Wellness and multiple sclerosis: The National MS Society establishes a Wellness Research Working Group and research priorities

Motl, Robert W.; Mowry, Ellen M.; Ehde, Dawn M.; LaRocca, Nicholas G.; Smith, Kathy E.; Costello, Kathleen; Shinto, Lynne; Ng, Alexander V.; Sullivan, Amy B.; Giesser, Barbara; McCully, Kevin K.; Fernhall, Bo; Bishop, Malachy; Plow, Matthew; Casaccia, Patrizia; Chiaravalloti, Nancy D.

doi:10.1177/1352458516687404

Cited by 68 publications

(46 citation statements)

References 25 publications

(28 reference statements)

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“…Wellness is a priority for people with multiple sclerosis (MS) 1 and can be achieved through health behaviors including physical activity and exercise. 2 – 4 …”

Section: Introductionmentioning

confidence: 99%

Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course

et al. 2020

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Objectives: To provide clinicians who treat multiple sclerosis (MS) patients with evidence-based or expert opinion–based recommendations for promoting exercise and lifestyle physical activity across disability levels. Methods: The National MS Society (“Society”) convened clinical and research experts in the fields of MS, exercise, rehabilitation, and physical activity to (1) reach consensus on optimal exercise and lifestyle physical activity recommendations for individuals with MS at disability levels 0–9.0 on the Expanded Disability Status Scale (EDSS) and (2) identify and address barriers/facilitators for participation. Recommendations: Based on current evidence and expert opinion, the Society makes the following recommendations, endorsed by the Consortium of Multiple Sclerosis Centers: Healthcare providers should endorse and promote the benefits/safety of exercise and lifestyle physical activity for every person with MS. Early evaluation by a physical or occupational therapist or exercise or sport scientist, experienced in MS (hereafter referred to as “specialists”), is recommended to establish an individualized exercise and/or lifestyle physical activity plan. Taking into account comorbidities and symptom fluctuations, healthcare providers should encourage ⩾150 min/week of exercise and/or ⩾150 min/week of lifestyle physical activity. Progress toward these targets should be gradual, based on the person’s abilities, preferences, and safety. If disability increases and exercise/physical activity becomes more challenging, referrals to specialists are essential to ensure safe and appropriate prescriptions. When physical mobility is very limited, exercise should be facilitated by a trained assistant.

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“…Wellness is a priority for people with multiple sclerosis (MS) 1 and can be achieved through health behaviors including physical activity and exercise. 2 – 4 …”

Section: Introductionmentioning

confidence: 99%

Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course

et al. 2020

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“…5 Several reviews have examined the role of diet therapy on the management of MS symptoms and disease progression including two systematic reviews 6,7 and several scoping or short reviews. [8][9][10][11][12][13][14] Evidence for a therapeutic diet for MS is insufficient and dietary advice for PwMS is to consume a healthy diet in line with national dietary guidelines. 7 The aims of this advice is to improve the wellbeing and sense of control in PwMS.…”

Section: Introductionmentioning

confidence: 99%

Dietary responses to a multiple sclerosis diagnosis: a qualitative study

et al. 2018

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Given the seriousness of the disease, there is a perceived gap in dietary information provided at the time of diagnosis. Healthcare professionals should address concerns with alternative therapeutic diets advertised to treat or cure MS, and clearly convey the reasoning for the general healthy dietary recommendations. This would better align advice with the perceptions about the role of diet in MS, assist people with MS in need of information and minimise dietary self-experimentation. Future research should explore the importance of diet for those who have had MS for a longer period of time.

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“…Unfortunately, the role of nutrition in MS is neglected at present, but among the good news we can say that the National Society for Multiple Sclerosis is responding to the request by patients of MS of more focus on wellness [131] and is creating a wellness group [132]. It will be of the outmost importance that this group creates dietary guidelines to be transmitted to neurologists who are caring for people with MS.…”

Section: Resultsmentioning

confidence: 99%

Diet, Gut Microbiota, and Vitamins D + A in Multiple Sclerosis

2018

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Central to the understanding of the relationships between diet, gut microbiota, and vitamins D and A in multiple sclerosis is low-grade inflammation, which is involved in all chronic inflammatory diseases and is influenced by each of the above effectors. We show that food components have either proinflammatory or anti-inflammatory effects and influence both the human metabolism (the "metabolome") and the composition of gut microbiota. Hypercaloric, high-animal-fat Western diets favor anabolism and change gut microbiota composition towards dysbiosis. Subsequent intestinal inflammation leads to leakage of the gut barrier, disruption of the blood-brain barrier, and neuroinflammation. Conversely, a vegetarian diet, rich in fiber, is coherent with gut eubiosis and a healthy condition. Vitamin D levels, mainly insufficient in a persistent low-grade inflammatory status, can be restored to optimal values only by administration of high amounts of cholecalciferol. At its optimal values (>30 ng/ml), vitamin D requires vitamin A for the binding to the vitamin D receptor and exert its anti-inflammatory action. Both vitamins must be supplied to the subjects lacking vitamin D. We conclude that nutrients, including the nondigestible dietary fibers, have a leading role in tackling the low-grade inflammation associated with chronic inflammatory diseases. Their action is mediated by gut microbiota and any microbial change induced by diet modifies host-microbe interactions in a consequent way, to improve the disease or worsen it.

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Wellness and multiple sclerosis: The National MS Society establishes a Wellness Research Working Group and research priorities

Cited by 68 publications

References 25 publications

Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course

Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course

Dietary responses to a multiple sclerosis diagnosis: a qualitative study

Diet, Gut Microbiota, and Vitamins D + A in Multiple Sclerosis

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