A high-carbohydrate, high-calorie diet could delay the progression of motor neurone disease, according to a pilot study published today (28 February 2014).
The disease – also known as Amyotrophic Lateral Sclerosis (ALS) – is a rapidly progressive, fatal neurodegenerative disorder affecting the nerve cells that control muscle movement.
As the disease progresses, loss of muscle and fat is common and patients experience difficulty eating and swallowing, which means they are unable to maintain their bodyweight.
Recent studies have shown that patients who are mildly obese are more likely to live longer, while mice carrying a gene that causes the disease lived longer when they were fed a calorie-rich diet high in fat.
Now, a new study, funded by the Muscular Dystrophy Association, has found that patients should eat a higher fat, calorie-rich diet.
The study, led by Dr Anne-Marie Wills at the Massachusetts General Hospital, in Boston, USA, involved 20 patients with advanced motor neurone disease who already used a feeding tube to deliver food directly into the stomach.
The participants were split into 3 groups: a control group, to maintain weight, plus 2 high-calorie groups: 1 that was given a high carbohydrate diet and the other a high fat diet.
The diets lasted for 4 months, and data on safety and survival were collected for 5 months.
Patients given the high-carbohydrate/high-calorie diet gained slightly more weight than the other groups – an average of 0.86lbs – per month, compared to an average gain of 0.24lbs per month in the control group, and an average weight loss of 1.01lbs in the high-fat high-calorie diet group.
“There is good epidemiological evidence that, in ALS, survival is determined by nutritional status,” said Dr Wills.
“This pilot study demonstrates the safety of a novel, simple, low-cost treatment for a devastating disease where currently, very few treatment options are available. The adverse outcomes that we feared might result from weight gain, such as diabetes or heart disease, were not observed in our study period of five months.”
She called for a larger trial with similar nutritional interventions tested at an earlier stage in the disease.
“Although the sample size was small, we are optimistic about these results, because they are consistent with previous studies in ALS mouse models that showed that hypercaloric diets improve survival,” explained Dr Wills.
“Not only could this type of nutritional intervention be a novel way to treat and slow down the progression of ALS, it might also be useful in other neurological diseases.”
Wills A, Hubbard J et al. Hypercaloric enteral nutrition in patients with amyotrophic lateral sclerosis: a randomised, double-blind, placebo-controlled phase 2 trial. The Lancet 28 February 2014. [abstract]
Leave a Reply