57 msfocusmagazine.org How many people with MS will fall into this category? Does this form of MS respond to our current treatment options? Short of a biopsy or autopsy, how can we diagnose this form of MS? These questions are yet to be answered. Study: Diets high in vegetables and fish may lower MS risk Anew study suggests people who consume a diet high in vegetables and fish may have a reduced risk of multiple sclerosis.The findings couldhavepotentialimplicationsforimproving people’s diets to help lower the risk of MS in those who are at high risk. The findings were published in the Multiple Sclerosis Journal. Dr.Thrower: One MS topic that always seems to generate interest is that of diet. What is the best diet to reduce the risk of MS or to lower the risk of MS progression for those that have the diagnosis? The simple answer is we don’t know, but there does seem to be increasing evidence pointing towards some diets being “anti-inflammatory” in nature.There are many reasons to pursue a diet that is higher in fruitsandvegetablesandlowerinsaturatedfats. No one really needs that double cheeseburger. One can argue for a healthy diet based upon weight management and the prevention of diabetes, hypertension, and heart disease.This study suggests that a diet high in vegetables and fish (a great source of anti-inflammatory omega 3 fatty acids) had a 50 percent lower risk of developing MS. It’s tough to know what diet to follow with many choices out there. These include the Wahl’s Diet, the Swank Diet, Paleo, Whole 30, and dozens of others. As more data comes in, I would suggest following a diet that you can stick to for the long run and that looks some- thing like a Mediterranean diet. New Findings on Pregnancy and Outcomes in MS Two new studies using data from medical claims show that the rate of pregnancy is increasing among women with MS, and that womenwithMStendtohavemorecomplications (compared towomenwithout MS).The studies also show an unexpectedly low use of MS disease-modifying therapies before and after pregnancy. In general, pregnancy does not appearto affect the long-term clinical course of MS. Women who have MS and wish to have a family can usually do so successfullywith the assistance of theirneurologist and obstetrician. The findings were published in the journal Neurology. Dr.Thrower: The majority of newly diagnosed people with MS are women of childbearing age. So, it’s only natural that there would be great interest in pregnancy issues as they relate to MS. Unfortunately, misinformation still abounds in regard to this topic and couples may be making family planning decisions based upon bad information. In general pregnancy is not discouraged forwomen with MS. It has long been noted that MS relapse risk is decreased during pregnancy and somewhat increased in the six months following delivery. Somestudieshavesuggestedthatbreastfeeding mayprolong the protective effectsofpregnancy in women with MS. This study is interesting in that it uses real world insurance claims data. A pitfall of this approach is that these women, by definition, have health insurance. Would a group of uninsuredwomenwithMSlookdifferent?With that caveat, the study found that pregnancy rates in women with MS are going up, while the rates in the non-MS population are going down. We don’t have an explanation for this, but one could argue that the increased rates