Australian experts have teamed up with MS Research Australia to build an evidence-based lifestyle guide to help people living with the chronic neurological condition multiple sclerosis (MS) improve their disease outcomes by making changes to daily habits. The guidelines conclude that fad MS diets have no supporting evidence and should be avoided, and simple changes to lifestyle including a balanced diet and physical activity need to be prioritised.
‘Adapting your lifestyle – a guide for people with MS’ is an expert review and assessment of the latest scientific evidence in nine lifestyle areas (also known as modifiable risk factors) relevant to MS – smoking, physical activity, diet and nutrition, gut health, supplements, vitamin D and sun exposure, weight and obesity, living with other medical conditions and lipids.
The guide aims to give those living with MS a clear understanding of the important areas of their daily life they can actively manage that will positively impact their condition – helping to manage relapses, disability and improve quality of life. It also seeks to give a much-needed sense of independence, empowerment, and peace of mind in these challenging times.
Dr Julia Morahan, Head of Research at MS Research Australia, says; “The launch of this unique publication has the potential to impact how millions of people with MS around the world live now. We know there are around 25,600 Australians currently living with MS – so working together with experts to create these guidelines and equipping people with MS with effective, evidence-based ‘self-care’ strategies to fight this chronic disease is of critical importance.”
Associate Professor Yasmine Probst, Dietitian and Nutritionist at the University of Wollongong, and The Illawarra Health and Medical Research Institute says; “While exercise, diet and weight management are a focus on most of the general population’s ‘To Do’ lists – particularly during COVID-19 – these lifestyle measures were formally confirmed by the experts building this guide as very important ‘Must Dos’ for those living with MS.”
“From a diet perspective, it’s important for those with MS to avoid fad diets – as there is no evidence supporting these. Instead, following the nutritional guidelines set out for the general population by the Australian Dietary Guidelines and consuming a balanced diet with the necessary food groups must be the priority,” adds Associate Professor Probst.
The guidelines uncover five lifestyle areas where there is very strong evidence supporting a significant positive impact on MS:
| SMOKING | Strong recommendation for those with MS not to smoke as it increases the risk of disability progression by ~55%, as well as increasing the risk of early death. |
| PHYSICAL ACTIVITY | Regular physical activity is extremely important in helping with mobility, fatigue and pain in MS, together with reducing the rate of relapse and a slowing of disability progression. |
| DIET & NUTRITION | Nutritional guidelines set out for the general population by the Australian Dietary Guidelines are strongly recommended for people with MS. |
| WEIGHT & OBESITY | Young people who are overweight or obese are at higher risk of developing MS later in life. |
| VITAMIN D & SUN EXPOSURE | Studies have found those living with MS have lower levels of vitamin D in their serum. Preliminary evidence suggests vitamin D may have an effect on the risk and progression of MS. People with MS should maintain healthy vitamin D levels and obtain sufficient levels of sun exposure. |
“The release of these guidelines couldn’t arrive at a more important time. We know many in the MS community are missing out on their regular check-ups and feeling fearful and disconnected from their support networks. People are struggling to maintain health behaviours and may need extra support to ensure they stay well,” says Dr Claudia Marck, Senior Research Fellow, University of Melbourne.
MS is a neurological condition with no known cure. Every week approximately 10 Australians, aged between 20-40 years old, are newly diagnosed with the lifelong condition.
Dr Yvonne Learmonth, Neurological Physiotherapist, and Senior Lecturer at Murdoch University, Perth, says; “There’s evidence indicating that people with MS are less active than the general population, and that right now, during the pandemic, people with MS are not maintaining positive lifestyle behaviours. These guidelines are so important to support the MS community – especially now.”
“For many years, some doctors advised people with MS to avoid physical activity or exercise, fearing it could trigger the onset or worsening of MS symptoms. Now we know that exercise not only can help to manage pain, mobility and fatigue with MS – it can also result in a reduced rate of relapse and may slow disability progression,” adds Dr Learmonth.
The new evidence-based guidelines provide a crucial tool for those living with MS, their families, carers, as well as healthcare professionals.
The patient guide ‘Adapting your lifestyle – a guide for people with MS’ can be found online here.
The guidelines ‘Modifiable Lifestyle Factors and MS: A guide for Health Professionals’ can be found online here.
Expert contributors: Professor Bruce Taylor, Dr Amin Zarghami, Associate Professor Ingrid van der Mei and Ms Lara Marie Pangan Lo, Menzies Institute for Medical Research; Dr Claudia Marck and Dr Steve Simpson-Yap, University of Melbourne; Dr Lucinda Black, Curtin University; Dr Mary Webb ACT; Dr Phu Hoang, NeuRA; Ms Rachel Whiffen and Dr Sarah White, Quit; Dr Wolfgang Marx, Deakin University; Associate Professor Yasmine Probst, University of Wollongong and The Illawarra Health and Medical Research Institute; Dr Yvonne Learmonth, Murdoch University.
