Modifiable Risk Factors in Multiple Sclerosis Epidemiology
Summary
Research over the past decade has delineated a spectrum of environmental and lifestyle factors that can be altered to influence both the likelihood of developing multiple sclerosis (MS) and the pace of disability progression. Tobacco exposure, encompassing active smoking and passive inhalation, remains one of the most consistently robust risk factors for both disease onset and accelerated neurological decline. Low levels of sun exposure and vitamin D deficiency are closely linked to increased MS incidence, supported by geographic gradients in prevalence and mechanistic studies of immune regulation. Adolescent and adult obesity interact with genetic predisposition to raise susceptibility, while emerging evidence implicates occupational exposures—such as organic solvents, pesticides and low-frequency electromagnetic fields—in modulating risk. Recent explorations of the lung–brain axis and the gut microbiome point to indirect pathways by which inhaled pollutants and dietary components shape systemic immune responses and central neuroinflammation. Integration of epidemiological data with genetic and immunological profiling is under way to stratify individuals according to risk, inform targeted prevention strategies and identify opportunities for secondary prevention through modification of diet, sun habits, smoking status and workplace safety measures.
Research from Nature Portfolio
No recent Nature Portfolio content available.
Modifiable Risk Factors in Multiple Sclerosis Epidemiology publication trend
The graph below shows the total number of articles in modifiable risk factors in multiple sclerosis epidemiology across all publications each year (not limited to Nature Index journals).
Technical terms
Expanded Disability Status Scale (EDSS): An ordinal scale ranging from 0 (normal neurological status) to 10 (death due to MS), used to quantify disability and monitor disease progression.
Modifiable risk factor: An environmental or behavioural exposure that can be changed or avoided to reduce disease risk or severity.
Occupational exposure: Contact with potentially harmful agents (chemical, physical or biological) in the workplace that may influence disease susceptibility.
Lung–brain axis: The two-way interaction between pulmonary immune activity and central nervous system inflammation, whereby inhaled agents can impact neuroimmunity and vice versa.
References
- Influence of oral tobacco versus smoking on multiple sclerosis disease activity and progression. Journal of Neurology Neurosurgery & Psychiatry (2023).
- Occupational risk factors for multiple sclerosis: a systematic review with meta-analysis. Frontiers in Public Health (2023).
- The lung-brain axis in multiple sclerosis: Mechanistic insights and future directions. Brain Behavior & Immunity - Health (2024).
About these summaries
This Nature Research Intelligence Topic summary is created with the cited references and a large language model. We take care to ground generated text with facts, and have systems in place to gain human feedback on the overall quality of the process in line with our AI principles. We strive to create accurate and useful summaries for people unfamiliar with the research topic and that supports this goal. These pages are a beta release and will be updated as we learn how best to help people gain value from a research topic summary.
Turn complex research questions into confident strategic decisions
When you're under pressure to set direction, justify investment, or understand your competitive position, you need more than raw data — you need trusted insights you can act on.
Benchmark your performance against global peers using robust, methodologically sound analysis.
Combine quantitative metrics with qualitative expert insight to uncover strengths, gaps and emerging opportunities.
Gain tailored, decision-ready recommendations aligned to your strategic priorities.
Talk to us to learn more about our data dashboards and bespoke strategy reports.
Grow research skills, confidence and careers with training built for every stage of the research lifecycle.
Developed with Nature Portfolio journal Editors and internationally renowned experts. Discover three ways to learn:
Self-paced, online courses in convenient bite-sized units, covering key skills across scientific writing, publishing, grant writing, data analysis, and more.
Expert trainer-led workshops with hands-on exercises and real-time feedback across core research skills, delivered via interactive group sessions.
Editor-led workshops combining core principles in writing and publishing, personalised 1:1 feedback from Nature Portfolio Editors and hands-on exercises.
Explore course catalogues and workshop agendas, enquire about the options or request institutional pricing.