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Symptoms checklistFatigue is a common symptom of multiple sclerosis (MS), and its effects can severely compromise an individual’s quality of life. But new research from the University of Buffalo (UB) indicates that multiple sclerosis-related fatigue could be improved with a diet that raises high-density lipoprotein (HDL), or good cholesterol, and lowers total cholesterol.

“Fatigue in people with multiple sclerosis has been viewed as a complex and difficult clinical problem with contributions from disability, depression, and inflammation,” says lead researcher Murali Ramanathan, professor in the UB School of Pharmacy and Pharmaceutical Sciences. “Our study implicates lipids and fat metabolism in fatigue. This is a novel finding that may open doors to new approaches for treating fatigue.”

In previous studies, a team led by Terry Wahls, clinical professor of internal medicine and neurology at the University of Iowa, showed that a diet-based intervention accompanied by exercise, stress reduction, and neuromuscular electrical stimulation is effective at lowering fatigue. However, the physiological changes underlying the improvements were unknown.

The University of Buffalo study followed 18 progressive multiple sclerosis patients over the course of a year who were placed on the diet developed by Wahls. High in fruits and vegetables, the diet also encourages the consumption of meat, plant protein, fish oil, and B vitamins, but excludes gluten, dairy, and eggs.

Participants also engaged in a home-based exercise program that included stretches and strength training, neuromuscular electrical stimulation to stimulate muscle contraction and movement, and meditation and self-massages for stress reduction. At the conclusion of the study, it was ascertained that the main factor associated with reductions in fatigue was adherence to the diet.

“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.” Although the study participants consumed fewer calories and experienced decreases in BMI, as well as in triglyceride and LDL levels, these factors were found unrelated to changes in fatigue.

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

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