Department of Physical Education & Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran.
Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA.
Complement Ther Med. 2019 Apr;43:240-246. doi: 10.1016/j.ctim.2019.02.006. Epub 2019 Feb 8.
There is extensive data supporting a high prevalence of both overweight and obesity status in people with multiple sclerosis, and increases in body mass index has been associated with an increased risk of multiple sclerosis. Body composition may influence the course, treatment and management of multiple sclerosis. One proposed strategy for managing overweight and obesity status and associated secondary effects in people with multiple sclerosis involves increasing the levels of physical activity. In fact, increased levels of physical activity affect various physiological (endurance capacity, strength, balance) and biological processes (fat oxidation, insulin sensitivity, anti-inflammation, neurotrophic factors) which are known to be dysfunctional in multiple sclerosis and which may worsen with increases in obesity. When designing personalized exercise programs it should be kept in mind that current exercise recommendations for people with multiple sclerosis should exceed energy expenditure recommendations to efficiently counteract weight gain. Therefore, it is necessary to consider body composition as a primary endpoint in experimental studies. In addition, designing guidelines for weight control or weight loss in people MS is needed. The most comprehensive weight management guidelines are outlined in the American College of Sports Medicine Position Statement, which recommends between 150-250 min per week of moderate-intensity physical activity for preventing weight gain, and between 225-420 min per week of moderate-intensity physical activity for weight loss. These recommendations seem applicable for people with multiple sclerosis.
有大量数据支持多发性硬化症患者中普遍存在超重和肥胖状态，并且体重指数的增加与多发性硬化症的风险增加有关。身体成分可能会影响多发性硬化症的病程、治疗和管理。管理多发性硬化症患者超重和肥胖状态及相关继发性影响的一种策略涉及增加身体活动水平。事实上，身体活动水平的增加会影响各种生理（耐力、力量、平衡）和生物学过程（脂肪氧化、胰岛素敏感性、抗炎、神经营养因子），这些过程在多发性硬化症中是失调的，并且随着肥胖的增加可能会恶化。在设计个性化运动计划时，应牢记目前针对多发性硬化症患者的运动建议应超过能量消耗建议，以有效地对抗体重增加。因此，有必要将身体成分作为实验研究的主要终点。此外，还需要为多发性硬化症患者制定体重控制或减肥的指南。美国运动医学学院立场声明概述了最全面的体重管理指南，建议每周进行 150-250 分钟的中等强度身体活动，以预防体重增加，每周进行 225-420 分钟的中等强度身体活动，以减轻体重。这些建议似乎适用于多发性硬化症患者。
