Weight-Gain Diet Safe for ALS Patients

High calorie diet found to be tolerable and safe for ALS patients

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Patients with ALS sometimes consume a high-calorie diet to gain weight and body mass. A recent study investigated whether these diets are safe.

Researchers recruited ALS, or amyotrophic lateral sclerosis, patients to participate in a clinical trial on calorie-dense diets. One group of patients consumed enough calories to maintain their weight. The other patients consumed high-calorie diets that were either dense in fats or carbohydrates.

The researchers found that patients eating high-calorie diets experienced fewer adverse events. They concluded that calorie-dense diets were safe and tolerable for patients with ALS.

"If you have ALS, talk to your doctor about your diet."

Anne-Marie Wills, MD, of the Neurological Clinical Research Institute, led this study on ALS.

ALS, or amyotrophic lateral sclerosis, is a disease that affects the part of the brain, spinal cord and brain stem involved with movement (the motor system). ALS is a fatal disease that often results in muscle atrophy, difficulty speaking and difficulty breathing. ALS patients normally lose a significant amount of body mass.

According to Dr. Wills and colleagues, mild obesity has been tied to longer survival in ALS patients. These authors referenced several studies that have reported a link between higher BMI and slower disease progression.

This study tested the safety and tolerability of two calorie-dense diets for individuals with ALS.

The researchers recruited 20 participants with ALS for the study. Six patients, each of whom had already been receiving nutrition through tube-feeding, were assigned to a diet intended for weight maintenance. Researchers assigned eight participants each to a high calorie/high carbohydrate group and a high calorie/high fat group.

Participants in the intervention group consumed an average of 1.21 times their energy requirements. Each of the participants was tube-fed.

The patients adhered to the diets for four months. Researchers followed up with the patients for five months afterward.

At each follow-up visit, researchers measured each participants' weight and fat mass. They also measured physical functioning using an ALS-specific scale.

The researchers paid special attention to how safe and tolerable the diets were for the patients.

Participants in the high calorie/high carbohydrate diet experienced fewer adverse events than those in the control group and the high fat group.

The group receiving a high fat diet had more than twice as many adverse events compared to the high carbohydrate group (48 versus 23).

The most common adverse events were related to digestion.

Nine participants in the control group experienced serious adverse events like pneumonia and lung problems. No participants in the carbohydrate group reported serious adverse events.

Additionally, more control group participants discontinued their study diet than the intervention groups.

The researchers found that the hypercaloric diets did not show evidence of leading to diabetes based on participants' blood sugar levels.

During the five-month follow-up period, three participants in the control group died. No participants consuming a high-calorie diet died.

The researchers concluded that these results provide evidence for the safety and tolerability of a high-calorie diet for ALS patients who wish to gain or maintain their weight.

These researchers acknowledged that the sample size was small and more controlled trials are necessary to confirm their findings.

This study was published by The Lancet on February 28.

The research was funded by the Muscular Dystrophy Association, the National Center for Research Resources, the National Institutes of Health and the Harvard NeuroDiscovery Center. Some of the researchers reported financial ties to pharmaceutical companies and medical organizations.

Review Date: 
March 7, 2014
Last Updated:
March 14, 2014