High-calorie diet may slow ALS progression

A small study reported in The Lancet on Friday indicates that a diet heavy in calories and carbohydrates may slow progression of Lou Gehrig's disease.

Formally referred to as amyotrophic lateral sclerosis (ALS) or motor neuron disease, the condition affects nerve cells that control muscle movement. It results in weakness, paralysis and usually death from respiratory failure. Patients often lose a large amount of weight as the disease progresses.

"We are particularly excited because these results provide the first preliminary evidence that a dietary intervention may improve life expectancy in ALS, and they are strongly supported by epidemiological and animal data," said corresponding author of the paper Anne-Marie Willis, MD, of the MGH Department of Neurology and Neurological Clinical Research Institute (NCRI). "This strategy has never been tested before in ALS, and we are optimistic that it may provide a new, effective and inexpensive therapy for this devastating illness."

The new research comes after suspicions that ALS patients may be at an even larger risk if they lose weight. Patients find it difficult to eat and swallow, and eventually have to be fed through a tube.

To come to their conclusions, researchers tested 20 volunteers with advanced ALS, who were divided into three groups. The "control" group received a nutritional formula to keep their weight stable and the two other groups received 125 percent of the calories they required to maintain their weight. Of the latter two groups, one received a diet heavy in carbohydrates, while the other received a diet heavy in fats. The patients partook in the diet for four months and were monitored for five months afterward.

The researchers found that the patients on the high-calorie and high-carbohydrate diets did much better than their counterparts. They had less "adverse effects" and also gained more weight. Over the course of the five-month follow-up period, no deaths occurred among the high-calorie, high-carbohydrate patients. One person died in the high-fat group and three died in the control group.

"While it's not possible to make clinical recommendations based on this single, small study, I think the results support the importance of avoiding weight loss in this disease," Willis said. "We're hoping to obtain funding for a large study of whether nutrition counseling to encourage weight gain - something not currently covered by health insurers - can help slow the progression of ALS, and I'm optimistic that interventions designed to maintain or increase weight could be even more effective if started before patients have lost a significant amount of weight."


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