High-calorie diet may slow progression of motor neuron disease

Washington: A high-carbohydrate, high-calorie diet could delay the progression of Amyotrophic Lateral Sclerosis (ALS), also known as motor neuron disease or Lou Gehrig's disease, according to a new study.

ALS is a rapidly progressive, fatal neurodegenerative disorder affecting the nerve cells that control muscle movement (motor neurons).

Patients gradually lose the ability to control the body's muscles, including the muscles which control breathing. This leads to respiratory failure and death on average about 3 years after patients are diagnosed.

Loss of weight, both muscle and fat, is common as ALS progresses, and patients experience more difficulties eating, swallowing, and maintaining their bodyweight.

Recent studies have suggested that these problems might also contribute to the course of the disease: patients who are mildly obese are more likely to live longer, and mice carrying a gene which causes ALS lived longer when they were fed a calorie-rich diet high in fat.

The new study was led by Dr Anne-Marie Wills at the Massachusetts General Hospital in Boston.

To participate in the study, patients with advanced ALS had to already have a feeding tube (known as PEG tubes, or percutaneous endoscopic gastrostomy tubes), which allows food to be delivered directly into the stomach.

Twenty patients were split into three groups, each with a different diet plan - a control group (to maintain weight) and two high-calorie (hypercaloric) groups: one high in carbohydrates, the other high in fat.

The diets lasted for 4 months, and data on safety and survival were collected from the beginning of the study for a total of 5 months.

Patients given the high-carbohydrate/high-calorie diet experienced fewer adverse events (23 vs 42), and significantly fewer serious adverse events (0 vs 9) including deaths from respiratory failure than the control group.

Patients given the high-carbohydrate/high-calorie diet also gained slightly more weight than the other groups (an average of 0?39kg gained per month, compared to an average gain of 0?11kg per month in the control group, and an average weight loss of 0?46kg in the high-fat high-calorie diet group).

"There is good epidemiological evidence that, in ALS, survival is determined by nutritional status. This pilot study demonstrates the safety of a novel, simple, low-cost treatment for a devastating disease where currently, very few treatment options are available," Wills said.

"The adverse outcomes that we feared might result from weight gain, such as diabetes or heart disease, were not observed in our study period of five months," Wills added.

The authors warned that the findings should be interpreted "with caution", and call for larger trials, with similar nutritional interventions tested at an earlier stage in the disease for ALS patients.

The study was published in The Lancet.