We often hear that family history is a strong risk factor for certain chronic diseases. Having a parent or sibling with heart disease or diabetes, for example, increases your chance for developing it. Likewise, research suggests that adopting a healthier lifestyle helps reduce the risk of getting one of those conditions.
Family history is also a risk factor for multiple sclerosis, the autoimmune disease that attacks the central nervous system and can lead to disability, cognitive decline and vision loss. But the family link to MS is unclear, as is a means of prevention. “Most of the kids I take care of who have MS do not have a parent with MS. And similarly, adults I take care of with MS don’t have a child with MS,” says Dr. Lauren Krupp, a neurologist who researches and treats MS in children and adults. She’s the director of the NYU Langone Multiple Sclerosis Comprehensive Care Center.
[See: 5 Rare Diseases You’ve Never Heard of (Until Now).]
The Genetic Connection
Your unique genetic blueprint is made up of about 20,000 to 25,000 genes that you inherited from your parents. Among your genes, there may be hundreds of damaging or potentially disease-causing variations, although most have little impact on health, according to Jacob McCauley, associate professor of genetics at the University of Miami Medical School and director of the Center for Genome Technology within the John P. Hussman Institute for Human Genomics.
But some variants may play a role in MS. “The International Multiple Sclerosis Genetics Consortium is wrapping up a study that points to 200 risk variants for MS,” McCauley says.
Carrying MS-associated variants increases the risk for developing the disease. For example, a study published earlier this year in Cell suggests that people with two particular variants — within the genes IL7R and DDX39B — are about three times more likely to get MS.
But the genetic variants identified by scientists so far don’t directly cause MS. “They make you more susceptible to getting MS, but having them doesn’t mean you’ll get it,” McCauley says.
Triggers
What pushes someone past the risk threshold to full-blown disease development? Scientists believe it’s likely a combination of genes and environmental factors. McCauley points to a number of environmental factors suspected in MS development, including vitamin D deficiency, reduced sunlight (which may be linked to reduced to low vitamin D levels), smoking, too much saturated fat in the diet and exposure to the Epstein Barr virus.
Other potential triggers being considered include dietary salt consumption, exposure to measles and herpes, hormone levels, geography (because there is a higher chance of developing MS the farther you live from the equator), high body mass index and even childhood adversity. “One study among adults with MS showed that increased levels of childhood adverse events — from divorce to physical abuse — were associated with an earlier age of MS onset,” Krupp notes.
[See: The 10 Best Diets for Healthy Eating.]
The Family Odds
Because genes and exposure are different for everyone, simply having MS in the family doesn’t mean you’re destined for disease. “You may share some of the genes, but you may not share all of the environmental exposure, all of the genes necessary or a particular event that triggers MS,” McCauley says.
However, MS in the family does increase your MS risk. The MS Trust in England points to a review of numerous studies that suggests the following lifetime MS risks when someone in the family has a diagnosed case:
— 1 in 48 for a child.
— 1 in 67 for a parent.
— 1 in 5 for an identical twin.
— 1 in 22 for a non-identical twin.
— 1 in 37 for a sibling.
That’s compared to a lifetime MS risk of 1 in 330 for the general population.
Coping With Risk Factors
Sometimes people who have MS in the family tend to worry that they’ll develop the condition. “A certain amount of anxiety is understandable. If you’re worried about it, it makes sense to get an evaluation. If you don’t have MS, put it to rest,” Krupp says.
McCauley recommends knowing MS signs and symptoms, so that you can get checked out sooner rather than later if you have health concerns. If you do have MS, then taking disease-modifying medications can help reduce attacks on the nerves and slow MS progression.
And while we don’t yet have proof that healthy lifestyle habits reduce the risk for developing MS — the way we do for heart disease or diabetes — we do have hope that they can help. “If you stress your body, you’ll make it easier for genetic predisposition to express itself because you’re creating an unstable position,” Krupp warns.
[See: 6 Reasons You’re Procrastinating on Your Health Goals — and How to Stop.]
That means you should:
— Quit smoking.
— Control your weight.
— Exercise every day. The federal government’s Physical Activity Guidelines for Americans recommends 150 minutes per week of moderate-intensity physical activity, such as brisk walking.
— Take vitamin D if your blood levels are low. “Aim for a higher-than-normal vitamin D level of 50 or higher,” Krupp suggests. “Take 2,000 IU of vitamin D daily.”
— Eat a healthy diet of fresh vegetables, fruits, whole grains and lean protein sources. Ditch inflammation-causing prepackaged foods with lots of added sugar and saturated or trans fats.
— Reduce stress. Mindfulness-based stress reduction has been shown to reduce the body’s inflammation response.
“Seizing control and being informed about what MS is will be powerful,” Krupp says. “Once you take control, it reframes the situation.”
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When MS Is in Your Family History originally appeared on usnews.com
