Higher levels of blood high-density lipoprotein (HDL) — or good cholesterol — may improve fatigue in multiple sclerosis (MS), according to a new study led by researchers at the University of Buffalo in the US. It was found that lowering total cholesterol also reduced exhaustion.
The study, led by Murali Ramanathan, PhD, Professor in the University of Buffalo School of Pharmacy and Pharmaceutical Sciences, investigated the effects of fat levels in blood on fatigue caused by MS.
The study results, published recently in the journal PLOS ONE, highlight the impact that changes in diet could have on severe fatigue, which impacts the majority of those with MS. Despite its prevalence and the severity of its impact, treatment options for fatigue in MS are limited. The medications used to treat severe fatigue often come with unwanted side effects.
“Fatigue in people with MS has been viewed as a complex and difficult clinical problem with contributions from disability, depression and inflammation. Our study implicates lipids and fat metabolism in fatigue,” said Dr. Ramanathan. “This is a novel finding that may open doors to new approaches for treating fatigue.”
In previous studies, Terry Wahls, MD, clinical professor of internal medicine and neurology and creator of the Wahls Protocol diet, and her team of researchers at the University of Iowa, have shown that a diet-based approach accompanied by exercise, stress reduction and neuromuscular electrical stimulation (NMES) is effective in lowering fatigue. However, the physiological changes underlying these improvements are unknown.
In the Buffalo study, 18 progressive MS patients were placed on the Wahls diet, which is high in fruits and vegetables and followed for a year. The Wahls diet encourages the consumption of meat, plant protein, fish oil and B vitamins. Gluten, dairy and eggs are excluded.
Participants also engaged in a home-based exercise program that included stretches and strength training NMES to stimulate muscle contraction and movement, and meditation and self-massages for stress reduction. However, adherence to the diet was the main factor associated with reductions in fatigue.
The Buffalo researchers examined changes in body mass index (BMI), calories, total cholesterol, HDL, triglycerides, and low-density lipoprotein (LDL) — commonly known as bad cholesterol. Fatigue was measured on the Fatigue Severity Scale.
“Higher levels of HDL had the greatest impact on fatigue,” said Ramanathan, “possibly because good cholesterol plays a critical role in muscle, stimulating glucose uptake and increasing respiration in cells to improve physical performance and muscle strength.”
Patients consumed fewer calories and experienced decreases in BMI and triglyceride and LDL levels as well. However, these factors were found unrelated to changes in fatigue.
The researchers say their results provide the basis for a larger study that could examine the effects of metabolic changes on fatigue.
Source: MS-UK 19/08/2019