Driving Research on Wellness and Lifestyle Solutions for Everyone with MS
A great deal of progress has been made in the development of 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 an unmet need for information on additional ways for 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:
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Smoking seems to increase MS risk and progression.
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Obesity in teenage girls may be associated with increased MS risk.
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Vitamin D levels 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. In 2014, the Society convened a Wellness Strategy Meeting with leaders in the fields of diet, exercise and psychology, including individuals who also directly live with MS. This meeting launched an initiative whose future steps include creating an MS Wellness Research Network – including researchers in the areas of diet, exercise and mood – with the goal of developing research priorities, refining study methodologies, and engaging more scientists in MS wellness research.
Is there an ideal “MS Diet” that can reduce symptoms or change the course of MS? While emerging evidence suggests that wellness behaviors and lifestyle factors can influence the risk for developing MS, disease course, severity of symptoms and quality of life, most of the diets promoted for MS have not been subjected to rigorous, controlled studies. That’s one reason why studies looking at the impacts of diets, supplements and complementary approaches on the course of disease and quality of life are among the key topics identified as Society Research Priorities.
- Clinical trials of diets -- Investigators at Washington University in St. Louis are testing the safety and tolerability of a diet that intermittently restricts calorie intake as a treatment for disease activity in people with MS.A team at the University of Iowa is conducting a trial comparing the effects on fatigue of a low saturated fat diet (a diet developed by Roy Swank, MD) or a modified paleolithic diet (a diet developed by Terry Wahls, MD).
- Vitamin D – Research is increasingly pointing to a reduced level of vitamin D in the blood as a risk factor for developing MS. The Society led the way in preclinical studies, and is now funding a nationwide clinical trial of vitamin D supplementation, led by a team at Johns Hopkins University.
- Salt may speed the development of an MS-like disease in mice, providing new insights on immune system activity in MS. 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 may affect the immune system in people.
- Antioxidants are natural or manmade substances found in many foods that 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 progression in 118 participants with primary progressive or secondary progressive MS.
- Gut bacteria are critical in the establishment and maintenance of immune balance. Several teams funded by the Society are conducting comprehensive analyses of gut bacteria in people with MS to determine factors that may drive progression and help to develop probiotic strategies for stopping it. The National MS Society continues to fund research in this area, most recently The International MS Microbiome Study, a comprehensive analysis of gut bacteria in people with MS to determine factors that may drive progression and develop probiotic strategies for stopping progression.
- Adolescent obesity has been associated with developing MS. Researchers funded by the Society are exploring further, with teams at Washington University in St. Louis testing whether a diet that restricts calorie intake reduces MS disease activity.
Sometimes the Society invests in testing a complementary strategy that holds promise. 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 and Ginkgo biloba to treat cognitive impairment. Results so far have not supported benefit of either in MS.
Exercise and Rehabilitation Research
Rehabilitation interventions 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. In 2005 the Society engaged advisors to help determine why the kind of rigorous science applied to other types of research had often been lacking in rehabilitation research. As a result, the Society established a fellowship program that supports expert mentors who train rehabilitation professionals in how to properly conduct MS rehabilitation research studies. The Society funds rehabilitation research testing fsolutions so that people with MS can live their best lives every day:
- testing whether increasing physical activity through the use of simple accelerometers can improve cognitive functioning in MS
- testing a method of walking to a beat or music to see if it improves walking in people with MS
- Testing the efficacy of a unique group-based therapy for improving emotion regulation in people with MS and their carepartners
We are making progress - here are some recent reports:
- In a small study, researchers found that people with MS largely complied with a diet study that was administered via telehealth (coaching by phone and email check-ins).
- To provide the MS community with evidence-based guidance for promoting exercise and lifestyle physical activity, the National MS Society convened a group of experts in the fields of MS, exercise, rehabilitation, and physical activity to review available studies and develop recommendations for healthcare providers who can advise individuals with MS at all disability levels.
- In a pilot study of 61 people with MS, researchers found that a four-week “mindfulness” (meditation)-based attention training program reduced difficulties in modulating emotions and improved thinking abilities better than either a computer-based cognitive training program or no treatment.
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.