TY - JOUR
T1 - Effect of intermittent vs. daily calorie restriction on changes in weight and patient-reported outcomes in people with multiple sclerosis
AU - Fitzgerald, Kathryn C.
AU - Vizthum, Diane
AU - Henry-Barron, Bobbie
AU - Schweitzer, Amy
AU - Cassard, Sandra D.
AU - Kossoff, Eric
AU - Hartman, Adam L.
AU - Kapogiannis, Dimitrios
AU - Sullivan, Patrick
AU - Baer, David J.
AU - Mattson, Mark P.
AU - Appel, Lawrence J.
AU - Mowry, Ellen M.
N1 - Funding Information:
The authors would like to acknowledge advice and guidance provided the late Dr. John Milner of the United States Department of Agriculture in developing the design of the study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Neurological Disorders and Stroke or National Institutes of Health (NIH). This work was performed while ALH was a full-time employee of Johns Hopkins University. This publication was made possible by the Johns Hopkins Institute for Clinical and Translational Research (ICTR) which is funded in part by Grant Number UL1 TR 001079 from the National Center for Advancing Translational Sciences (NCATS) a component of the National Institutes of Health ( NIH ), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the Johns Hopkins ICTR, NCATS or NIH. This study was supported in part by the Intramural Research Program of the National Institute on Aging.
Funding Information:
Dr. Fitzgerald has nothing to disclose. Ms. Vizthum has nothing to disclose. Ms. Henry-Barron has nothing to disclose. Dr. Schweitzer has nothing to disclose. Dr. Cassard has nothing to disclose. Dr. Kossoff reports serving on scientific advisory boards for Atkins Nutritionals and for Nutricia, outside the submitted work Dr. Hartman has nothing to disclose. Dr. Kappogiannis has nothing to disclose Dr. Mattson has nothing to disclose. Mr. Sullivan has nothing to disclose. Dr. Baer has nothing to disclose. Dr. Appel reports that Healthways, Inc. developed the website for two weight loss interventions used in the POWER trial in collaboration with Johns Hopkins investigators and provided coaching effort for the transtelephonic intervention. Healthways also provided some research funding to supplement NIH support. Under an institutional consulting agreement with Healthways, the Johns Hopkins University received fees for advisory services to Healthways during the POWER trial. Faculty members who participated in the consulting services received a portion of the University fees. On the basis of POWER trial results, Healthways developed and is commercializing a weight-loss intervention program called Innergy. Under an agreement with Healthways, Johns Hopkins faculty monitor the Innergy program's content and process (staffing, training, and counseling) and outcomes (engagement and weight loss ) to ensure consistency with the corresponding arm of the POWER Trial. Johns Hopkins receives fees for these services and faculty members who participate in the consulting services receive a portion of these fees. Johns Hopkins receives royalty on sales of the Innergy program. Dr. Mowry reports receiving free glatiramer acetate for the investigator-initiated vitamin D trial, of which she is the PI from Teva Neuroscience provides. She is also the PI of investigator-initiated studies funded by Biogen, Sanofi-Genzyme. She is also a site investigator of trials sponsored by Sun Pharma, Biogen and royalties from Up-to-date.
Funding Information:
This study was supported by a Harry Weaver Neuroscience Scholar Award from the National MS Society (NMSS) to Ellen M. Mowry. Kathryn Fitzgerald is supported by postdoctoral fellowships from the National MS Society and the Consortium of MS Centers. This study was also supported in part by the Intramural Research Program of the National Institute on Aging.
Publisher Copyright:
© 2018
PY - 2018/7
Y1 - 2018/7
N2 - 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.
AB - 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.
KW - Dietary intervention
KW - Multiple sclerosis
KW - Weight loss intervention
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U2 - 10.1016/j.msard.2018.05.002
DO - 10.1016/j.msard.2018.05.002
M3 - Article
C2 - 29753994
AN - SCOPUS:85046883240
SN - 2211-0348
VL - 23
SP - 33
EP - 39
JO - Multiple Sclerosis and Related Disorders
JF - Multiple Sclerosis and Related Disorders
ER -