Contributions
Abstract: EP1442
Type: ePoster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background: Overweight and obesity have been correlated with worse clinical outcomes in people with multiple sclerosis (pwMS), but little research has evaluated changes in outcomes with weight loss. Calorie restriction and time-restricted feeding (i.e. daily 16-hour fasts) are two dietary interventions that are associated with weight loss and improved fatigue and metabolic outcomes in the general population. However, whether these diets lead to improvements in symptoms among pwMS is unknown.
Objective: To evaluate the effect of weight change due to calorie restriction and time-restricted feeding on patient-reported outcomes (PROs) including fatigue, sleep quality, depression and self-esteem.
Methods: We conducted a 6-month pragmatic pilot study of either calorie restriction or time-restricted feeding in 43 pwMS who were being treated with natalizumab at the Johns Hopkins MS Center. At months 0, 3 and 6 weight and waist and hip circumference were collected. Participants provided information on fatigue (MS-specific PROMIS short-form), sleep (Pittsburgh Quality Sleep Index), and depression (emotional well-being components of the functional assessment of MS [FAMS]) at each time point. We assessed whether changes in anthropometric measures were associated with changes in PROs using linear regression models adjusting for age and gender.
Results: Of the 43 participants (86% female), 21 (48.8%) of the 38 who have completed to date lost weight over 6 months (4 of the 5 who will soon complete had lost weight at 3 months), with median weight change of -1.40kg (interquartile range [IQR]: -3.2 to 1.25kg) and median change of waist circumference of -0.25cm (IQR: -2.47 to 1.25). Change in waist circumference was associated with changes in fatigue scores, where a 5 cm decrease (or increase) in waist circumference was associated with an average decrease (or increase) of 1.85 points in fatigue severity (95% CI: -3.41 to -0.26; P=0.02). Similarly, each 5 kg decrease in weight was marginally associated with a 2.24-point decrease in fatigue score (95% CI: -4.52 to 0.06; P=0.09). Changes in weight or waist circumference were not associated with changes in sleep or depression.
Conclusions: In this pilot study of various fasting-mimicking diets, a reduction in waist circumference was associated with improvements in fatigue. Further studies investigating the impact of weight reduction, and mechanisms by which it is achieved, on classical MS endpoints and symptoms are needed.
Disclosure:
Samantha Roman: nothing to disclose
Kathryn C Fitzgerald: nothing to disclose
Bobbie Henry Barron: nothing to disclose
Diane Steinbeck: nothing to disclose
Lauren Ryan: nothing to disclose
Ellen Mowry: receives funding from the National MS Society (RG4407A2, Harry Weaver Award) and Department of Defense. Teva Neuroscience provides free glatiramer acetate for the investigator-initiated vitamin D trial, for which she is the PI. She is also the PI of investigator-initiated studies funded by Biogen, Sanofi-Genzyme and a site investigator of trials sponsored by Sun Pharma, Biogen and royalties from Up to Date.
Abstract: EP1442
Type: ePoster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background: Overweight and obesity have been correlated with worse clinical outcomes in people with multiple sclerosis (pwMS), but little research has evaluated changes in outcomes with weight loss. Calorie restriction and time-restricted feeding (i.e. daily 16-hour fasts) are two dietary interventions that are associated with weight loss and improved fatigue and metabolic outcomes in the general population. However, whether these diets lead to improvements in symptoms among pwMS is unknown.
Objective: To evaluate the effect of weight change due to calorie restriction and time-restricted feeding on patient-reported outcomes (PROs) including fatigue, sleep quality, depression and self-esteem.
Methods: We conducted a 6-month pragmatic pilot study of either calorie restriction or time-restricted feeding in 43 pwMS who were being treated with natalizumab at the Johns Hopkins MS Center. At months 0, 3 and 6 weight and waist and hip circumference were collected. Participants provided information on fatigue (MS-specific PROMIS short-form), sleep (Pittsburgh Quality Sleep Index), and depression (emotional well-being components of the functional assessment of MS [FAMS]) at each time point. We assessed whether changes in anthropometric measures were associated with changes in PROs using linear regression models adjusting for age and gender.
Results: Of the 43 participants (86% female), 21 (48.8%) of the 38 who have completed to date lost weight over 6 months (4 of the 5 who will soon complete had lost weight at 3 months), with median weight change of -1.40kg (interquartile range [IQR]: -3.2 to 1.25kg) and median change of waist circumference of -0.25cm (IQR: -2.47 to 1.25). Change in waist circumference was associated with changes in fatigue scores, where a 5 cm decrease (or increase) in waist circumference was associated with an average decrease (or increase) of 1.85 points in fatigue severity (95% CI: -3.41 to -0.26; P=0.02). Similarly, each 5 kg decrease in weight was marginally associated with a 2.24-point decrease in fatigue score (95% CI: -4.52 to 0.06; P=0.09). Changes in weight or waist circumference were not associated with changes in sleep or depression.
Conclusions: In this pilot study of various fasting-mimicking diets, a reduction in waist circumference was associated with improvements in fatigue. Further studies investigating the impact of weight reduction, and mechanisms by which it is achieved, on classical MS endpoints and symptoms are needed.
Disclosure:
Samantha Roman: nothing to disclose
Kathryn C Fitzgerald: nothing to disclose
Bobbie Henry Barron: nothing to disclose
Diane Steinbeck: nothing to disclose
Lauren Ryan: nothing to disclose
Ellen Mowry: receives funding from the National MS Society (RG4407A2, Harry Weaver Award) and Department of Defense. Teva Neuroscience provides free glatiramer acetate for the investigator-initiated vitamin D trial, for which she is the PI. She is also the PI of investigator-initiated studies funded by Biogen, Sanofi-Genzyme and a site investigator of trials sponsored by Sun Pharma, Biogen and royalties from Up to Date.