Living with MS: Diet, Exercise and Work

With multiple sclerosis, contrary to many assumptions, you can live a normal life. In terms of nutrition, some aspects can be taken into account. Both the body and the soul can benefit from regular exercise. However, the diagnosis of the chronic disease usually represents a drastic cut in the lives of the mostly young people affected and means a redefinition of the professional and private future.

Nutrition in multiple sclerosis

The exact triggers of MS are as yet unknown, as are the causes. MS is particularly common in industrially developed countries with more temperate climates. In these countries, high-fat foods such as meat, sausage, cheese, and butter are part of the diet. Climate, diet and lifestyle habits therefore seem to have an influence on multiple sclerosis. It is not scientifically proven that a certain diet has a positive effect on the course of MS. This is merely suspected and reported by those affected. As in the general dietary recommendations, the diet in MS should be as balanced and wholesome as possible, with plenty of fresh fruits and vegetables, little meat and fat. It is assumed that certain messenger substances are responsible for the misdirected immune reaction in MS. These are formed from the polyunsaturated fatty acid arachidonic acid, which is mainly found in animal foods. For this reason, the diet in MS should be limited to a maximum of two meat meals per week. Fatty sausages and offal should be avoided. Instead of animal fats such as butter, lard and goose fat, diet margarine and vegetable oils (soybean oil, linseed oil, wheat germ oil) are suitable. A high proportion of omega-3 fatty acids, which have been shown to inhibit the formation of inflammatory substances in the body, is ideal. Many types of fish also have these fatty acids in high concentrations. An optimal diet includes at least two to three meals of fatty sea fish per week.

Healthy eating in multiple sclerosis at a glance

  • Fruits and vegetables daily (berries are especially recommended, as well as fresh herbs daily).
  • Regularly fish and protein foods
  • Prefers products made from whole grains (pasta, rice, bread, flour).
  • Few animal products, such as meat, sausage, eggs and from milk.
  • Little fat
  • Little alcohol

Sports in multiple sclerosis

Sport has many positive effects on body and soul – this is also true in multiple sclerosis. Thus, the body feeling and mobility are improved, but also the risk of depression is reduced. In general, sports can bring a variety of health benefits:

What should sufferers pay attention to?

According to current knowledge, a mix of endurance and strength training is most useful for people with multiple sclerosis. It is important to find a healthy level of exertion and avoid over-exertion. According to the German Multiple Sclerosis Society (DMSG), two to three training sessions per week, each lasting ten to 40 minutes, are recommended. Since temperature regulation is often impaired in MS patients, it is particularly important to ensure that exercise is not performed in overheated rooms or outdoors in extreme heat. It is also advisable to drink sufficient fluids before, during and after exercise. In MS, the so-called Uthoff phenomenon often occurs. This means that neurological symptoms worsen when the body temperature is increased by sport. However, this usually recedes after sport and can be regulated again, for example, by taking a cool shower. It is advisable to consult your doctor or physiotherapist before exercising in order to achieve the best possible therapeutic effects.

Choice of sport in multiple sclerosis

Several factors are crucial for the choice of sport in MS. On the one hand, the physical condition plays a major role as well as the symptoms experienced so far. On the other hand, of course, individual abilities as well as personal inclinations to certain sports are also decisive. Sports that have proven successful for people with MS:

  • Swimming: Ideal for many people with MS, as the weightlessness in the water even allows for gymnastic exercises that may be limited outside of the water due to the disease. Swimming can promote endurance as well as coordination, therefore positive effects on movement disorders (ataxia) as well as fatigue are possible. Movement patterns can minimize existing spasticity. However, when swimming, it should be noted that if spasticity is severe, the risk of muscle hypertonia could also be increased by the buoyancy of the water. Therefore, sports in the water in MS should be clarified beforehand with a doctor or physiotherapist.
  • Yoga: Typical yoga movements as well as stretching exercises can lead to improvements in spasticity. Breathing exercises in yoga cause a holistic relaxation in the body. Strengthening as well as coordination improve disorders in the movement sequences.
  • Nordic Walking: Ideal for the cardiovascular system. Nordic Walking trains endurance, strengthens arms and legs and improves coordination. Nordic Walking can positively affect ataxia, spasticity as well as paralysis, depending on the stage of MS.
  • Tai Chi: Slow as well as consciously performed exercises in Tai Chi support coordination and train balance. Movements can also reduce spasticity while standing.

Occupation and workplace with multiple sclerosis

More than healthy people, MS sufferers must be careful to avoid both physical and psychological stress in order to live well with their disease. MS progresses very differently: while some sufferers become severely impaired, many others can live well with it without major limitations. Therefore, a diagnosis of MS should not automatically lead to giving up one’s job. On the contrary, many affected people even cope better with the disease due to the distraction and confirmation provided by the job. People with multiple sclerosis should also avoid stress at work as far as possible in order not to provoke any relapses of the disease. Therefore, jobs with night shifts or double shifts are just as unsuitable as jobs with a high stress factor or long travel distances. The workplace itself should be designed so that you feel comfortable and can work in peace. Make sure the distance to the nearest restroom is as short as possible and that you have access to a window that you can open during working hours to take a short break for fresh air.

Be open about your illness

In the job interview, you are not required to tell about the illness. However, if the job demands a lot and you are not sure if you will be able to perform it to the fullest, you must tell the potential employer. This also applies if you have a confirmed severe disability. If you expect support from your boss in the form of flexible working hours or a transfer in your job after the diagnosis of multiple sclerosis, you must explain your motives to him or her. However, if you feel able to stay in your current job, it is up to you to decide whether to tell your employer and colleagues about your condition. Consider how open you want to be about the condition. While positive stress and personal validation from the challenge of work are important and beneficial for people with MS, too much stress can quickly have the opposite effect. Keeping the disease quiet can also have a negative impact on disease progression by hiding and masking symptoms. If your job offers a harmonious work environment, it can be helpful to play your cards close to your chest. Inform colleagues accurately about multiple sclerosis and your symptoms and discomfort with it. If you have understanding colleagues, they will be more considerate in the future if you ever suffer from fatigue or lack of concentration. However, also explain that you will not automatically end up in a wheelchair, but that the disease can progress in very different ways.In this way, you take away colleagues’ fear and shyness about MS and show them that they can still count on a fully-fledged employee. MS patients are not legally obligated to talk about the disease on the job. Unless the symptoms of multiple sclerosis pose a danger to you and others in your job.

Workplace

Extra-large monitors and keyboards can make it easier to work on a PC, depending on your symptoms. Since the course of MS is difficult to predict, you should also keep in mind whether your workplace could be reached by wheelchair if necessary, or at least redesigned to be barrier-free. Since high temperatures affect many sufferers, ensure that the room temperature is as low as possible. Air conditioning is usually useful in the summer. If normal MS work is not possible in your office, you can consult with your boss about working in a home office. This would also eliminate the potentially exhausting commute to work. If you suffer from episodic dizziness, balance problems and poor concentration, you should avoid working at heights or on heavy machinery. Whether a sufferer decides to withdraw from working life depends first of all on how severely he or she is affected by the disease. If, for example, they can barely get out of bed due to extreme fatigue and pain, full-time employment is out of the question. Before giving up your job altogether, however, measures such as retraining, part-time work, part-time retirement or transferring within the company to a less strenuous post would be worth considering. This not only contributes to the individual’s financial independence and self-confidence, but also preserves for the boss the experience and expertise of a valuable employee. However, sufferers who cope quite well with their disease and feel comfortable in their job can easily stay in the workforce. After all, more than a third of all MS sufferers in Germany work in a normal job until retirement age. If you are not sure whether you can meet the demands of a full-time job, you should first check with your doctor and then with the employer. You can find help and contact other people affected by multiple sclerosis at the German Multiple Sclerosis Society.