Multiple Sclerosis

What is Multiple Sclerosis?

Multiple Sclerosis (MS) is a chronic immune mediated inflammatory disorder. The central nervous system specifically the brain and the spinal cord are affected by the the body’s own immune system inflicting damage to the protective layer around the nervous system tissue (the myelin sheath). Due to this damage, a delay or blockage occurs in the signals to and from the brain to the rest of the body. Diagnosis of MS usually occurs between the ages of 20-40, however it can be diagnosed at any age.

MS is more common in women than in men. MS has been characterised into main types; these include:

Relapsing-remitting pattern: exacerbations alternating with remissions. Remissions can last months, or years and exacerbations can be spontaneous or occur due to an infection such as the flu.

Primary progressive pattern: disease progresses gradually with no remissions. There may be occasional plateaus when the disease doesn’t progress.

Secondary progressive pattern: this begins with relapses alternating with remissions, followed with gradual disease progression.

Progressive relapsing pattern: the disease progresses gradually; progression is interrupted with relapses.

About 85% of individuals with MS are diagnosed with relapsing-remitting. About 80% of those individuals are estimated to develop secondary progressive. 10% are diagnosed with primary progressive and only 5% are diagnosed with progressive relapsing.

What causes malnutrition and unintentional weight loss?

The cause of MS is unknown. However, it is suggested that it could be caused due to an autoimmune response. Genetic susceptibility has also been suggested to be a cause of MS with an increased rate of incidence in families with the presence of human leukocyte antigen (HLA) allotypes.

MS symptoms vary from person to person and can be unpredictable. Not all people with MS will experience these symptoms and symptoms can improve during periods of remission.

Symptoms can include:

Sensory: numbness, pins and needles and itching.
Motor: muscular spasms, coordination and function of the arms and legs.
Visual: double vision Fatigue
Balance
Urinary: bladder incontinence
Pain
Cognitive: memory loss and trouble concentrating.

How can Bites Dietitians help?

It has been found that by making lifestyle and dietary modifications that improve fat profiles in the bloo, this may slow the rate of disability progression! This means that by limiting your intake of saturated fats, you may be able to significantly reduce the level of disability experienced and also the rate at which disease progression occurs. The evidence suggests that the fats present in the blood may influence ongoing degeneration of brain tissue which drives the progression of the disease. Reducing the amount of saturated fats, we consume in your diet is beneficial as saturated fats are used to make different inflammatory factors. Alternatively, unsaturated fats have been shown to be an important part of your diet and can assist in the repair and maintenance of neural tissue (brain and nerve tissue). Our dietitians can calculate the amounts of fat you are currently eating of each type and help you to tweak your typical day to help you better manage your MS symptoms. We will generally help you increase your consumption of neuroprotective unsaturated fats by adding more omega-3-fatty acids and monounsaturated fats (for example, extra virgin olive oil as it contains many phytochemicals including phenolic compounds which are anti- inflammatory as well as neuroprotective).

Additionally, our dietitians are able to guide you with food choices to minimise fatigue and other symptoms that are commonly experienced with MS. You and your dietitian will work closely together to make modifications to current dietary habits and lifestyle behaviours that are practical for you to follow. We will adapt your meal plan along the way if your needs change and liaise with your other treating professionals to make sure what we do complements your other treatments well!

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An interesting fact about diet and Multiple Sclerosis:

It has been evident that MS is more common in countries that consume a western style diet compared to developing countries where typically low-saturated fat diets are consumed.

How can Bites Exercise Physiologists help?

Regular exercise is very beneficial for overall health and wellbeing, it improves cardiovascular health, improves strength and endurance, relieves MS related fatigue and manages spasticity. Research has shown that exercise has been associated with great outcomes ranging from a cellular level to overall quality of life. Exercise has also been proven to improve brain health based on magnetic resonance imaging and better cognition based on speed of information processing. Another benefit of exercise in individuals with MS is less fatigue, depression, anxiety, pain and better sleep!!! A barrier for some may be thinking that exercise could trigger a relapse or cause other adverse health complications, however, exercise is NOT associated with increased risk of relapse or risk of any adverse health effects!

Our Exercise Physiologists can create a tailored exercise prescription that will help you to develop your maximum potential of muscle, bone and cardiorespiratory fitness therefore improving and maintaining overall health and wellbeing whilst avoiding secondary complications. The physical activity guidelines for adults with mild to moderate MS include 30 minutes of moderate intensity aerobic activity two days per week and strength training for major muscle groups two days per week. With this in mind, our Exercise Physiologists will use these guidelines as well as your individual experience of MS to create a suitable plan for you. Moderate intensity activity will VARY from person to person. Therefore, not any generic plan will be suitable as this will depend on your physical fitness, ability and what you enjoy to do!

Living a healthy life involves recognising how your MS affects you and how you’re feeling. This is essential when deciding whether to exercise or rest; it is important to listen to your body, your symptoms and understand how they impact you. Our Exercise Physiologists can give you physical signs and guidelines to help you determine whether you should use your “light” or “more intense” exercise plan. We would usually create a variety of plans for you to use under different circumstances so that you’re still able to do something positive and keep moving during times of remission and exacerbations. This will ensure you are reaching your goals and that your exercise prescription is benefiting you no matter where your body is at!

An interesting fact about Exercise and Multiple Sclerosis.

Exercise should not be seen as a cure of MS; however, it has been proven to have positive effects on disease modulation. About 80% of individuals with MS do not participate in regular exercise or physical activity. This is a worrying statistic as it can be represented as 80% of individuals are not utilising a successful prescription to managing the disease.

What improvements can you expect from a tailored Dietary/Exercise prescription?

By following dietary and exercise prescriptions you can expect successful management of MS symptoms, overall feeling of optimal wellbeing, improvements in MS fatigue and improvements in dietary habits.