Wellness and lifestyle highlighted at ECTRIMS 2015
European Committee for Treatment and Research in MS (ECTRIMS) – 31st Congress – Barcelona, Spain, October 7-10, 2015 – ECTRIMS 2015 is the largest annual conference on MS research, and numerous studies presented new information addressing wellness and lifestyle issues in MS. The following is a summary of some of the highlights.
Exercise: A study at the Hospital for Sick Children in Toronto looked at exercise levels in children and adolescents with MS compared to healthy individuals (Grover and colleagues. ECTRIMS 2015; abstract P763). Younger people with MS spent less time exercising compared to other people in their age group – on average about 14 minutes a day of moderate exercise, and only 30 seconds of vigorous exercise daily. An important finding was that those with higher levels of vigorous activity had less fatigue and fewer symptoms of depression.
Mindfulness: Mindfulness is a meditation technique to reduce stress and improve feelings of well-being, and a new study investigated whether a mindfulness-based stress reduction program provided any benefits in MS (Guevara and colleagues. ECTRIMS 2015; abstract P674). People participated in one 90-minute session per week for eight weeks. After completing the program, people reported feeling less anxious and depressed, and there was also some improvement in their MS fatigue. These results are in line with a recent review of this topic, which found that mindfulness improved people’s quality of life, eased symptoms of anxiety and depression, and improved some aspects of physical functioning (Simpson and colleagues. BMC Neurol 2014;14:15; free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC3900731/pdf/1471-2377-14-15.pdf). For more on the topic, see Senders and colleagues. J Evid Based Complementary Altern Med 2014;19:104-111; free full text at www.ncbi.nlm.nih.gov/pmc/articles/pmid/24647090/.
Oral contraceptives: While MS is more common among women, a number of lines of evidence suggest that female hormones can have positive effects on the disease (e.g. relapses are less frequent and severe during pregnancy). So researchers looked at whether oral contraceptive (OC) use had an impact on MS (Clares and colleagues. ECTRIMS 2015; P805). The study compared women who had never taken OCs, those who had been taking them before they were diagnosed with MS, and those who started taking them after their diagnosis. There was no difference in relapses among the three groups, but MS was less severe and appeared to progress more slowly in women who started taking OCs after their diagnosis.
Smoking: People who quit smoking after being diagnosed with MS delay the development of secondary-progressive MS, according to a study at the Karolinska Institute in Sweden (Ramanujam and colleagues. ECTRIMS 2015; abstract P399). Ex-smokers developed SPMS (the beginning of irreversible disability) on average in their late 50s – whereas those who continued to smoke reached SPMS about 10 years earlier.
Air pollution: A few studies have suggested that air pollution can worsen MS. For example, a study in Finland found that the risk of having a relapse was four-fold higher when air pollution levels – sulphur dioxide, nitrogen dioxide, and small particulates called PM10 that can get into the lungs – were high (Oikonen and colleagues. Neuroepidemiology 2003;22:95-99). A new study looked at the impact of air pollution on people living in Strasbourg, France (Leray and colleagues. ECTRIMS 2015; abstract EP1421). They found that higher levels of small particulates (PM10) increased the risk of a relapse by about 35%. Relapses were more likely 0-3 days after exposure to air pollution. The people at risk were women who were 30-50 years of age. Men appeared to suffer less from the effects of air pollution, although the reasons for this aren’t clear. A separate study in Italy found that people with MS had more inflammatory activity on their MRI after exposure to air pollution (Cortese and colleagues. ECTRIMS 2015; P916).
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