Effect of intermittent vs. daily calorie restriction on changes in weight and patient-reported outcomes in people with multiple sclerosis

Kathryn Fitzgerald, Diane Vizthum, Bobbie Henry-Barron, Amy Schweitzer, Sandra Cassard, Eric H Kossoff, Adam L. Hartman, Dimitrios Kapogiannis, Patrick Sullivan, David J. Baer, Mark P. Mattson, Lawrence Appel, Ellen Mahar Mowry

Research output: Contribution to journalArticle

Abstract

An intermittent fasting or calorie restriction diet has favorable effects in the mouse forms of multiple sclerosis (MS) and may provide additional anti-inflammatory and neuroprotective advantages beyond benefits obtained from weight loss alone. We conducted a pilot randomized controlled feeding study in 36 people with MS to assess safety and feasibility of different types of calorie restriction (CR) diets and assess their effects on weight and patient reported outcomes in people with MS. Patients were randomized to receive 1 of 3 diets for 8 weeks: daily CR diet (22% daily reduction in energy needs), intermittent CR diet (75% reduction in energy needs, 2 days/week; 0% reduction, 5 days/week), or a weight-stable diet (0% reduction in energy needs, 7 days/week). Of the 36 patients enrolled, 31 (86%) completed the trial; no significant adverse events occurred. Participants randomized to CR diets lost a median 3.4 kg (interquartile range [IQR]: −2.4, −4.0). Changes in weight did not differ significantly by type of CR diet, although participants randomized to daily CR tended to have greater weight loss (daily CR: −3.6 kg [IQR: −3.0, −4.1] vs. intermittent CR: −3.0 kg [IQR: −1.95, −4.1]; P = 0.15). Adherence to study diets differed significantly between intermittent CR vs. daily CR, with lesser adherence observed for intermittent CR (P = 0.002). Randomization to either CR diet was associated with significant improvements in emotional well-being/depression scores relative to control, with an average 8-week increase of 1.69 points (95% CI: 0.72, 2.66). CR diets are a safe/feasible way to achieve weight loss in people with MS and may be associated with improved emotional health.

Original languageEnglish (US)
Pages (from-to)33-39
Number of pages7
JournalMultiple Sclerosis and Related Disorders
Volume23
DOIs
StatePublished - Jul 1 2018

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Multiple Sclerosis
Diet
Weights and Measures
Weight Loss
Patient Reported Outcome Measures
Random Allocation
Fasting
Anti-Inflammatory Agents
Safety
Health

Keywords

  • Dietary intervention
  • Multiple sclerosis
  • Weight loss intervention

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Effect of intermittent vs. daily calorie restriction on changes in weight and patient-reported outcomes in people with multiple sclerosis. / Fitzgerald, Kathryn; Vizthum, Diane; Henry-Barron, Bobbie; Schweitzer, Amy; Cassard, Sandra; Kossoff, Eric H; Hartman, Adam L.; Kapogiannis, Dimitrios; Sullivan, Patrick; Baer, David J.; Mattson, Mark P.; Appel, Lawrence; Mowry, Ellen Mahar.

In: Multiple Sclerosis and Related Disorders, Vol. 23, 01.07.2018, p. 33-39.

Research output: Contribution to journalArticle

Fitzgerald, Kathryn ; Vizthum, Diane ; Henry-Barron, Bobbie ; Schweitzer, Amy ; Cassard, Sandra ; Kossoff, Eric H ; Hartman, Adam L. ; Kapogiannis, Dimitrios ; Sullivan, Patrick ; Baer, David J. ; Mattson, Mark P. ; Appel, Lawrence ; Mowry, Ellen Mahar. / Effect of intermittent vs. daily calorie restriction on changes in weight and patient-reported outcomes in people with multiple sclerosis. In: Multiple Sclerosis and Related Disorders. 2018 ; Vol. 23. pp. 33-39.
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abstract = "An intermittent fasting or calorie restriction diet has favorable effects in the mouse forms of multiple sclerosis (MS) and may provide additional anti-inflammatory and neuroprotective advantages beyond benefits obtained from weight loss alone. We conducted a pilot randomized controlled feeding study in 36 people with MS to assess safety and feasibility of different types of calorie restriction (CR) diets and assess their effects on weight and patient reported outcomes in people with MS. Patients were randomized to receive 1 of 3 diets for 8 weeks: daily CR diet (22{\%} daily reduction in energy needs), intermittent CR diet (75{\%} reduction in energy needs, 2 days/week; 0{\%} reduction, 5 days/week), or a weight-stable diet (0{\%} reduction in energy needs, 7 days/week). Of the 36 patients enrolled, 31 (86{\%}) completed the trial; no significant adverse events occurred. Participants randomized to CR diets lost a median 3.4 kg (interquartile range [IQR]: −2.4, −4.0). Changes in weight did not differ significantly by type of CR diet, although participants randomized to daily CR tended to have greater weight loss (daily CR: −3.6 kg [IQR: −3.0, −4.1] vs. intermittent CR: −3.0 kg [IQR: −1.95, −4.1]; P = 0.15). Adherence to study diets differed significantly between intermittent CR vs. daily CR, with lesser adherence observed for intermittent CR (P = 0.002). Randomization to either CR diet was associated with significant improvements in emotional well-being/depression scores relative to control, with an average 8-week increase of 1.69 points (95{\%} CI: 0.72, 2.66). CR diets are a safe/feasible way to achieve weight loss in people with MS and may be associated with improved emotional health.",
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