Professor George Jelinek is Professor and Head of the Neuroepidemiology Unit (NEU) within the Melbourne School of Population and Global Health at The University of Melbourne. The NEU’s charter is to investigate the modifiable lifestyle risk factors that predict the progression of MS with a view to refining a preventive medicine approach to management of the disease.
This large international observational cohort study commenced in 2011 and involved recruitment of an international sample of people with MS through web 2.0 platforms to contribute very detailed, self-reported lifestyle, medication and MS disease outcome data.
This is a unique study, being the first study of its type to collect detailed lifestyle data from a very large group of people with MS world-wide and correlate this with outcome, and because it is not funded by industry but by charitable trusts.
The first part of the study collated these data, which are undergoing detailed analysis to determine the association between lifestyle factors and MS disease outcomes as the epidemiological foundation of a secondary and tertiary preventive strategy for managing MS.
The database is one of the largest in the world, and is the only database containing a comprehensive suite of modifiable lifestyle risk factors that is independently funded (as opposed to drug company-funded).
The study has ethics approval from the Human Research Ethics Committee at St Vincent’s Hospital Melbourne Australia. A number of papers have been published from this database, and further studies are ongoing as follows:
The methodology of the HOLISM study
Given its complexity, this study’s methodology could not be satisfactorily reported in the Methods section of individual published papers emanating from the study. As such, this paper reported the methodology in detail. It also contains a published erratum due to a small number of data errors.
► Hadgkiss EJ, Jelinek GA, Weiland TJ, Pereira N, Marck CH, van der Meer DM. Methodology of an international study of people with multiple sclerosis recruited through web 2.0 platforms: demographics, lifestyle and disease characteristics. Neurol Res Int 2013; Article ID 580596, 12 pages, doi:10.1155/2013/580596 View pdf
Omega 3 and fish consumption association with MS disease outcomes
This paper reports the strong significant associations of omega 3 intake and frequency of fish consumption with MS disease activity, relapse rate, disability and quality of life for around two and a half thousand people with MS from 57 countries world-wide. It is in this paper that we report the over 60% reduced relapse rate associated with flaxseed oil supplements.
► Jelinek GA, Hadgkiss EJ, Weiland TJ, Pereira N, Marck CH, van der Meer DM. Association of fish consumption and omega 3 supplementation with quality of life, disability and disease activity in an international cohort of people with multiple sclerosis. Int J Neurosci 2013; in press; DOI: 10.3109/00207454.2013.803104 View pdf
Smoking and alcohol association with MS disease outcomes
This paper reports the important significant negative effects of smoking on MS disability and quality in the same cohort; it further highlights the apparent improvement in quality of life associated with moderate alcohol intake.
► Weiland TJ, Hadgkiss EJ, Jelinek GA, Pereira N, Marck CH, van der Meer DM. The association of alcohol consumption and smoking with quality of life, disability and disease activity in an international cross-section of people with multiple sclerosis. J Neuro Sci 2013; in press View pdf
Dietary factors and MS
This study explores in detail the association between the full range of dietary factors and MS disease outcomes in the HOLISM cohort. The paper has been now been published in the journal Nutritional Neurosciences.
► Hadgkiss EJ, Jelinek GA, Weiland TJ, Pereira NG, Marck CH, van der Meer DM. The association of diet with quality of life, disability and relapse rate in an international sample of people with multiple sclerosis. Nutritional Neuroscience 2014; in press View pdf
Depression and MS
Under the leadership of psychiatrist Dr Keryn Taylor, this study examines the association between lifestyle factors and the risk of depression in the HOLISM study participants, finding that the OMS Recovery Program lifestyle modifications are associated with the lowest risk of depression. The study has been published in BMC Psychiatry, a major psychiatry journal.
► Taylor KL, Hadgkiss EJ, Jelinek GA, Weiland TJ, Pereira NG, Marck CH, van der Meer DM. Lifestyle factors, medications and demographics associated with depression risk in an international sample of people with multiple sclerosis. BMC Psych 2014;14:327 View pdf
Exercise and MS
This study, headed by Dr Claudia Marck, examined the link between exercise and MS disease outcomes in the study group. The results were presented at the Rehabilitation in MS Conference in Brighton in June 2014, and the paper has been published by the highly ranked journal BMC Neurology.
The association between frequency of meditation and MS disease outcomes in the HOLISM study group. A second paper reviewing the effectiveness of meditation as an intervention in MS in the published literature has been published in the journal Neurology Research International.
► Marck CH, Hadgkiss EJ, Weiland TJ, van der Meer DM, Pereira NG, Jelinek GA. Physical activity and associated levels of disability and quality of life in people with multiple sclerosis: a large international survey. BMC Neurol 2014 Jul 12;14:143 View pdf
Meditation and MS
This study examined the association between frequency of meditation and MS disease outcomes in the HOLISM study group. A second paper reviewing the effectiveness of meditation as an intervention in MS in the published literature has been published in the journal Neurology Research International.
► Levin AB, Hadgkiss EJ, Weiland TJ, Marck CH, van der Meer DM, Pereira NG, Jelinek GA. Can meditation influence quality of life, depression and disease outcome in multiple sclerosis? Findings from a large international web-based study. Behavioural Neurol 2014;14:916519 View pdf
► Levin A, Hadgkiss EJ, Weiland TJ, Jelinek GA. Meditation as an adjunct to the management of multiple sclerosis. Neurol Res Int 2014;4:704691 View pdf
Sexual function and MS
In this study, headed by Dr Claudia Marck, we analyse sexual function in this large cohort, and relate that to lifestyle risk factors and quality of life. This paper has been submitted to BMC Neurology.
Medication and MS
Here we explore in detail the various medications that people in the study group are taking and their association with disease outcomes, depression and fatigue. This paper has now been published in the journal Neurological Research.
► Jelinek GA, Hadgkiss EJ, Weiland TJ, Pereira N, Marck CH, van der Meer DM. Medication use in a large international sample of people with multiple sclerosis: associations with quality of life, relapse rate and disability. Neurol Res 2015 Apr 23:1743132815Y0000000036 View pdf
Fatigue and MS
This study, led by Dr Tracey Weiland, explores the lifestyle factors associated with fatigue in the HOLISM participants. This important study has now been published in PLOS One, the largest medical journal in the world. There really is something that can be done about fatigue!
► Weiland TJ, Hadgkiss EJ, Pereira N, Marck CH, van der Meer DM, Taylor KL, Jelinek GA. Clinically significant fatigue: Prevalence and associated factors in an international sample of adults with multiple sclerosis. PLOS ONE 2015 Feb 18;10(2):e0115541. doi: 10.1371/journal.pone.0115541 View pdf
Sunlight, vitamin D, latitude and MS
This study examines reported levels of vitamin D intake, sun exposure and place of living (latitude) and their relationship to MS disease outcomes. It has been published in BMC Neurology.
► Jelinek, GA, Marck C, Weiland TJ, van der Meer, et al. Latitude, sun exposure, and Vitamin D supplementation: Associations with quality of life, and disease outcomes in a large international cohort of people with multiple sclerosis. BMC Neurology 2015;15:132. doi: 10.1186/s12883-015-0394-1 View pdf
Engagement with OMS resources and MS
This study looks at whether PwMS have attended an OMS retreat, read Overcoming Multiple Sclerosis, or visited the OMS website and compares quality of life, depression and fatigue in those who have versus those who haven't, finding that those who have done all three have one-tenth (yes, one-tenth!) the risk of depression, one third of the fatigue, and about 20 points higher quality of life than those who have done none of the three. Published in Neurological Sciences.
► Hadgkiss EJ, Jelinek GA, Taylor KL, Marck CH, van der Meer DM, Pereira NG, Weiland TJ. Engagement in a program promoting lifestyle modification is associated with better patient-reported outcomes for people with MS. Neurol Sci 2015; in press View pdf
Co-morbidities and MS
This study examines the association between co-morbidities such as heart disease, diabetes and high blood pressure with health outcomes from MS. Led by Dr Claudia Marck, this paper is currently being reviewed by PLoS ONE.
Part two of the HOLISM study is an ongoing longitudinal cohort study in which we obtain further data from participants in part one to examine how changes in lifestyle affect MS disease progression and activity. The study has ethics approval from the Research Ethics Committee at The University of Melbourne, Australia.
Data have now been collected for the first 2.5 year follow up after participants completes questionnaires online in 2014/15. We anticipate an increase in the number of participants as well, with many more people with MS likely to join the study as the reach of OMS world-wide grows. This will give us a larger dataset for the next 2.5 year follow up planned for 2017.
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