Six ways to lead a brain-healthy lifestyle


Having a healthy brain that functions well is important for people with multiple sclerosis. Here are six positive steps you can take to keep your brain as healthy as possible, whatever your MS diagnosis.

1. Keep as active as you can

Higher levels of aerobic fitness are associated with faster information processing and preserved brain tissue volume.1,a This suggests that being as active as possible may help to preserve brain health in people with MS.

2. Keep your weight under control

Obesity is associated with higher numbers of MS lesions (areas of intensive damage) than maintaining a healthy weight.2

3. Keep your mind active

Education, reading, hobbies and artistic or creative pastimes help to protect against cognitive problems in MS when pursued over a lifetime.3–7

4. Avoid smoking

Cigarette smoking in people with MS is associated with decreased brain volume2 as well as with higher relapse rates,8 increased disability progression,8,9 more cognitive problems10 and reduced survival11 compared with not smoking.

5. Watch how much you drink

Unsafe levels of alcohol lead to reduced survival in people with MS.11

6. Continue taking other medicines your doctor has prescribed

Diseases such as high blood pressure, heart disease, diabetes or high cholesterol can affect the MS disease course.

This resource is available in English and Slovakian, via the download button below.

For more information about why having a healthy brain is important for people with MS, see our article ‘Why time matters in multiple sclerosis’.


aAlthough it is normal for healthy adults to lose small amounts of brain tissue as they get older, this process happens more quickly in people with MS.


  1. Prakash RS et al. Aerobic fitness is associated with gray matter volume and white matter integrity in multiple sclerosis. Brain Res 2010;1341:41–51.
  2. Kappus N et al. Cardiovascular risk factors are associated with increased lesion burden and brain atrophy in multiple sclerosis. J Neurol Neurosurg Psychiatry 2016;87:181–7.
  3. Sumowski JF et al. Brain reserve and cognitive reserve protect against cognitive decline over 4.5 years in MS. Neurology 2014;82:1776–83.
  4. Pinter D et al. Higher education moderates the effect of T2 lesion load and third ventricle width on cognition in multiple sclerosis. PLoS One 2014;9:e87567.
  5. Modica CM et al. Cognitive reserve moderates the impact of subcortical gray matter atrophy on neuropsychological status in multiple sclerosis. Mult Scler 2016; 22(1):36–42.
  6. Sumowski JF et al. Intellectual enrichment lessens the effect of brain atrophy on learning and memory in multiple sclerosis. Neurology 2010;74:1942–5.
  7. Sumowski JF et al. Cognitive reserve moderates the negative effect of brain atrophy on cognitive efficiency in multiple sclerosis. J Int Neuropsychol Soc 2009;15:606–12.
  8. D'Hooghe M B et al. Modifiable factors influencing relapses and disability in multiple sclerosis. Mult Scler 2010;16:773–85.
  9. Pittas F et al. Smoking is associated with progressive disease course and increased progression in clinical disability in a prospective cohort of people with multiple sclerosis. J Neurol 2009;256:577–85.
  10. Ozcan ME et al. Association between smoking and cognitive impairment in multiple sclerosis. Neuropsychiatr Dis Treat 2014;10:1715–19.
  11. Jick SS et al. Epidemiology of multiple sclerosis: results from a large observational study in the UK. J Neurol 2015;262(9):2033-41.