Diet and Exercise Updates
Diet for Persons with MS
Life after diagnosis with multiple sclerosis (MS) can be overwhelming because symptoms vary from person to person. Remember, there is a lot of information out there that may be misleading. Rely on healthcare providers and valid organizations to provide factual information.
The expression “You are what you eat” has been around for a long time and has proven to hold true. Your diet can be an important tool in dealing with life with MS. Although there is no diet for curing MS, there are dietary habits that may alter the course of the disease. It has been demonstrated that people with MS who have an increased Body Mass Index (BMI) experience more relapses than people with a normal BMI.
There has also been an association with worsening scores with Expanded Disability Status Scale (ECCS), with higher cholesterol and triglycerides. Finally, diet has significant effects on the gut microbiome.
Everyone’s diet goals are different and should be made in consultation with your healthcare team (including a dietitian with experience in MS), but your goals may include:
- Maintaining a normal BMI and a “good” cholesterol level.
- Monitor caloric intake.
- Avoid sugar-laden foods which will keep glycemic index down.
- Limit salt intake.
- Try to avoid fast foods which contain increased amounts of fat and salt.
- Eat a low fat/plant-based diet.
- Limit red meats.
- Fiber intake (25 grams for women; 38 grams for men).
- Eat foods high in omega-3 and 6 fatty acids.
- This includes fatty fish, walnuts, flaxseeds and canola oil.
- Consume alcohol and caffeine in moderation.
- Make sure to supplement with Vitamin D and have your levels checked periodically
Exercise Updates for Persons with MS
It is hard to believe that at one time not too long ago, persons with MS were told to avoid exercise. We know that exercise is not only safe for persons with MS, but beneficial. Exercise or physical activity is recommended for everyone, with or without MS, to optimize health and wellness; there is evidence that exercise can help with the following for people living with MS:
- Bone Health
- Sex Drive and/or Function
- Memory and Cognition
These benefits to someone with MS are in addition to the more well-known strength and endurance benefits of exercise.
Despite all that is known about the benefits of exercise for persons with MS, it can still be difficult to know just where and how to start an exercise program appropriate for you and your unique circumstances. To help individuals, clinicians, and scientists navigate what is currently known about exercise for persons with MS, several guidelines and updates have been published over the past several years.
These guidelines stress a multiprong approach to exercise starting with a base of moderate aerobic endurance exercise, or physical activity. Also included are resistance, or strength training; neuromotor, balance, or coordination; and flexibility.
How do these updates affect you? Perhaps the most dramatic change was an increase in recommended exercise times per week have been increased from 60 minutes to 150 minutes of moderate exercise. While this may seem like a lot, this recommendation is the same as for the general population— no more no less!
It is further recognized that exercise can be mixed and matched with lifestyle physical activity or recreation, such as gardening, walking a dog, or even doing the dishes.
Another important change is the understanding that high intensity exercise, where you are really breathing hard, has its place in an exercise program for persons with MS, so long as it is short and not overdone! Finally, whether you have MS or not, you can benefit from exercise or physical activity. Furthermore, adaptations, or assistance, however creative, should be sought out as necessary to help you attain your exercise goals.
Both dietary changes and exercise will allow the person with MS to gain control with a disease that often makes one feel out of control. Small changes in lifestyle can have a big change in quality of life. It is important to realize behavior change does not occur overnight and there are health and wellness benefits from doing any physical activity regardless of whether any guidelines are met.
Kalb, R. et. Al. Multiple Sclerosis Journal DOI:10.1177/1352458530915629, 2020
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Tettey, JNNP 2017; Weinstock-Guttman, J neuroinflammation 2011