Impact of the Swank and Wahls elimination dietary interventions on fatigue, quality of life in RRMS

[ActiveMSers]

Multiple Sclerosis Journal – Experimental, Translational and Clinical
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Impact of the Swank and Wahls elimination dietary interventions on fatigue and quality of life in relapsing-remitting multiple sclerosis: The WAVES randomized parallel-arm clinical trial

Terry L Wahls*, Tyler J Titcomb*, Babita Bisht, et al
First Published July 31, 2021
https://doi.org/10.1177/20552173211035399

Abstract

Objective
To compare the effect of the modified Paleolithic elimination (Wahls) and low-saturated fat (Swank) diets in relapsing-remitting MS (RRMS).

Methods
Individuals (n = 87) with RRMS were randomized to the Swank or Wahls diets in a parallel group clinical trial consisting of four timepoints: 1) run-in, 2) baseline, 3) 12-weeks, and 4) 24-weeks.

Results
77 participants completed 12 weeks and 72 completed 24 weeks. The 12-week change from baseline in fatigue was -0.94 ± 0.18 (FSS) and -9.87 ± 1.93 (MFIS; both p < 0.0001) for Swank, and -0.71 ± 0.24 (FSS; p = 0.004) and -14.41 ± 2.22 (MFIS; p ≤ 0.0001) for Wahls. Physical MSQoL scores improved by 6.04 ± 2.18 (p = 0.006) for Swank and by 14.5 ± 2.63 (p < 0.0001) for Wahls. Mental MSQoL scores improved by 11.3 ± at 2.79 (p < 0.0001) for Wahls while the Swank did not change (3.85 ± 2.63; p = 0.14). Neither group showed significant changes in 6-minute walking distance at 12 weeks. All outcomes were maintained or further improved at 24 weeks.

Conclusions
Both diets were associated with clinically meaningful within-group reductions in fatigue and improvements in QoL.

[ActiveMSers]

I have concerns with this study, so so many concerns, that I'll address them in a separate blog post. So stay tuned!

[AMFADVENTURES]

I doubt they'll get this peer reviewed, I didn't see a conflict of interest statement.

I take it back, I just found it and I still doubt it will ever get seriously peer reviewed because of the fundamental conflict of interest.

[ActiveMSers]

Another diet study. Perhaps any decent diet will lower fatigue, not just "MS" diets.

Br J Nutr
. 2021 Aug 16;1-35.
doi: 10.1017/S000711452100307X. Online ahead of print.

Modified Mediterranean Diet VS. Traditional Iranian Diet: Efficacy of Dietary Interventions on Dietary Inflammatory Index Score, Fatigue Severity and Disability in Multiple Sclerosis Patients

Jalal Bohlouli ¹, Iman Namjoo ², Mohammad Borzoo-Isfahani ³, Fariborz Poorbaferani ⁴, Amir Reza Moravejolahkami ⁵, Cain C T Clark ⁶, Mohammad Ali Hojjati Kermani ⁷

• PMID: 34392854
• DOI: 10.1017/S000711452100307X

Abstract

Background: Current evidence suggests that adherence to the Mediterranean Diet (MeD) can reduce inflammation in chronic diseases; however, studies pertaining to Relapsing-Remitting Multiple Sclerosis (RRMS) are limited. Therefore, the aim of this study was to investigate the potential of the modified MeD (mMeD) in improving Dietary Inflammatory Index (DII) scores, disability, and fatigue severity, compared to Traditional Iranian Diet (TID), in RRMS patients.

Methods: After initial screening (n=261), 180 RRMS patients were randomized to receive mMeD or TID (as control) for six months. DII score, Expanded Disability Status Scale (EDSS) and 21-item Modified Fatigue Impact Scale (MFIS) were evaluated at baseline and trial cessation. Multivariate analysis of covariance was conducted and adjusted for age, gender, body weight, body mass index, education level, supplement use, family history and duration of MS.

Results: Of the 180 patients enrolled, 147 participants were included in the final analysis (n of mMeD=68; n of TID=79). Self-reported adherence was good (˜81%). Dietary intakes of 45 food parameters were assessed through the food frequency questionnaire. The mMeD significantly reduced DII scores after six months (2.38±0.21 to -1.87±0.86, P<0.001), but TID did not elicit any changes (2.21±0.44 to 2.14±1.01, P=0.771). Additionally, MFIS total score decreased significantly (72.4±17.2 to 63.9±14.2, P<0.001), whereas there was no considerable improvement for EDSS in the mMeD group.

Conclusion: Adherence to mMeD, for six months, improved dietary inflammatory status and fatigue severity in RRMS patients, however, the traditional Iranian diet did not positively impact dietary inflammation and MFIS score.