Villa Aneli T, Tu Betty H, Titcomb Tyler J, Saxby Solange M, Shemirani Farnoosh, Ten Eyck Patrick, Rubenstein Linda M, Snetselaar Linda G, Wahls Terry L
Department of Internal Medicine, University of Iowa, Iowa City, IA, United States.
Department of Epidemiology, University of Iowa, Iowa City, IA, United States.
Front Neurol. 2023 Jan 19;13:1022728. doi: 10.3389/fneur.2022.1022728. eCollection 2022.
Preliminary dietary intervention trials with the low-saturated fat (Swank) and modified Paleolithic elimination (Wahls) diets have shown favorable effects on fatigue among people with multiple sclerosis (MS); however, their impact on metabolic health is unknown.
To evaluate the impact of the Swank and Wahls diets on markers of metabolic health and to determine the association and mediation effect between changes in metabolic health and perceived fatigue among people with relapsing-remitting MS (RRMS).
As part of a randomized parallel-arm trial, vital signs, blood metabolic biomarkers, and the fatigue scale for motor and cognitive functions (FSMC) were collected from participants with relapsing-remitting MS ( = 77) at four study visits spaced 12 weeks apart: (1) run-in, (2) baseline, (3) 12-weeks, and (4) 24-weeks. Participants followed their usual diet at run-in, then were randomized at baseline to either the Swank or Wahls diets and followed for 24 weeks.
Both groups had significant reductions in weight, body mass index (BMI), total cholesterol, and low-density lipoprotein (LDL) at 12- and 24-weeks compared to respective baseline values ( ≤ 0.04 for all). The Swank group also had a significant reduction in high-density lipoprotein (HDL) at 12- and 24-weeks ( = 0.0001 and = 0.02, respectively), while the Wahls group had significant reductions in diastolic blood pressure (DBP). In addition, both groups had significant reductions in FSMC total perceived fatigue and the motor and cognitive fatigue subscales at 12- and 24-weeks ( ≤ 0.01 for all); however, change in the cognitive subscale was not significant at 12-weeks in the Swank group ( = 0.06). Furthermore, the favorable effects, of both diets, on markers of metabolic health were not associated with and did not mediate the effect of the diets on perceived fatigue ( > 0.05 for all).
Both diets lead to significant reductions in perceived fatigue, weight, BMI, total cholesterol, and LDL, but the significant reductions in perceived fatigue were independent of changes in markers of metabolic health.
采用低饱和脂肪饮食（斯旺克饮食法）和改良旧石器时代排除饮食（瓦尔饮食法）进行的初步饮食干预试验显示，对多发性硬化症（MS）患者的疲劳有积极影响；然而，它们对代谢健康的影响尚不清楚。
评估斯旺克饮食法和瓦尔饮食法对代谢健康标志物的影响，并确定复发缓解型多发性硬化症（RRMS）患者代谢健康变化与感知疲劳之间的关联及中介效应。
作为一项随机平行组试验的一部分，在间隔12周的四次研究访视中，收集复发缓解型多发性硬化症患者（n = 77）的生命体征、血液代谢生物标志物以及运动和认知功能疲劳量表（FSMC）：（1）导入期，（2）基线期，（3）12周时，（4）24周时。参与者在导入期遵循其日常饮食，然后在基线期随机分为斯旺克饮食组或瓦尔饮食组，并随访24周。
与各自的基线值相比，两组在12周和24周时体重、体重指数（BMI）、总胆固醇和低密度脂蛋白（LDL）均显著降低（所有P≤0.04）。斯旺克饮食组在12周和24周时高密度脂蛋白（HDL）也显著降低（分别为P = 0.0001和P = 0.02），而瓦尔饮食组舒张压（DBP）显著降低。此外，两组在12周和24周时FSMC总感知疲劳以及运动和认知疲劳子量表均显著降低（所有P≤0.01）；然而，斯旺克饮食组在12周时认知子量表的变化不显著（P = 0.06）。此外，两种饮食对代谢健康标志物的有益影响与饮食对感知疲劳的影响无关，也不是其介导因素（所有P>0.05）。
两种饮食均能显著降低感知疲劳、体重、BMI、总胆固醇和LDL，但感知疲劳的显著降低与代谢健康标志物的变化无关。
