$3.9M Grant Awarded to Study Effects of Low-glycemic Diet

The U.S. Department of Defense (DOD) has awarded $3.9 million to fund clinical research to test the impact of a low-glycemic diet on physical, cognitive, and psychological function in people with multiple sclerosis (MS).

The four-year project, called “Impact of diet quality and calorie restriction on physical function and patient-reported outcomes in multiple sclerosis,” will take the form of a clinical trial (NCT05327322) that’s expected to launch in November.

It will be spearheaded by Brooks Wingo, PhD, and Amy Goss, PhD, along with colleagues at the University of Alabama (UAB) and Washington University in St. Louis, the two sites where participants will be enrolled.

“This study is unique because it is highly translatable,” Goss said in a university news release.

“We not only have the potential to change the lives of the people directly involved in the study but hopefully to improve health outcomes for all people living with MS. Our findings could possess the potential to change clinical care when it comes to multiple sclerosis,” Goss said.

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Diet can significantly influence energy, strength, gastrointestinal function, mood, and immune health, among other things. In MS patients, an unhealthy diet has been linked to worse health outcomes. While healthy eating is advised, and many dietary guidelines exist, a standardized diet for MS has not been established.

A diet with a low glycemic load, or one with carbohydrates that cause fewer blood sugar spikes, is thought to enable fat loss while maintaining or increasing muscle mass, and could be a promising diet for MS patients. Examples of low-glycemic foods include green vegetables, most fruits, beans, and nuts.

Previously, Wingo and Goss were involved in a pilot trial (NCT03372187) that evaluated the feasibility of delivering a calorie-restricted diet with low glycemic load via telehealth in 20 patients with relapsing-remitting MS (RRMS). Results showed the diet is feasible and may be associated with positive effects on symptoms and cardiac health.

The upcoming FOOD_for_MS trial will be conducted to test the effectiveness of the diet over eight months in 100 RRMS or secondary progressive MS patients who are overweight or obese.

Participants will be randomly assigned to receive either a low or standard glycemic load diet designed by dietitians. Food will be delivered via a grocery delivery service, and participants will be asked to log their meals in an online research portal. All patients will also receive weekly phone calls to discuss goals and meal preparation.

For the first 16 weeks (about four months), participants will eat enough calories from their assigned diet to maintain their weight. In the second half of the study, however, participants will reduce their calorie intake by 500 kilocalories a day, with a goal of losing 5–10% of their body weight.

“By analyzing four distinct treatments, we are hopeful to determine if weight loss is needed to improve MS outcomes, and if improving food quality leads to separate and additional benefits,” Wingo said.

The study’s primary goal is to assess changes in physical function, as assessed with the Multiple Sclerosis Functional Composite (MSFC) scale. The team will also look at the effects of the dietary interventions on other facets of health, including cognitive function, pain, fatigue, sleep, mood, and anxiety.

All participants will undergo a full-body MRI to analyze body fat distribution in response to the diet, and whether fat deposits throughout the body are associated with worse metabolic health outcomes. With the imaging, researchers will be able to see whether the diet allows participants to lose fat but maintain muscle mass.

Routine bloodwork and clinical assessments will be performed to monitor blood sugar, inflammation, metabolic markers, blood pressure, and weight. Some participants will also undergo imaging to assess changes in neuroinflammation with the diet.

The trial was funded by the DOD-administered Multiple Sclerosis Research Program, a part of the Congressionally Directed Medical Research Program, which funds research aligned with the research goals of the National Institutes of Health. It’s administered by the DOD and funded by the U.S. Congress.