A low-fat diet improves fatigue in multiple sclerosis: Results from a randomized controlled trial.

Christopher Hollen, Vijayshree Yadav, Priya Srikanth, Akram Khan, Angela Horgan, Anna Orban, Carly Vong, Jonathan Q Purnell, Allison Fryman, Emma Chase, Elizabeth Silbermann, Jessica Rice, Claire Adams, Lindsey Wooliscroft, Michael Lane, Kayla Martin, Vicky Chen

Journal: Multiple sclerosis (Houndmills, Basingstoke, England) 2023;29(13):1659-1675

PMID: 37941305

Abstract

BACKGROUND

Fatigue can be a disabling multiple sclerosis (MS) symptom with no effective treatment options.

OBJECTIVE

Determine whether a low-fat diet improves fatigue in people with MS (PwMS).

METHODS

We conducted a 16-week randomized controlled trial (RCT) and allocated PwMS to a low-fat diet (active, total daily fat calories not exceeding 20%) or wait-list (control) group. Subjects underwent 2 weeks of baseline diet data collection (24-hour diet recalls (24HDRs)), followed by randomization. The active group received 2 weeks of nutrition counseling and underwent a 12-week low-fat diet intervention. One set of three 24HDRs at baseline and week 16 were collected. We administered a food frequency questionnaire (FFQ) and Modified Fatigue Impact Scale (MFIS) every 4 weeks. The control group continued their pre-study diet and received diet training during the study completion.

RESULTS

We recruited 39 PwMS (20-active; 19-control). The active group decreased their daily caloric intake by 11% (95% confidence interval (CI): -18.5%, -3.0%) and the mean MFIS by 4.0 (95% CI: -12.0, 4.0) compared to the control (intent-to-treat). Sensitivity analysis strengthened the association with a mean MFIS difference of -13.9 (95% CI: -20.7, -7.2).

CONCLUSIONS

We demonstrated a significant reduction in fatigue with a low-fat dietary intervention in PwMS.

Address: Department of Neurology, Oregon Health & Science University, Portland, OR, USA.; Department of Neurology, Oregon Health & Science University, Portland, OR, USA/Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR, USA.; Department of Medicine, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA.; Oregon Clinical & Translational Research Institute, Portland, OR, USA.; Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Oregon Health & Science University, Portland, OR, USA.; School of Public Health, Oregon Health & Science University-Portland State University, Portland, OR, USA.
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