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 Multiple Sclerosis 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 worldwide 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 Research Ethics Committee at The University of 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.
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 worldwide. It is in this paper that we report the over 60% reduced relapse rate associated with flaxseed oil supplements.
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.
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.
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.
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.
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.
Sexual function and MS
In this study, headed by Dr Dania van der Meer, we analyse sexual function in this large cohort, and relate that to lifestyle risk factors and quality of life. Published in the major neurology journal BMC Neurology, this paper highlighted the role of depression and fatigue in sexual dysfunction in people with MS.
Medications 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.
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!
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
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.
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 was published in the world's biggest medical journal PLOS One.
Lifestyle, medication and socio-demographic determinants of quality of life
This major study looked at all of the individual lifestyle factors, medication use, disease characteristics and socio-demographics to find what determines quality of life in MS. No surprises here, lifestyle is critical. Led by George Jelinek, this paper was published in BMC Neurology.
Lifestyle, medication and socio-demographic determinants of disability in MS
This important study looked at all of the individual lifestyle factors, medication use, disease characteristics and socio-demographics to find the important associations with disability in MS. Again, this strongly supported our hypothesis about lifestyle being critical. Led by George Jelinek, this paper was published in 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. A call went out to participants of the HOLISM study at the 2.5 year mark in November/December 2014 to complete questionnaires online. We also called for new participants who will form a validation sample in which population we can test some of the associations we have found in the main sample. Five year follow up commenced June 2017.
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