A DIET RICH IN ANTIOXIDANTS AND CAROTENOIDS IS LINKED WITH BETTER OUTCOMES FOR PATIENTS WITH AMYOTROPHIC LATERAL SCLEROSIS (ASL)
New research at Columbia University’s Mailman School of Public Health reveals that foods like fruits and vegetables that are high in antioxidant nutrients and carotenoids are associated with better function in amyotrophic lateral sclerosis (ALS) patients around the time of diagnosis. This is among the first studies to evaluate diet in association with ALS function and the first to show that healthy nutrients and antioxidants are associated with better ALS functioning. The findings are published online in JAMA Neurology.
ALS, also known as Lou Gehrig’s Disease, is a severe neurodegenerative disorder that causes atrophy, paralysis, and eventually respiratory failure. Median survival for ALS patients ranges from 20 to 48 months, although 10 percent to 20 percent of patients can live longer than 10 years.
Credit @ CU
Credit @ CU
Jeri W. Nieves, PhD, associate professor of Epidemiology, and co-authors examined the links between nutritional intake and severity of ALS for patients who had ALS symptoms for 18 months or less. The study, which relied on nutrient intake reported using a food questionnaire, followed 302 participants recruited at 16 clinical centers throughout the U.S. The researchers used a validated measure of ALS severity and respiratory function.
“It appears that nutrition plays a role both in triggering the disease and why it progresses,” said Dr. Nieves. “For this reason, ALS patients should eat foods high in antioxidants and carotenes, as well as high fiber grains, fish, and poultry.”
The researchers also found that milk and lunch meats were associated with lower measures of function, or more severe disease. Two different statistical analyses by Dr. Nieves both indicate that diet may help minimize the severity of ALS and point to the role of oxidative stress in ALS severity.
“The foods and nutrients that may help reduce the severity of ALS are very similar to the recommendation to prevent many other chronic diseases,” noted Dr. Nieves.
“Our cross-sectional study relied on a food questionnaire and those may not always represent a true daily diet,” cautioned Dr. Nieves. “However, those responsible for nutritional care of the patient with ALS should consider promoting fruits and vegetables since they are high in antioxidants and carotenes. Future studies will look at follow-up-data on both dietary intake and progression of ALS.”
Co-authors are Pam Factor-Litvak of Columbia University’s Mailman School of Public Health; Jonathan Hupf, Jessica Singleton, Valerie Sharf, and Hiroshi Mitsumoto, all of the Department of Neurology, Columbia University; Chris Gennings, Icahn School of Medicine at Mount Sinai; Bjorn Oskarsson, University of California–Davis, Sacramento; Fernandes Filho, University of Nebraska Medical Center; Eric J. Sorenson, Mayo Clinic; Emanuele D’Amico, Neurological Institute, Catania, Italy; and Ray Goetz, Department of Psychiatry, New York State Psychiatric Institute.
What is ALS?
ALS, or amyotrophic lateral sclerosis, is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. A-myo-trophic comes from the Greek language. “A” means no. “Myo” refers to muscle, and “Trophic” means nourishment – “No muscle nourishment.” When a muscle has no nourishment, it “atrophies” or wastes away. “Lateral” identifies the areas in a person’s spinal cord where portions of the nerve cells that signal and control the muscles are located. As this area degenerates it leads to scarring or hardening (“sclerosis”) in the region.
Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually leads to their demise. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action progressively affected, people may lose the ability to speak, eat, move and breathe. The motor nerves that are affected when you have ALS are the motor neurons that provide voluntary movements and muscle control. Examples of voluntary movements are making the effort to reach for a smart phone or step off a curb. These actions are controlled by the muscles in the arms and legs.
There are two different types of ALS, sporadic and familial. Sporadic which is the most common form of the disease in the U.S., is 90 – 95 percent of all cases. It may affect anyone, anywhere. Familial ALS (FALS) accounts for 5 to 10 percent of all cases in the U.S. Familial ALS means the disease is inherited. In those families, there is a 50% chance each offspring will inherit the gene mutation and may develop the disease. French neurologist Jean-Martin Charcot discovered the disease in 1869.
During the 2014 ALS Ice Bucket Challenge, millions of people started talking about ALS. Keep the conversation going to increase understanding of the disease.
Facts You Should Know
ALS is not contagious.
Although the life expectancy of a person with ALS averages about two to five years from the time of diagnosis, this disease is variable, and many people can live with the disease for five years and more. More than half of all people with ALS live more than three years after diagnosis.
Once ALS starts, it almost always progresses, eventually taking away the ability to walk, dress, write, speak, swallow, and breathe and shortening the life span. How fast and in what order this occurs is very different from person to person. While the average survival time is 3 years, about twenty percent of people with ALS live five years, 10 percent will survive ten years and five percent will live 20 years or more.
Progression is not always a straight line in an individual either. It is not uncommon to have periods lasting weeks to months where there is very little or no loss of function. There are even very rare examples in which there is significant improvement and recovery of lost function. These ALS “arrests” and “reversals” are unfortunately usually transient. Less than 1% of patients with ALS will have significant improvement in function lasting 12 months or more.
Approximately 6,000 people in the U.S. are diagnosed with ALS each year. The incidence of ALS is two per 100,000 people, and it is estimated that more than 20,000 Americans may be living with ALS at any given time.
ALS occurs throughout the world with no racial, ethnic or socioeconomic boundaries and can affect anyone.
Military veterans are approximately twice as likely to develop ALS.
The onset of ALS often involves muscle weakness or stiffness as early symptoms. Progression of weakness, wasting and paralysis of the muscles of the limbs and trunk as well as those that control vital functions such as speech, swallowing and later breathing generally follows.
There can be significant costs for medical care, equipment and home health caregiving later in the disease. It is important to be knowledgeable about your health plan coverage and other programs for which you may be eligible, including Social Security Disability, Medicare, Mediciad and Veteran Affairs benefits.