Update on family, diet and exercise
European Committee for Treatment and Research in MS (ECTRIMS), London UK, September 14-17, 2016 – Genetic factors contribute to MS risk, so family members of a person with MS have a somewhat higher chance of developing it. According to a recent estimate, the lifetime risk of MS in family members is about 3% in a brother or sister, and about 2% in your child (O’Gorman and colleagues. Neuroepidemiology 2013;40:1-12). As you might expect, the risk is highest in your identical twin – 18% (or about 1 in 5).
Two new studies have looked more closely at family members of people with MS. A study in healthy identical twins found that one-third of them had some degree of MS-like inflammation on their MRI, although not enough to be diagnosed with MS (Gerdes and colleagues. ECTRIMS 2016; abstract 169). These results may help to identify the specific genetic factors that contribute to MS risk. Similarly, the Genes and Environment in MS (GEMS) study of family members reported on 65 first-degree relatives of people with MS (Xia and colleagues. ECTRIMS 2016; abstract P537). A first-degree relative is a parent, sibling or child. None of these relatives had MS, but 8% had MRI features suggestive of MS and 22% had inflammatory lesions in the brain. They also had some numbness in their hands and feet. So there were some low-level features of MS in these close relatives even though they didn’t develop MS.
Diet: Many “MS diets” are promoted on the Internet but there is little scientific evidence to support their claims. A review of 15 diet studies (mostly involving vitamin D or fatty acids) found that none of these diets provided any clear benefits (Riemann-Lorenz and colleagues. ECTRIMS 2016; abstract P781). The researchers also surveyed 337 people with MS about their diet. Overall, 42% had tried a special diet. The most common was the Mediterranean diet. The main reasons for trying a special diet were to improve overall well-being and to slow the development of disability. Watch for our new booklet on Nutrition & MS, available soon for free download on www.msology.com.
Exercise: A new study looked at whether a 12-week Pilates program was worthwhile for people with MS (Kalron and colleagues. ECTRIMS 2016; abstract P792). At the end of the three months, people showed improvements in walking speed and balance. So Pilates was useful for fitness and flexibility in people with MS, although the researchers noted that it didn’t appear to be better than other types of regular exercise programs.
A second study used Fitbits to monitor people’s activity level (Block and colleagues. ECTRIMS 2016; abstract P343). Not surprisingly, people with more disability (as measured by the EDSS score) took fewer steps than people without disability. And people with progressive MS took fewer steps than people with relapsing-remitting MS (about 2,500 fewer steps per day). But there was great variability: among those requiring a cane (EDSS 6): some people took 1,000 steps a day while others took up to 7,000 steps a day. Devices such as the Fitbit may enable researchers in the future to more closely measure activity in clinical trials, especially studies of people with progressive MS.
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