A digital lifestyle programme in MS changed diet and weight, but benefits on daily impact were small

Design

Single-arm real-world intervention study with 24-month follow-up (LIMS)

Population

659 people with MS in the Netherlands, mean age 46

Primary outcome

MS Impact Scale-29 physical and psychological scores

Effect

At 24 months: psychological −3.4 (−4.6 to −2.3); physical −0.8 (−1.7 to 0.3)

The Dutch LIMS study enrolled 659 people with MS (mean age 46, 84% women) in a three-month digital programme covering a Mediterranean-style diet, physical activity, sleep and stress, followed by a 21-month maintenance phase.

MS Impact Scale-29 physical and psychological scores improved during the intervention (−2.7 and −3.7 points) but attenuated afterwards; at 24 months the psychological score remained improved (−3.4) while the physical score was no longer clearly different from baseline (−0.8, 95% CI −1.7 to 0.3). Only 4–7% of participants exceeded the smallest detectable change. Diet adherence and BMI improved and stayed partly improved; physical activity did not change.

There was no control group, so these are within-group changes. The programme is a reasonable adjunct for motivated patients, especially for weight, but should not be sold as a way to change the course of MS.

• Encourage a Mediterranean-style diet and weight management in MS; these changes were sustained.
• Expect modest effects on daily functioning from lifestyle programmes alone.
• Build in structured exercise support; activity did not improve without it.
• Keep disease-modifying therapy central — lifestyle is complementary.

Why it matters

Patients often ask whether diet can control MS; this gives an honest answer about scale.

Don't overread it

Uncontrolled before-and-after data — improvements may partly reflect regression to the mean or natural fluctuation.

The statistics, in plain English

Within-group changes without a comparison arm cannot separate the effect of the programme from what would have happened anyway. Only 4–7% of individuals improved beyond measurement noise.

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