Driving Research on Wellness and Lifestyle Solutions for Everyone with MS
A great deal of progress has been made in the development of pharmaceutical therapies that can help slow MS and reduce attacks in many, and substantial research is underway to find better therapies for everyone with MS. Yet there is a substantial unmet need for information on additional ways that will allow people with MS to live their best lives each and every day. For that reason, the National MS Society has made research on wellness and lifestyle factors a priority.
Increasing evidence suggests that lifestyle factors help influence whether a person develops MS, and may also influence disease course and quality of life. Some candidates include:
• Smoking is being pinpointed increasingly as a factor that can increase MS risk and progression.
• Obesity in teenage girls may be associated with increased MS risk.
• Vitamin D levels, increased through sunlight exposure or foods such as fatty fish, are associated with reduced risk of MS.
Targeting research on rehabilitative techniques, exercise, diet, complementary therapies and other factors allows us to respond to the most crucial concerns of people who live with MS. The Society recently convened a Wellness Strategy Meeting with leaders in the fields of diet, exercise and psychology, including individuals who also directly live with MS. This team is identifying gaps in knowledge and programming and mapping out next steps for how these
Diet and Complementary Medicine
Maintenance of general good health is important for people with MS or any chronic disorder. While many different diets or complementary treatments have been proposed in MS, evidence of effectiveness is very limited. Most of these proposed diets or treatments have not been subjected to rigorous, controlled studies, and the few that have produced mixed results. Researchers are making significant connections, however, that may eventually impact the lives of people living with MS.
• Vitamin D – Research is increasingly pointing to a reduced level of vitamin D in the blood as a risk factor for developing MS. Studies are underway to determine if vitamin D levels influence disease activity. The Society led the way in preclinical studies, and is now funding a clinical trial of vitamin D supplementation.
• Salt – Several reports suggest that dietary salt may speed the development of an MS-like disease in mice, providing new insights on immune system activity in MS. While more research is needed to confirm a role for salt in triggering MS, or to determine whether reducing salt can inhibit MS immune attacks, these studies pinpoint new avenues for strategies that can decrease MS attacks. These studies were funded by the Society, and current funded research explores how salt affects the immune system in people.
• Antioxidants – These natural or manmade substances are found in many foods. In MS, the immune system damages and destroys myelin, the material that surrounds and protects nerve fibers in the brain and spinal cord. Antioxidants block the action of “free radicals,” by-products of bodily processes that may cause tissue injury and promote immune attacks in MS. The Society is funding scientists at Oregon Health Science University to test whether an antioxidant can reduce optic nerve damage (often the first symptom of MS).
Sometimes the Society invests in testing a complementary strategy that holds promise, particularly through its Pilot Research Award program that funds high-risk ideas. Although studies may lead to disappointing results, this learning is just as crucial to keep research moving in the right direction. Among strategies investigated in the past are a component of red wine (resveratrol) for protecting the nervous system; Ginkgo biloba to treat cognitive impairment; and omega-3 fatty acids. Results have not supported benefit in MS.
Exercise and Rehabilitation Research
We choose investments with the best return in changing lives. Rehabilitation comprises interventions that can help people with MS to achieve their physical, psychological, social and vocational potential. But to convince doctors and insurers of their effectiveness, we need the kind of evidence that can only come from well designed and conducted scientific studies. The kind of rigorous science applied to other types of research has been lacking in rehabilitation research. So in 2005 the National MS Society engaged advisors to help determine what was standing in the way. As a result, the Society established a fellowship program that supports expert mentors who train rehabilitation professionals in how to conduct well-designed MS rehabilitation research studies.
The Society now funds more than 30 projects in the area of rehabilitation research, testing these and other solutions so that people with MS can live their best lives every day:
• New strategies for balance control
• Methods for improving lung function
• Exercise regimens for people with advanced MS
• Home-based exercise to improve mobility and cardiovascular health
• New strategies for improving cognitive function and psychosocial wellness
We are making progress - here are some recent reports:
• Weight training improves walking and quality of life: Women participating in a small study of progressive resistance (weight) training improved significantly in walking. The Society-funded study used in-depth interviews of participants to determine full effects on quality of life, which improved significantly.
• Balance/eye movement training improves fatigue: A 6-week balance and eye movement-focused exercise program improved balance, reduced fatigue, and reduced disability due to dizziness or disequilibrium in a group of people with MS. The results lasted for at least 4 weeks following supervised training. The study was funded by a pilot research grant from the Society.
• Strong evidence that cognitive rehabilitation improves learning and memory: Researchers at Kessler Foundation in New Jersey reported that a specific type of memory training improves learning in people with MS. Effects lasted for 6 months after training ended, and also benefits other aspects of quality of life. The Kessler team is training rehab researchers through the Society’s mentor-based fellowship program.
• Vitamin D and MS progression: Society-funded researchers at Harvard found that low levels of vitamin D early in MS may predict disease activity and progression later on. Society funding for this study leveraged data that cost millions of dollars to gather during an industry-funded clinical trial.
Finding Solutions That Will Change Lives
The National MS Society pursues all promising paths to uncover solutions for EVERYONE with MS, wherever those opportunities exist. Research going on right now on lifestyle and wellness may uncover substantial results that will help people with MS live their best lives.