Low-fat, plant-based diet in multiple sclerosis: A randomized controlled trial

Vijayshree Yadav, Gail Marracci, Edward Kim, Rebecca Spain, Michelle Cameron, Shannon Overs, Andrew Riddehough, David K B Li, John McDougall, Jesus Lovera, Charles Murchison, Dennis Bourdette

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background The role that dietary interventions can play in multiple sclerosis (MS) management is of huge interest amongst patients and researchers but data evaluating this is limited. Possible effects of a very-low-fat, plant-based dietary intervention on MS related progression and disease activity as measured by brain imaging and MS related symptoms have not been evaluated in a randomized-controlled trial. Despite use of disease modifying therapies (DMT), poor quality of life (QOL) in MS patients can be a significant problem with fatigue being one of the common disabling symptoms. Effective treatment options for fatigue remain limited. Emerging evidence suggests diet and vascular risk factors including obesity and hyperlipidemia may influence MS disease progression and improve QOL. Objectives To evaluate adherence, safety and effects of a very-low-fat, plant-based diet (Diet) on brain MRI, clinical [MS relapses and disability, body mass index (BMI)] and metabolic (blood lipids and insulin) outcomes, QOL [Short Form-36 (SF-36)], and fatigue [Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS)], in relapsing-remitting MS (RRMS). Methods This was a randomized-controlled, assessor-blinded, one-year long study with 61 participants assigned to either Diet (N=32) or wait-listed (Control, N=29) group. Results The mean age (years) [Control−40.9±8.48; Diet−40.8±8.86] and the mean disease duration (years) [Control −5.3±3.86; Diet−5.33±3.63] were comparable between the two groups. There was a slight difference between the two study groups in the baseline mean expanded disability status scale (EDSS) score [Control−2.22±0.90; Diet−2.72±1.05]. Eight subjects withdrew (Diet, N=6; Control, N=2). Adherence to the study diet based on monthly Food Frequency Questionnaire (FFQ) was excellent with the diet group showing significant difference in the total fat caloric intake compared to the control group [total fat intake/total calories averaged ~15% (Diet) versus ~40% (Control)]. The two groups showed no differences in brain MRI outcomes, number of MS relapses or disability at 12 months. The diet group showed improvements at six months in low-density lipoprotein cholesterol (Δ=−11.99 mg/dL; p=0.031), total cholesterol (Δ=−13.18 mg/dL; p=0.027) and insulin (Δ=−2.82 mg/dL; p=0.0067), mean monthly reductions in BMI (Rate=−1.125 kg/m2 per month; p

Original languageEnglish (US)
Pages (from-to)80-90
Number of pages11
JournalMultiple Sclerosis and Related Disorders
Volume9
DOIs
StatePublished - Sep 1 2016

Fingerprint

Multiple Sclerosis
Randomized Controlled Trials
Fats
Diet
Fatigue
Quality of Life
Disease Progression
Body Mass Index
Insulin
Recurrence
Relapsing-Remitting Multiple Sclerosis
Brain
Hyperlipidemias
Energy Intake
Neuroimaging
LDL Cholesterol
Obesity
Cholesterol
Research Personnel
Lipids

Keywords

  • Diet
  • Fatigue
  • Low fat
  • Magnetic resonance imaging
  • Multiple sclerosis

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Low-fat, plant-based diet in multiple sclerosis : A randomized controlled trial. / Yadav, Vijayshree; Marracci, Gail; Kim, Edward; Spain, Rebecca; Cameron, Michelle; Overs, Shannon; Riddehough, Andrew; Li, David K B; McDougall, John; Lovera, Jesus; Murchison, Charles; Bourdette, Dennis.

In: Multiple Sclerosis and Related Disorders, Vol. 9, 01.09.2016, p. 80-90.

Research output: Contribution to journalArticle

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abstract = "Background The role that dietary interventions can play in multiple sclerosis (MS) management is of huge interest amongst patients and researchers but data evaluating this is limited. Possible effects of a very-low-fat, plant-based dietary intervention on MS related progression and disease activity as measured by brain imaging and MS related symptoms have not been evaluated in a randomized-controlled trial. Despite use of disease modifying therapies (DMT), poor quality of life (QOL) in MS patients can be a significant problem with fatigue being one of the common disabling symptoms. Effective treatment options for fatigue remain limited. Emerging evidence suggests diet and vascular risk factors including obesity and hyperlipidemia may influence MS disease progression and improve QOL. Objectives To evaluate adherence, safety and effects of a very-low-fat, plant-based diet (Diet) on brain MRI, clinical [MS relapses and disability, body mass index (BMI)] and metabolic (blood lipids and insulin) outcomes, QOL [Short Form-36 (SF-36)], and fatigue [Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS)], in relapsing-remitting MS (RRMS). Methods This was a randomized-controlled, assessor-blinded, one-year long study with 61 participants assigned to either Diet (N=32) or wait-listed (Control, N=29) group. Results The mean age (years) [Control−40.9±8.48; Diet−40.8±8.86] and the mean disease duration (years) [Control −5.3±3.86; Diet−5.33±3.63] were comparable between the two groups. There was a slight difference between the two study groups in the baseline mean expanded disability status scale (EDSS) score [Control−2.22±0.90; Diet−2.72±1.05]. Eight subjects withdrew (Diet, N=6; Control, N=2). Adherence to the study diet based on monthly Food Frequency Questionnaire (FFQ) was excellent with the diet group showing significant difference in the total fat caloric intake compared to the control group [total fat intake/total calories averaged ~15{\%} (Diet) versus ~40{\%} (Control)]. The two groups showed no differences in brain MRI outcomes, number of MS relapses or disability at 12 months. The diet group showed improvements at six months in low-density lipoprotein cholesterol (Δ=−11.99 mg/dL; p=0.031), total cholesterol (Δ=−13.18 mg/dL; p=0.027) and insulin (Δ=−2.82 mg/dL; p=0.0067), mean monthly reductions in BMI (Rate=−1.125 kg/m2 per month; p",
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author = "Vijayshree Yadav and Gail Marracci and Edward Kim and Rebecca Spain and Michelle Cameron and Shannon Overs and Andrew Riddehough and Li, {David K B} and John McDougall and Jesus Lovera and Charles Murchison and Dennis Bourdette",
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AU - Yadav, Vijayshree

AU - Marracci, Gail

AU - Kim, Edward

AU - Spain, Rebecca

AU - Cameron, Michelle

AU - Overs, Shannon

AU - Riddehough, Andrew

AU - Li, David K B

AU - McDougall, John

AU - Lovera, Jesus

AU - Murchison, Charles

AU - Bourdette, Dennis

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N2 - Background The role that dietary interventions can play in multiple sclerosis (MS) management is of huge interest amongst patients and researchers but data evaluating this is limited. Possible effects of a very-low-fat, plant-based dietary intervention on MS related progression and disease activity as measured by brain imaging and MS related symptoms have not been evaluated in a randomized-controlled trial. Despite use of disease modifying therapies (DMT), poor quality of life (QOL) in MS patients can be a significant problem with fatigue being one of the common disabling symptoms. Effective treatment options for fatigue remain limited. Emerging evidence suggests diet and vascular risk factors including obesity and hyperlipidemia may influence MS disease progression and improve QOL. Objectives To evaluate adherence, safety and effects of a very-low-fat, plant-based diet (Diet) on brain MRI, clinical [MS relapses and disability, body mass index (BMI)] and metabolic (blood lipids and insulin) outcomes, QOL [Short Form-36 (SF-36)], and fatigue [Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS)], in relapsing-remitting MS (RRMS). Methods This was a randomized-controlled, assessor-blinded, one-year long study with 61 participants assigned to either Diet (N=32) or wait-listed (Control, N=29) group. Results The mean age (years) [Control−40.9±8.48; Diet−40.8±8.86] and the mean disease duration (years) [Control −5.3±3.86; Diet−5.33±3.63] were comparable between the two groups. There was a slight difference between the two study groups in the baseline mean expanded disability status scale (EDSS) score [Control−2.22±0.90; Diet−2.72±1.05]. Eight subjects withdrew (Diet, N=6; Control, N=2). Adherence to the study diet based on monthly Food Frequency Questionnaire (FFQ) was excellent with the diet group showing significant difference in the total fat caloric intake compared to the control group [total fat intake/total calories averaged ~15% (Diet) versus ~40% (Control)]. The two groups showed no differences in brain MRI outcomes, number of MS relapses or disability at 12 months. The diet group showed improvements at six months in low-density lipoprotein cholesterol (Δ=−11.99 mg/dL; p=0.031), total cholesterol (Δ=−13.18 mg/dL; p=0.027) and insulin (Δ=−2.82 mg/dL; p=0.0067), mean monthly reductions in BMI (Rate=−1.125 kg/m2 per month; p

AB - Background The role that dietary interventions can play in multiple sclerosis (MS) management is of huge interest amongst patients and researchers but data evaluating this is limited. Possible effects of a very-low-fat, plant-based dietary intervention on MS related progression and disease activity as measured by brain imaging and MS related symptoms have not been evaluated in a randomized-controlled trial. Despite use of disease modifying therapies (DMT), poor quality of life (QOL) in MS patients can be a significant problem with fatigue being one of the common disabling symptoms. Effective treatment options for fatigue remain limited. Emerging evidence suggests diet and vascular risk factors including obesity and hyperlipidemia may influence MS disease progression and improve QOL. Objectives To evaluate adherence, safety and effects of a very-low-fat, plant-based diet (Diet) on brain MRI, clinical [MS relapses and disability, body mass index (BMI)] and metabolic (blood lipids and insulin) outcomes, QOL [Short Form-36 (SF-36)], and fatigue [Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS)], in relapsing-remitting MS (RRMS). Methods This was a randomized-controlled, assessor-blinded, one-year long study with 61 participants assigned to either Diet (N=32) or wait-listed (Control, N=29) group. Results The mean age (years) [Control−40.9±8.48; Diet−40.8±8.86] and the mean disease duration (years) [Control −5.3±3.86; Diet−5.33±3.63] were comparable between the two groups. There was a slight difference between the two study groups in the baseline mean expanded disability status scale (EDSS) score [Control−2.22±0.90; Diet−2.72±1.05]. Eight subjects withdrew (Diet, N=6; Control, N=2). Adherence to the study diet based on monthly Food Frequency Questionnaire (FFQ) was excellent with the diet group showing significant difference in the total fat caloric intake compared to the control group [total fat intake/total calories averaged ~15% (Diet) versus ~40% (Control)]. The two groups showed no differences in brain MRI outcomes, number of MS relapses or disability at 12 months. The diet group showed improvements at six months in low-density lipoprotein cholesterol (Δ=−11.99 mg/dL; p=0.031), total cholesterol (Δ=−13.18 mg/dL; p=0.027) and insulin (Δ=−2.82 mg/dL; p=0.0067), mean monthly reductions in BMI (Rate=−1.125 kg/m2 per month; p

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