A new study of 839 people with multiple sclerosis found that healthy lifestyle choices—like exercising regularly, eating well, meditating, not smoking, and getting enough vitamin D—are linked to feeling less tired, less depressed, and having fewer mobility problems. The good news is that these benefits seem to add up: people who followed three or more healthy habits did even better than those who followed just one or two. The study tracked people over five years and found that exercise and good eating habits had the strongest and longest-lasting effects on how people felt and functioned.

The Quick Take

  • What they studied: Whether healthy lifestyle choices like exercise, good nutrition, meditation, not smoking, and vitamin D intake help people with multiple sclerosis feel better and stay more active over time.
  • Who participated: 839 people with multiple sclerosis who were part of a long-term health study called HOLISM. Researchers followed these people and checked in on their health over five years.
  • Key finding: People who did three or more healthy lifestyle habits had significantly less fatigue, depression, and disability problems compared to those who did fewer healthy habits. Exercise and eating well were the most powerful habits, with benefits that lasted throughout the five-year study.
  • What it means for you: If you have MS, making even small changes to your lifestyle—especially adding exercise and improving your diet—may help you feel better and stay more active. The more healthy habits you add, the better the results may be. However, this study shows a connection, not proof that these habits cause the improvement, so talk with your doctor about what’s right for you.

The Research Details

Researchers looked at health information from 839 people with multiple sclerosis who were part of a long-term study. They measured five healthy lifestyle factors: how much people exercised, the quality of their diet, whether they meditated, whether they smoked, and their vitamin D levels (from supplements or sun exposure). They also measured three health outcomes: fatigue (tiredness), depression (mood problems), and disability (difficulty with movement and daily activities). The researchers used two types of analysis: first, they looked at all the data collected at one point in time to see which habits were connected to better health. Then, they followed people over 2.5 and 5 years to see if the habits predicted better outcomes in the future.

This research approach is important because it shows not just whether healthy habits are connected to feeling better, but whether those habits actually predict improvement over time. By following the same people for five years, researchers could see which habits had lasting effects. This helps doctors understand what advice to give people with MS about lifestyle changes that might actually help them feel better long-term.

This study is fairly reliable because it included a large number of people (839) and followed them over a long time (5 years). The researchers used validated tools—meaning trusted, scientifically-proven questionnaires—to measure fatigue, depression, and disability. However, because this is an observational study (watching what people do rather than assigning them to do specific things), we can’t be completely sure that the lifestyle habits caused the improvements. People who exercise and eat well might also do other healthy things we don’t know about. The study would be stronger if researchers randomly assigned some people to make lifestyle changes and others not to, to see what actually causes improvement.

What the Results Show

When researchers looked at all the data at one time, they found that exercise and eating a high-quality diet were connected to less fatigue, less depression, and less disability. Not smoking was linked to lower depression, and getting enough vitamin D was also connected to lower depression.

When researchers followed people over time, the benefits of exercise stayed strong at both the 2.5-year and 5-year check-ins. Eating well and not smoking were connected to less disability and depression, respectively, at the 5-year mark.

Most importantly, people who followed three or more healthy habits did better than those who followed fewer habits. This “stacking” effect means that combining multiple healthy behaviors appears to work better than doing just one. People who followed four or five healthy habits had the best results that lasted the full five years.

The study found that meditation and vitamin D intake showed some benefits, particularly for depression, though these effects were not as strong or consistent as exercise and diet. The cumulative effect—where doing multiple healthy habits together works better than doing them separately—was significant. At the 2.5-year mark, having three or more healthy habits made a real difference. By five years, people who maintained four to five healthy habits showed the most sustained improvement.

This research builds on earlier studies showing that lifestyle matters for people with MS. Previous research has suggested that exercise helps with MS symptoms, and this study confirms that finding while also showing it lasts over five years. The finding that multiple healthy habits work better together is newer and more detailed than what we knew before. This study also adds evidence that diet quality, not smoking, and vitamin D are important, not just exercise alone.

The biggest limitation is that this study observed what people naturally did rather than assigning them to make specific changes. This means we can’t be sure the lifestyle habits caused the improvements—people who exercise might also be more likely to take medications correctly or have other healthy behaviors we didn’t measure. The study also relied on people reporting their own habits and symptoms, which can be less accurate than objective measurements. We don’t know if the results would be the same for all people with MS or just those in this particular study group. Finally, the study can’t tell us exactly how much exercise or what type of diet is best—just that more of these healthy habits is associated with better outcomes.

The Bottom Line

If you have multiple sclerosis, consider adding or increasing physical activity (with your doctor’s approval), improving your diet quality, quitting smoking if applicable, meditating, and ensuring adequate vitamin D. The evidence is strongest for exercise and diet quality (moderate confidence). Start with one or two changes and gradually add more, as the study suggests that combining multiple habits works better than doing just one. These changes may take weeks to months to show benefits. (Confidence level: Moderate—this shows strong connections but isn’t definitive proof of cause and effect.)

Anyone with multiple sclerosis who experiences fatigue, depression, or mobility challenges should pay attention to these findings. People newly diagnosed with MS might benefit from starting healthy habits early. This is less relevant for people without MS, though the general benefits of exercise and good diet apply to everyone. Talk with your MS specialist or neurologist before making major lifestyle changes, especially regarding exercise intensity.

Some benefits, like improved mood from exercise, may appear within weeks. Reductions in fatigue and disability typically take longer—expect to see meaningful changes over 2-3 months with consistent effort. The study showed that benefits continue to improve and become more stable over five years, suggesting that long-term commitment to these habits pays off.

Want to Apply This Research?

  • Track three key metrics weekly: (1) minutes of physical activity completed, (2) number of days eating a high-quality diet (vegetables, whole grains, lean protein), and (3) fatigue and mood scores on a 1-10 scale. Monitor these together to see if adding more healthy habits correlates with feeling better.
  • Start by committing to one primary habit for two weeks (such as 150 minutes of moderate activity per week), then add a second habit (improving diet quality by adding one vegetable serving per meal). After establishing these, add a third habit (daily meditation or vitamin D supplementation). Use the app to set reminders and track progress toward the three-habit threshold, which the research suggests is when benefits become most noticeable.
  • Create a monthly dashboard showing your lifestyle habit score (how many of the five healthy habits you’re consistently doing) alongside your fatigue, depression, and disability ratings. Look for patterns over 3-6 months to see if increasing your habit score correlates with improvements in how you feel. Share this data with your healthcare provider to discuss what’s working best for you personally.

This research shows associations between healthy lifestyle habits and better outcomes in multiple sclerosis, but does not prove that these habits cause the improvements. Individual results vary significantly. Before making major changes to exercise, diet, or supplements, especially if you have multiple sclerosis, consult with your neurologist or MS specialist. This information is not a substitute for professional medical advice. If you are experiencing severe fatigue, depression, or worsening disability, seek immediate medical attention. Some people with MS may have limitations on certain types of exercise or dietary changes based on their specific condition.