---
title: "Lifestyle Factors and 2.5-Year Outcomes in Multiple Sclerosis: Effects Vary by Time Since Diagnosis"
id: "pubmed-42573837"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42573837"
content_type: "clinical_feed_article"
specialty: "Neurology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42573837/"
doi: "10.1007/s10072-026-09260-5"
published_at: "2026-08-10T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Lifestyle Factors and 2.5-Year Outcomes in Multiple Sclerosis: Effects Vary by Time Since Diagnosis
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42573837
- **Specialty:** [Neurology](https://medichelpline.com/clinical-feed/neurology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42573837/)
- **DOI:** [10.1007/s10072-026-09260-5](https://doi.org/10.1007%2Fs10072-026-09260-5)
- **Published At:** 2026-08-10T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This prospective cohort study used 1,401 people with multiple sclerosis (pwMS) from the HOLISM study who completed baseline and 2.5-year follow-up surveys. - Five baseline **lifestyle factors** were assessed: **high-quality diet**, **physical activity**, **smoking status**, **vitamin D supplementation**, and **meditation**. - Outcomes measured at 2.5 years included **fatigue**, **depression**, and **disability**. - Analyses used multivariable log-binomial regression and stratified participants by time since diagnosis (≤ 5 years vs > 5 years). - **Physical activity** showed stronger prospective associations with lower fatigue, depression, and disability in participants diagnosed ≤ 5 years compared with those diagnosed > 5 years. - Non-smoking was associated with reduced disability risk within the ≤ 5-year group but not in the > 5-year group. - **High-quality diet** was prospectively associated with lower depression and disability among participants with > 5 years since diagnosis; between-group differences were not statistically significant. - **Vitamin D supplementation** and **meditation** were not associated with the measured outcomes over 2.5 years. - Meeting 4–5 healthy lifestyle criteria was associated with lower depression risk in both duration groups and with lower fatigue and disability risk in the ≤ 5-year group; a between-group difference was observed for disability. - The authors conclude that associations between lifestyle factors and MS clinical outcomes may vary across the disease course, implying timing and duration of lifestyle engagement might influence impact and meriting further stage-specific research. - The study was approved by The University of Melbourne Human Research Ethics Committee and included conflict of interest disclosures for one author related to authored books and prior remuneration for workshops.
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Affiliations Expand ### Affiliations * 1 Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia. * 2 Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia. nnag@unimelb.edu.au. * PMID: **42573837** * DOI: [ 10.1007/s10072-026-09260-5 ](https://doi.org/10.1007/s10072-026-09260-5) Item in Clipboard # Associations between lifestyle factors and 2.5-year clinical outcomes differ by time since multiple sclerosis diagnosis Maggie Yu et al. Neurol Sci. 2026. Show details Display options Display options Format Abstract PubMed PMID Neurol Sci Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Neurol+Sci%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Neurol+Sci%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42573837/) . 2026 Aug 10;47(9):698. doi: 10.1007/s10072-026-09260-5. ### Authors [Maggie Yu](https://pubmed.ncbi.nlm.nih.gov/?term=Yu+M&cauthor_id=42573837)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42573837/#short-view-affiliation-1 "Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia."), [George Jelinek](https://pubmed.ncbi.nlm.nih.gov/?term=Jelinek+G&cauthor_id=42573837)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42573837/#short-view-affiliation-1 "Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia."), [Nupur Nag](https://pubmed.ncbi.nlm.nih.gov/?term=Nag+N&cauthor_id=42573837)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42573837/#short-view-affiliation-2 "Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia. nnag@unimelb.edu.au.") ### Affiliations * 1 Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia. * 2 Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia. nnag@unimelb.edu.au. * PMID: **42573837** * DOI: [ 10.1007/s10072-026-09260-5 ](https://doi.org/10.1007/s10072-026-09260-5) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Healthy lifestyle factors are associated with better health outcomes in people with multiple sclerosis (pwMS). Whether these associations differ according to time since diagnosis remains unclear. Understanding this may inform optimal timing for lifestyle modification. **Methods:** This prospective cohort study included 1,401 pwMS who completed baseline and 2.5-year follow-up surveys from the HOLISM study. Five lifestyle factors were assessed at baseline (high-quality diet, physical activity, smoking status, vitamin D supplementation, meditation). Outcomes included fatigue, depression, and disability. Multivariable log-binomial regression examined associations between individual and multiple lifestyle factors and outcomes stratified by time since diagnosis (≤ 5 vs. > 5 years). **Results:** Physical activity showed stronger prospective associations with reduced fatigue, depression, and disability among participants within 5 years of diagnosis than among those with longer duration. Non-smoking was associated with lower disability risk within the ≤ 5-year group. In contrast, high-quality diet was associated with lower depression and disability among participants with > 5-year since diagnosis, though non-significant between-group difference. Vitamin D supplementation and meditation were not associated with outcomes. Meeting 4-5 healthy lifestyle criteria was associated with lower depression risk in both duration groups and with lower fatigue and disability risk in the ≤ 5-year group, with a between-group difference for disability. **Conclusion:** Associations between lifestyle factors and MS outcomes may vary across the disease course, suggesting that the duration and timing of lifestyle engagement may influence their potential impact. These findings support further research on stage-specific lifestyle management strategies in MS. **Keywords:** Disease duration; Health outcomes; Lifestyle; MS care; Multiple sclerosis. © 2026. The Author(s). [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declarations. Institutional review board: The study was conducted in accordance with the Declaration of Helsinki and approved by The University of Melbourne Human Research Ethics Committee (ID: 1545102). Informed consent: Participants were provided with a participant information statement, and all provided informed consent. Conflict of interest: GJ is the author of “Overcoming Multiple Sclerosis” and co-editor of “Overcoming Multiple Sclerosis Handbook. Roadmap to Good Health”. GJ receives royalties from authored publications, has previously received remuneration from facilitation of Overcoming MS residential workshops. ## References 1. 1. Alammar W, Goja A, Khattab R (2024) Effect of diet and dietary patterns on the progression of multiple sclerosis: a review. Recent Adv Food Nutr Agric. - [DOI](https://doi.org/10.2174/012772574x325602240910075218) 2. 1. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35:1381–1395 - [DOI](https://doi.org/10.1249/01.mss.0000078924.61453.fb) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/12900694/) 3. 1. Dalgas U, Langeskov-Christensen M, Stenager E, Riemenschneider M, Hvid LG (2019) Exercise as medicine in multiple sclerosis—time for a paradigm shift: preventive, symptomatic, and disease-modifying aspects and perspectives. Curr Neurol Neurosci Rep 19:1–12 - [DOI](https://doi.org/10.1007/s11910-019-1002-3) 4. 1. Di Cara M, Grezzo D, Palmeri R, Lo Buono V, Cartella E, Micchia K, Formica C, Rifici C, Sessa E, D’aleo G (2022) Psychological well-being in people with multiple sclerosis: a descriptive review of the effects obtained with mindfulness interventions. Neurol Sci 43:211–217 - [DOI](https://doi.org/10.1007/s10072-021-05686-1) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/34697659/) 5. 1. Fitzgerald KC, Tyry T, Salter A, Cofield SS, Cutter G, Fox R, Marrie RA (2018) Diet quality is associated with disability and symptom severity in multiple sclerosis. 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