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Vegetable-rich Diet Lowers Fatigue in Multiple Sclerosis Patients by Raising Good Cholesterol

Higher levels of blood high-density lipoprotein (HDL) – or good cholesterol – may improve fatigue in multiple sclerosis patients, according to a new study led by the University at Buffalo (UB) in the USA.

The pilot study, which investigated the effects of fat levels in blood on fatigue caused by multiple sclerosis, found that lowering total cholesterol also reduced exhaustion.

The results, published recently in PLOS ONE and led by Murali Ramanathan, PhD, professor in the UB School of Pharmacy and Pharmaceutical Sciences, highlight the impact that changes in diet could have on severe fatigue, which impacts the majority of those with multiple sclerosis.

“Fatigue in people with multiple sclerosis 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 Ramanathan. “This is a novel finding that may open doors to new approaches for treating fatigue.”

The researchers examined changes in body mass index (BMI), calories, total cholesterol, HDL, triglycerides, and low-density lipoprotein (LDL). Fatigue was measured on the Fatigue Severity Scale.

The study followed 18 progressive multiple sclerosis patients over the course of a year who were placed on the Wahls diet, which is high in fruits and vegetables. The diet encourages the consumption of meat, plant protein, fish oil and B vitamins. Gluten, dairy and eggs are excluded.

“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.”

The results provide the basis for a larger study that could examine the effects of metabolic changes on fatigue.

Fellows Maxwell K, et al. (2019). Lipid profile is associated with decreased fatigue in individuals with progressive multiple sclerosis following a diet-based intervention: Results from a pilot study. PLOS; https://doi.org/10.1371/journal.pone.0218075.

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