By Tyler Titcomb

Diet, exercise, sleep, and stress reduction are ways people with MS can improve their personal wellness and possibly reduce symptoms. A recent study published in Multiple Sclerosis and Related Disorders provides new insights into the combined effect of these strategies delivered through a commercially available seven-week online course. 

People with self-reported physician-diagnosed MS were eligible for the study. The course taught ways to improve diets, exercise routines, sleep, and stress reduction habits. Participants were provided access to the course but did not receive support from the study team to improve their wellness behaviors.

After completing the initial surveys, people were randomized to the intervention group or the waitlist control group. That means there was an equal chance of being in either group. People who were in the intervention group got to start the wellness course immediately. People in the waitlist control group had to wait until they had completed the second set of surveys at 12 weeks. Then they got to start the wellness course. Everyone completed surveys three times. These times were baseline, 12 weeks, and 24 weeks, which was the end of the study. One survey asked about fatigue and was a validated way to measure the severity of the fatigue. Another survey asked about ability to do tasks of daily life and was a validated way to measure quality of life. 

One hundred people agreed to be in the study. Ninety-five completed the main endpoint, which was at 12 weeks. Eighty-six completed the entire 24-week study. The study found that the intervention group had significantly greater reductions in fatigue at 12 weeks than the waitlist control group. Also, the reductions in fatigue were maintained in the intervention group at 24 weeks. In addition, after the waitlist control group received access to the wellness course at 12 weeks, they also experienced significant reductions in fatigue. However, the reduction in fatigue was slightly smaller in magnitude than what the intervention group experienced. The intervention group’s physical quality of life significantly improved at 12 weeks compared to baseline values. However, there was no difference between the two groups at 12 weeks. The waitlist group’s physical quality of life values did not significantly increase from 12 to 24 weeks. However, the intervention group did have a significantly higher proportion of participants have clinically meaningful improvements in physical quality of life compared to the waitlist control group (50 percent compared to 22.5 percent, respectively). Neither group had significant changes in mental quality of life.

Overall, the intervention group had slightly better outcomes compared to the waitlist control group. This finding may be due to the observation that a much higher proportion of participants in the intervention group completed the entire course compared to the waitlist control (47.9 percent compared to 18.8 percent, respectively). Another possibility is that more people dropped out of the study between 12 and 24 weeks.

This study shows that if people with MS are provided access to an online wellness program fatigue and physical quality of life can be improved, at least for some. 

If you or someone you know has relapsing-remitting MS and are interested in improving wellness, the authors of this study are actively recruiting for an ongoing trial comparing multiple diets. For more information about the study go to: terrywahls.com/msstudy.

The commercially available online wellness program used in this clinical trial can be found at terrywahls.com/aim. 

Dr. Wahls has a conflict-of-interest management plan at the University of Iowa. People who participated in the study were aware of this. The person who did the statistical analysis did not know which group was the intervention group.