Association between improved metabolic risk factors and perceived fatigue during dietary intervention trial in relapsing-remitting multiple sclerosis: A secondary analysis of the WAVES trial.
Level 2 - randomized trial
Secondary analysis of a randomized parallel-arm trial
PubMed 36742040 · doi:10.3389/fneur.2022.1022728
What was done
This was a secondary analysis of the WAVES randomized parallel-arm trial in 77 individuals with relapsing-remitting multiple sclerosis (RRMS). After a 12-week run-in on their usual diet, participants were randomized to either a low-saturated fat (Swank) diet or a modified Paleolithic elimination (Wahls) diet for 24 weeks. Vital signs, blood metabolic markers (lipids, weight, BMI, blood pressure), and perceived fatigue (Fatigue Scale for Motor and Cognitive Functions [FSMC] total, motor, and cognitive subscales) were measured at run-in, baseline, 12 weeks, and 24 weeks. The authors tested whether metabolic changes mediated dietary effects on fatigue.
What was found
Both diets produced statistically significant reductions from baseline at 12 and 24 weeks in weight, BMI, total cholesterol, and LDL (p ≤ 0.04 for all). The Swank group experienced significant reductions in HDL at 12 and 24 weeks (p = 0.0001 and p = 0.02), whereas the Wahls group showed significant reductions in diastolic blood pressure. Both groups had significant reductions in total, motor, and cognitive fatigue at 12 and 24 weeks (p ≤ 0.01 for all, except Swank cognitive fatigue at 12 weeks, p = 0.06). However, the improvements in metabolic biomarkers did not correlate with or mediate the reductions in fatigue (p > 0.05 for all).
Why it matters
Both diets improve cardiometabolic risk markers and fatigue in relapsing-remitting MS, but the fatigue relief appears to occur through mechanisms independent of weight loss and lipid improvement.
Limits
The study is a secondary analysis with a modest sample size (n = 77) and no non-dietary control arm during the 24-week intervention phase. Specific nutrient intake, caloric changes, and long-term outcomes beyond 24 weeks were not reported in the abstract.
Cited by
- supports Dr. Terry Wahls has published studies showing positive clinical results using a functional medicine diet and lifestyle approach for multiple sclerosis.