serve an important complementary role.
Of the lifestyle behaviors targeted by the program, diet showed the clearest lasting change. Adherence to a Mediterranean-style diet rose substantially in the intensive period and, although it declined afterward, remained better than before the program at two years.
Sleep quality also improved and perceived stress eased, with both remaining better at two years than before the intervention.
Physical activity proved harder to change. About one-third of participants met Dutch recommendations at the study’s start, and that proportion did not significantly change throughout the study. The researchers noted that this yes-or-no measure may have missed smaller increases in activity and that fatigue, mobility problems, and fluctuating MS symptoms may make becoming more active particularly challenging.
Some gains faded as the program shifted to a less intensive maintenance phase and participation declined. The researchers suggested that continued engagement and more personalized support may help lifestyle changes last.
Overall, “the modest effects observed suggest that lifestyle interventions alone are unlikely to yield large symptomatic improvements in people with MS,” the researchers wrote. “Nevertheless, they may serve an important complementary role by supporting behavioral change, promoting self-management, and potentially contributing to the prevention of symptom deterioration over time.”
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