Higher levels of blood high-density lipoprotein (HDL) — or good cholesterol which are present in a vegetable-rich diet — may improve fatigue in multiple sclerosis patients, according to a new study.
The pilot study led by University at Buffalo investigated the effects of fat levels in blood on fatigue caused by multiple sclerosis and found that lowering total cholesterol also reduced exhaustion.
The findings, headed by Murali Ramanathan, PhD, professor in the UB School of Pharmacy and Pharmaceutical Sciences, and published recently in PLOS ONE, show the influence that dietary adjustments could have on severe fatigue, which affects most people with multiple sclerosis.
What is Multiple Sclerosis (MS)?
The immune system attacks nerve cells, causing symptoms that can include pain, blindness, weakness, poor coordination, and muscle spasms. Various medicines that suppress the immune system can be used to treat multiple sclerosis.
Lipids and fat metabolism have a role in fatigue in Multiple Sclerosis
Fatigue is a common and debilitating symptom of multiple sclerosis, affecting people’s quality of life and ability to work full-time. Treatment options for fatigue are limited, despite its ubiquity and severity. The drugs used to treat severe exhaustion frequently have negative side effects.
“Fatigue in people with multiple sclerosis has been viewed as a complex and difficult clinical problem with contributions from disability, depression, and inflammation. Our study implicates lipids and fat metabolism in fatigue,” said Ramanathan. “This is a novel finding that may open doors to new approaches for treating fatigue.”
Diet-based interventions along with other measures effective in reducing fatigue in MS
Terry Wahls, MD, clinical professor of internal medicine and neurology and creator of the Wahls Protocol diet, and her team of researchers at the University of Iowa previously demonstrated that a diet-based intervention combined with exercise, stress reduction, and neuromuscular electrical stimulation (NMES) is effective at reducing fatigue. The physiological alterations underlying the improvements, however, were unknown.
The researchers looked at changes in BMI, calories, total cholesterol, HDL, triglycerides, and low-density lipoprotein (LDL), also known as bad cholesterol. The Fatigue Severity Scale was used to assess fatigue.
The study tracked 18 patients with progressive multiple sclerosis for a year on the Wahls diet, which is strong in fruits and vegetables. Meat, plant protein, fish oil, and B vitamins are encouraged in the diet. Gluten, dairy, and eggs are not permitted.
Adherence to diet main factor associated with reductions in fatigue
Participants also participated in a home-based fitness program that comprised stretches and strength training, NMES to stimulate muscular contraction and movement, and stress-reduction meditation and self-massages. However, diet adherence was the key factor related to fatigue reduction.
“Higher levels of HDL had the greatest impact on fatigue,” said Ramanathan, “possibly because good cholesterol plays a critical role in muscle, stimulating glucose uptake and increasing respiration in cells to improve physical performance and muscle strength.” Patients consumed fewer calories and had lower BMI, lipid, and LDL levels as well. These parameters, however, were shown to be unrelated to changes in weariness.
The findings lay the groundwork for a broader investigation that might investigate the implications of metabolic alterations on weariness.
Materials provided by University at Buffalo. Note: Content may be edited for style and length.
Kelly Fellows Maxwell, Terry Wahls, Richard W. Browne, Linda Rubenstein, Babita Bisht, Catherine A. Chenard, Linda Snetselaar, Bianca Weinstock-Guttman, Murali Ramanathan. Lipid profile is associated with decreased fatigue in individuals with progressive multiple sclerosis following a diet-based intervention: Results from a pilot study. PLOS ONE, 2019; 14 (6): e0218075 DOI: 10.1371/journal.pone.0218075
University at Buffalo. “Vegetable-rich diet lowers fatigue in multiple sclerosis patients by raising good cholesterol: Fatigue affects a majority of MS patients, impacting the quality of life and ability to work full time.” ScienceDaily. ScienceDaily, 15 August 2019. <www.sciencedaily.com/releases/2019/08/190815134822.htm>.
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