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Associations between lifestyle behaviors and quality of life differ based on multiple sclerosis phenotype

Nag, N, Yu, M, Jelinek, GA, Simpson-Yap, S ORCID: 0000-0001-6521-3056, Neate, SL and Schmidt, HK 2021 , 'Associations between lifestyle behaviors and quality of life differ based on multiple sclerosis phenotype' , Journal of Personalized Medicine, vol. 11, no. 11 , pp. 1-11 , doi:

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Multiple sclerosis (MS), a neuroinflammatory disorder, occurs as non-progressive or progressive phenotypes; both forms present with diverse symptoms that may reduce quality of life (QoL). Adherence to healthy lifestyle behaviors has been associated with higher QoL in people with MS; whether these associations differ based on MS phenotype is unknown. Cross-sectional self-reported observational data from 1108 iConquerMS participants were analysed. Associations between lifestyle behaviors and QoL were assessed by linear regression, and phenotype differences via moderation analyses. Diet, wellness, and physical activity, but not vitamin D or omega-3 supplement use, were associated with QoL. Specifically, certain diet types were negatively associated with QoL in relapsing-remitting MS (RRMS), and positively associated in progressive MS (ProgMS). Participation in wellness activities had mixed associations with QoL in RRMS but was not associated in ProgMS. Physical activity was positively associated with QoL in RRMS and ProgMS. Phenotype differences were observed in diet and wellness with physical QoL, and physical activity with most QoL subdomains. Our findings show lifestyle behaviors are associated with QoL and appear to differ based on MS phenotype. Future studies assessing timing, duration, and adherence of adopting lifestyle behaviors may better inform their role in MS management.

Item Type: Article
Authors/Creators:Nag, N and Yu, M and Jelinek, GA and Simpson-Yap, S and Neate, SL and Schmidt, HK
Keywords: MS management; MS phenotype; lifestyle behavior; multiple sclerosis; quality of life
Journal or Publication Title: Journal of Personalized Medicine
Publisher: MDPI AG
ISSN: 2075-4426
DOI / ID Number:
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Copyright 2021 by the authors.Licensee MDPI, Basel, Switzerland.This article is an open access article distributed under the terms andconditions of the Creative Commons Attribution (CC BY) license (

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