Affiliation:
1. Department of Neurology Columbia University Irving Medical Center New York NY USA
2. Department of Biostatistics and Psychiatry Columbia University New York NY USA
3. Mental Health Data Science New York State Psychiatric Institute New York NY USA
4. Department of Neurology University of Kentucky Lexington KY USA
5. Department of Pediatrics and Medicine Columbia University Irving Medical Center New York NY USA
6. Department of Epidemiology Columbia University Mailman School of Public Health New York NY USA
Abstract
ObjectiveHigh‐caloric diets may slow the progression of amyotrophic lateral sclerosis; however, key macronutrients have not been identified. We examined whether dietary macronutrients are associated with the rate of progression and length of survival among the prospective cohort study participants.MethodsParticipants with a confirmed diagnosis of sporadic amyotrophic lateral sclerosis enrolled in the Multicenter Cohort Study of Oxidative Stress were included (n = 304). We evaluated baseline macronutrient intake assessed by food frequency questionnaire in relation to change in revised amyotrophic lateral sclerosis functional rating scale total‐score, and tracheostomy‐free survival using linear regression and Cox proportional hazard models. Baseline age, sex, disease duration, diagnostic certainty, body mass index, bulbar onset, revised amyotrophic lateral sclerosis functional rating scale total‐score, and forced vital capacity were included as covariates.ResultsBaseline higher glycemic index and load were associated with less decline of revised amyotrophic lateral sclerosis functional rating scale total score at 3‐month follow‐up (β = −0.13, 95% CI −0.2, −0.01, p = 0.03) and (β = −0.01, 95% CI −0.03, −0.0007, p = 0.04), respectively. Glycemic index second‐quartile, third‐quartile, and fourth‐quartile groups were associated with less decline at 3 months by 1.9 (95% CI −3.3, −0.5, p = 0.008), 2.0 (95% CI −3.3, −0.6, p = 0.006), and 1.6 (95% CI −3.0, −0.2, p = 0.03) points compared with the first‐quartile group; the glycemic load fourth‐quartile group had 1.4 points less decline compared with the first‐quartile group (95% CI −2.8, 0.1, p = 0.07). Higher glycemic index was associated with a trend toward longer tracheostomy‐free survival (HR 0.97, 95% CI 0.93, 1.00, p = 0.07).InterpretationHigher dietary glycemic index and load are associated with slower disease progression in amyotrophic lateral sclerosis. ANN NEUROL 2024;95:217–229
Funder
American Academy of Neurology
American Brain Foundation
Muscular Dystrophy Association
National Institute of Environmental Health Sciences
National Institute of Neurological Disorders and Stroke
Subject
Neurology (clinical),Neurology