Overcoming Multiple Sclerosis

1. MS is a chronic, progressive disease influenced by lifestyle factors

MS is a chronic, progressively disabling disease that is still regarded as incurable.

Environmental factors dominate. While genetics play a role in MS susceptibility, environmental factors account for about 75% of the risk of developing MS. These factors include diet, sun exposure, vitamin D levels, exercise, stress, and smoking. Importantly, these lifestyle factors are modifiable, offering hope for prevention and management of MS.

Disease characteristics. MS affects the brain and spinal cord, causing inflammation and damage to the myelin sheath that protects nerve fibers. This leads to a wide range of symptoms, including fatigue, mobility issues, and cognitive problems. The disease can take different forms, including relapsing-remitting, primary progressive, and secondary progressive MS.

Prevalence and trends. MS affects approximately 1 in 1000 people, with higher rates in countries further from the equator. The disease is becoming more common, likely due to changes in lifestyle and environmental factors. Women are more affected than men, with the ratio shifting from 3:2 to 3:1 in recent years.

2. Diet plays a crucial role in managing MS symptoms and progression

The evidence clearly and strongly shows that saturated fat consumption, and hence fat concentrations in cells and blood fat profiles, is a key determinant of the rate of developing disability for PwMS.

Plant-based wholefood diet. The Overcoming Multiple Sclerosis (OMS) Recovery Program recommends a plant-based wholefood diet plus seafood. This approach aims to minimize saturated fat intake while providing essential nutrients and omega-3 fatty acids. Key elements include:

• Avoiding meat, dairy, and processed foods
• Consuming plenty of fruits, vegetables, whole grains, and legumes
• Including seafood for omega-3 fatty acids
• Supplementing with flaxseed oil

Evidence-based benefits. Research, including the HOLISM study, has shown that adhering to this diet is associated with:

• Improved quality of life
• Reduced disability progression
• Lower relapse rates
• Better overall health outcomes

Practical implementation. Transitioning to this diet may seem challenging, but it becomes easier with time. Tips for success include:

• Gradually replacing unhealthy foods with healthier alternatives
• Experimenting with new recipes and cuisines
• Reading food labels carefully
• Planning meals in advance

3. Adequate sun exposure and vitamin D are essential for MS prevention and management

Vitamin D is made in the body from the action of UVB light on exposed skin.

Sun exposure benefits. Regular, moderate sun exposure is crucial for MS prevention and management. It helps produce vitamin D in the body and has other beneficial effects on the immune system. Aim for:

• 10-15 minutes of sun exposure on most of the skin when the UV index is 7
• Longer exposure times when UV index is lower
• Careful balance to avoid sunburn and skin damage

Vitamin D supplementation. Many people, especially those living far from the equator, may need to supplement with vitamin D. Recommendations include:

• For primary prevention: blood levels over 100 nmol/L (40 ng/mL)
• For secondary prevention: blood levels over 150 nmol/L (60 ng/mL)
• Typical dosages range from 5000-10,000 IU per day for adults
• Regular blood tests to monitor levels

Research support. Studies have shown that adequate vitamin D levels are associated with:

• Reduced risk of developing MS
• Lower relapse rates in people with MS
• Potential slowing of disease progression

4. Regular exercise improves overall health and may slow MS progression

Exercise can improve cognitive function.

Benefits of exercise. Regular physical activity offers numerous benefits for people with MS, including:

• Improved cardiovascular health and muscle strength
• Better balance and coordination
• Enhanced cognitive function
• Reduced fatigue and depression
• Potential slowing of disease progression

Exercise recommendations. The type and intensity of exercise should be tailored to individual abilities and preferences. General guidelines include:

• Aim for 30 minutes of moderate-intensity exercise on most days
• Incorporate both aerobic and strength training activities
• Consider activities like swimming, yoga, or tai chi for those with mobility issues
• Start slowly and gradually increase intensity and duration

Overcoming barriers. Many people with MS face challenges when it comes to exercise, such as fatigue or heat sensitivity. Strategies to address these issues include:

• Exercising in cooler environments or using cooling vests
• Breaking exercise into shorter sessions throughout the day
• Working with a physical therapist to develop a personalized program

5. Meditation and stress reduction techniques are powerful tools for MS management

Meditation has many beneficial effects for those with chronic illness, particularly auto-immune disease.

Stress and MS. Stress has been shown to trigger MS relapses and potentially accelerate disease progression. Managing stress is therefore crucial for MS management. Meditation and other stress reduction techniques can help by:

• Reducing inflammation in the body
• Improving immune system function
• Enhancing overall well-being and quality of life

Meditation practices. Various meditation techniques can be beneficial for people with MS:

• Mindfulness meditation
• Progressive muscle relaxation
• Guided imagery
• Breathing exercises

Implementing stress reduction. Incorporating stress reduction techniques into daily life can be achieved through:

• Setting aside dedicated time for meditation or relaxation
• Using apps or guided recordings to assist with practice
• Joining meditation groups or classes
• Integrating mindfulness into everyday activities

6. Medication can be beneficial, but should be considered alongside lifestyle changes

Steroids cut short relapses, but should not be used in the long term.

Medication options. Several types of medications are available for MS management:

• Steroids for acute relapses
• Disease-modifying drugs (DMDs) to reduce relapse rates and slow progression
• Symptomatic treatments for specific MS symptoms

Weighing benefits and risks. When considering medication, it's important to:

• Understand the potential benefits and side effects of each option
• Discuss the pros and cons with a healthcare provider
• Consider how medication fits into an overall MS management strategy

Holistic approach. The most effective MS management typically involves a combination of:

• Lifestyle modifications (diet, exercise, stress reduction)
• Medication when appropriate
• Regular monitoring and adjustment of the treatment plan

7. Empowerment and a proactive approach are key to overcoming MS

Hope has an important protective effect for the health of PwMS.

Taking control. Empowerment means becoming the captain of one's own health journey. This involves:

• Educating oneself about MS and treatment options
• Making informed decisions about lifestyle and medical care
• Actively participating in the management of one's health

Building resilience. A proactive approach to MS management can help build resilience and improve overall outcomes. Key elements include:

• Cultivating a positive mindset and finding sources of hope
• Developing a strong support network
• Setting realistic goals and celebrating progress

Ongoing commitment. Overcoming MS is a long-term process that requires ongoing commitment and adaptation. This may involve:

• Regularly reassessing and adjusting management strategies
• Staying informed about new research and treatment options
• Advocating for oneself in healthcare settings
• Sharing experiences and supporting others with MS

Last updated: September 17, 2024