Higher levels of blood high-density lipoprotein—good cholesterol—may improve fatigue in multiple sclerosis patients, according to a new study.
The pilot study, which investigated the effects of fat levels in blood on fatigue caused by multiple sclerosis, shows lowering total cholesterol also reduces exhaustion.
Fatigue is a frequent and debilitating symptom for people with multiple sclerosis that affects the quality of life and ability to work full time.
Despite fatigue’s prevalence and severity, treatment options are limited and medications used to treat it often come with unwanted side effects.
“Fatigue in people with multiple sclerosis has been viewed as a complex and difficult clinical problem with contributions from disability, depression, and inflammation,” says Murali Ramanathan, professor in the University at Buffalo 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, Terry Wahls, a clinical professor of internal medicine and neurology and creator of the Wahls Protocol diet, and her team of researchers at the University of Iowa showed that a diet-based intervention accompanied by exercise, stress reduction, and neuromuscular electrical stimulation (NMES) is effective at lowering fatigue.
However, researchers didn’t know the physiological changes underlying the improvements.
For the current study in PLOS ONE, researchers examined changes in body mass index (BMI), calories, total cholesterol, HDL, triglycerides, and low-density lipoprotein (LDL)—commonly known as bad cholesterol. Researchers used the Fatigue Severity Scale to measure fatigue.
Researchers followed 18 progressive multiple sclerosis patients who followed the Wahls diet, which is high in fruits and vegetables, over the course of a year.
The diet encourages the consumption of meat, plant protein, fish oil, and B vitamins. It excludes gluten, dairy, and eggs.
Participants also took part in a home-based exercise program that included stretches and strength training, NMES to stimulate muscle contraction and movement, and meditation and self-massages for stress reduction.
However, adherence to the diet was the main factor associated with reductions in fatigue.
“Higher levels of HDL had the greatest impact on fatigue,” Ramanathan says, “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.”
Patients consumed fewer calories and experienced decreases in BMI and triglyceride and LDL levels as well. However, researchers found these factors unrelated to changes in fatigue.
The results provide the basis for a larger study that could examine the effects of metabolic changes on fatigue.
Additional coauthors are from the University at Buffalo and the University of Iowa.
Written by Marcene Robinson.