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ALS is a rare neurological disease with no cure. Several studies have investigated the impact of different types of diets of progression of the disease. This article outlines the evidence for use of different types of diets in ALS treatment.

Amyotrophic lateral sclerosis (ALS) is a rare neurological condition that is characterized by progressive loss of motor neurons, which are nerve cells that control voluntary muscle movement.

As there is currently no cure for ALS, patients often look towards making lifestyle changes that can help slow down the progression of the disease. One of these lifestyle changes includes diet. Recently, several studies have investigated the benefits of different types of diets including ketogenic diet, use of antioxidants, restorative diet and calorie restriction.

Ketogenic diet in ALS

Prior studies have shown that diets that shift the body from burning carbohydrates to burning fat (popularly known as the ketogenic diet), can be beneficial in protecting nerve cells and preserving their ability to function.

Therefore, researchers in the field of ALS have investigated the benefits of using a ketogenic (high fat and low carbohydrate) diet in the treatment of a mouse model of ALS.

Results from one study indicated that the ketogenic diet was associated with a significant benefit as mice that were fed this diet had higher levels of energy and longer survival compared to mice that were on a calorie-restricted diet.

In fact, three animal studies based on mouse models of ALS with a mutation in the SOD1 gene (a genetic form of ALS) have shown that the ketogenic diet led to maintenance of motor function for longer, as well as longer survival time, compared to mice that were fed a normal diet.

Antioxidants and ALS

Antioxidants are substances in our body that are often obtained through a diet that counteract the activities of harmful and toxic species in our body known as reactive oxygen species. Several studies have pointed out that there are elevated levels of reactive oxygen species in patients with ALS, leading researchers to question whether antioxidants can help treat the disease.

In one previous study, researchers used a Food Frequency Questionnaire to investigate the dietary habits of 302 ALS patients. Then, researchers evaluated whether their respective diets had an effect on the ALS Functional Rating Scale-Revised score and forced vital capacity (which measures the ability to breathe).

Results from the study indicated that a diet rich in antioxidants, vitamin E, omega-3 polyunsaturated fatty acids, and carotenoids was found to be beneficial in regards to the patient’s functional activity compared to patients that had an intake of foods that were low in antioxidants (particularly diets that were high in carbohydrates, glutamate, and saturated fats). In particular, the study found that a high intake of fruits, vegetables, omega-3 fatty acids and other foods high in antioxidants were positively correlated with higher ALS function.

This result lends hope to the notion that better nutrition can lead to slower disease progression and less disability.

These are some good sources of antioxidants, omega-3 polyunsaturated fatty acids, and carotenoids:

  • Vegetables: leeks, onions, eggplant, carrots, spinach, red capsicum, corn, mushrooms, sweet potatoes and cruciferous vegetables (broccoli, cabbage and cauliflower)
  • Fruits: grapes, berries (goji berries, wild blueberries, acai berries, cranberries, and blackberries), pumpkin, mangoes, apricots, citrus fruits, apples, tomatoes, pink grapefruit, watermelon, oranges, blackcurrants, kiwifruit, strawberries and avocados,
  • Meat: seafood, lean meat and liver
  • Herbs: thyme, oregano and parsley
  • Others: garlic, red wine, tea, milk, nuts, soybeans, tofu, lentils, peas, red beans or kidney beans, sesame seeds, bran, whole grains, egg yolks, and vegetable oils.

Restorative Diet and ALS

Some schools of thought believe that a restorative diet, in which all sources of toxins and processed foods are removed from the diet, can help patients with ALS. These are the following things that need to be followed for a restorative diet:

  • Stop intake of all sugars, including artificial sweeteners.
  • Remove processed foods from the diet, particularly food items made with refined grains, hydrogenated oils, preservatives and other chemicals.
  • Eat proper food that is high vitamins and nutrients as supplements are generally not absorbed properly in the body.
  • Eat unprocessed and nutritious foods, such as those that are in high in antioxidants and concentrated nutrients.
  • Eat quality meat, such as meat from organic sources in order to avoid hormones and other chemicals. These can include grass-fed beef, free-range chicken and lamb.
  • Supplement diet with other protein sources, such as cage-free eggs, lentils, pecans, cashews and pumpkin and squash seeds.
  • Eat healthy fats, such as oil from coconut, cold-pressed olive oil, cultured butter or ghee and avocado.

Calorie restriction and ALS

Prior studies had indicated that a calorie restriction diet might be of benefit with regards to age-related diseases and the study was found to prolong the lifespan of healthy insects, rodents, and nonhuman primates.

Hence, researchers sought to investigate the effect of calorie restriction on ALS patients. In fact, contrary to what the researchers had hypothesized, they found that age of disease onset in mice with the ALS mutation that were maintained on a calorie restricted diet was not significantly different from mice fed a normal diet.

Furthermore, another group of researchers that were investigating the same thing found that the mice that were fed a calorie-restricted diet actually had a younger age of disease onset compared to mice on a normal diet. Furthermore, mice on a calorie-restricted diet survived for less time than their normal diet counterparts.

Therefore, researchers do not believe that a calorie restricted diet is an appropriate therapy for ALS. They suggest that high fat or ketogenic diet is better.

  • Zhao, Zhong, et al. "A ketogenic diet as a potential novel therapeutic intervention in amyotrophic lateral sclerosis." BMC neuroscience 7.1 (2006): 29.
  • Siva, Nayanah. "Can ketogenic diet slow progression of ALS?." The LMorozova, Natalia, et al. "Diet and amyotrophic lateral sclerosis." Epidemiology (2008): 324-337.Maalouf, Marwan, Jong M. Rho, and Mark P. Mattson. "The neuroprotective properties of calorie restriction, the ketogenic diet, and ketone bodies." Brain research reviews 59.2 (2009): 293-315.lancet Neurology 5.6 (2006): 476.
  • Pioro, Erik P. "Antioxidant therapy in ALS." Amyotrophic Lateral Sclerosis and Other Motor Neuron Disorders 1.sup4 (2000): S5-S15.
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