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Living with multiple sclerosis

Multiple sclerosis (MS) is widely thought to be a disease of immune dysfunction, whereby the immune system becomes activated to attack components of the nerves in the brain, spinal cord, and optic nerve. New information about environmental factors and lifestyle are giving persons with MS and their health care providers new tools with which to manage the disease and live healthier and more productive lives.

It has been known for decades that there is a higher incidence of MS the farther away one is from the equator. One explanation for this may be that in colder climates there is less sunlight and less Vitamin D production by the body, because sunlight helps stimulate the production of Vitamin D. Low Vitamin D levels early in life have been shown to correlate with an increased risk of MS later on. Additionally there is some evidence that in someone who already has MS, lower Vitamin D levels may increase the chance of a relapse. People who have MS should consult with their health care providers about Vitamin D levels and appropriate supplementation and monitoring; too much vitamin D can also be dangerous.

Another environmental factor that has recently been identified as possibly influencing Mmultiple sclerosis is salt. In the animal model of MS, a high salt diet makes the “mouse MS” worse. Another study in humans suggests that a high salt diet is associated with more severe disease. These are preliminary findings and more studies in this area are needed. Diets high in saturated fats may also be a problem for persons with MS, as they can promote obesity, and fat tissue has been demonstrated in some models of disease to be a contributor to inflammation.

Recent studies seem to show that salt intake influences the expression of MS. Image Credit: Paul Goyette, CC BY-SA 2.0 via Wikimedia Commons.
Recent studies suggest that salt intake influences MS symptoms. Image Credit: Paul Goyette, CC BY-SA 2.0 via Wikimedia Commons.

While no specific dietary regimen has been shown in controlled trials to impact the course or progression of MS, new data are emerging that the bacterial population of the intestinal tract, the “gut microbiome,” may have an important role in the mechanisms of MS, and the composition of this bacterial population is heavily influenced by diet. Diets that are high in plant-based foods, and low in saturated fats and refined sugars are thought to promote a more beneficial bacterial population.

Smoking tobacco has definitely been shown to be bad for multiple sclerosis. Not only do smokers have an increased risk of developing MS, but persons with MS who smoke have higher rates of disability and shorter life spans.

Exercise not only has the same benefits for persons with MS as it does for the general population — i.e. in terms of promoting cardiovascular and bone health and general fitness — but some studies have demonstrated that exercise may help a person with MS to manage certain symptoms of the disease. These include fatigue, weakness, spasticity, and depression. There is no one established exercise regimen for persons with MS, but some experts suggest a combination of aerobic exercise and resistance training, for 20-30 minutes, at least 3-4 days/week. Other forms of exercise such as yoga or Pilates®-type training may help some people feel and function better by addressing problems of spasticity and balance.

In summary, in addition to disease management with medication and standard rehabilitation therapies, there are several lifestyle choices that a person with multiple sclerosis can make to feel and function better, and possibly impact their disease course. Don’t smoke, eat a “heart healthy” diet, and get some regular physical activity.

Featured Image: Nerve cells in the brain. CC0 Public Domain via Pixabay.

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