High-Calorie Diet Could Slow Lou Gehrig’s Disease

Amyotrophic lateral sclerosis(ALS), commonly called Lou Gehrig’s disease, is a rapidly progressive and fatal neurodegenerative disorder affecting the nerve cells that control muscle movement. Patients gradually lose the ability to control the body's muscles, including those that control breathing. This leads to respiratory failure and death on average about three years after patients are diagnosed.

Now a study performed at 12 ALS centers and led by Dr, Anne-Marie Wills at the Massachusetts General Hospital, in Boston and published in the journal Lancet has shown that patients given a high-carbohydrate/high-calorie diet experienced fewer adverse events and significantly fewer serious adverse events including deaths from respiratory failure than the control group. A release from the publishers notes that loss of weight, both muscle and fat, is common as ALS progresses, and patients experience more difficulties eating, swallowing, and maintaining their bodyweight. Previous research has suggested that these problems might also contribute to the course of the disease since patients who are mildly obese are more likely to live longer. 

To participate in the study, patients with advanced ALS had to already have a feeding tube that allows food to be delivered directly into the stomach. Twenty patients were split into three groups, each with a different diet plan – a control group to maintain weight and two high-calorie groups, one high in carbohydrates and the other high in fat. The diets lasted for four months. Data on safety and survival were collected from the beginning of the study for a total of five months. Patients given the high-carbohydrate/high-calorie diet gained slightly more weight than the other groups.

The release quotes Dr. Wills as saying, "There is good epidemiological evidence that, in ALS, survival is determined by nutritional status. 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." Nonetheless, the authors point out that the findings should be interpreted "with caution", and call for larger trials with similar nutritional interventions tested at an earlier stage in the disease for ALS patients. "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," Dr. Wills said. "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."* Writing in a linked Comment, Dr Ammar Al-Chalabi, of King's College London, UK, stated that, "I will not be changing my advice to patients on the basis of this study, but I am eager to see the results of a large Phase 3 trial. Wills and colleagues have taken the first steps needed to provide evidence for a robust, non-pharmacological treatment that is well tolerated and easy to administer. We must finish the work they have started."
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