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Early Study Hints at Improved ALS Survival with High-Calorie Diet — Physician’s First Watch

Medical News |
February 28, 2014

Early Study Hints at Improved ALS Survival with High-Calorie Diet

By Kelly Young

A high-carbohydrate, high-calorie enteral diet is well tolerated among patients with advanced amyotrophic lateral sclerosis (ALS) and may even improve survival, according to a phase II trial in the Lancet.

Twenty-four patients with ALS requiring enteral nutrition were randomized to one of three diets for 4 months: a control diet to maintain their energy intake; a high-carbohydrate, high-calorie diet; or a high-fat, high-calorie diet. The high-calorie diets provided about 1.5 times patients' estimated energy requirements.

Control patients were more likely than high-calorie patients to withdraw because of adverse events. Over 5 months' follow-up, none of the patients on the high-carbohydrate diet died, compared with 43% on the control diet and 13% on the high-fat diet.

A commentator notes that there is "mounting evidence that this disease induces a hypermetabolic state, and that countering the increased metabolism might improve outcomes." He concludes: "I will not be changing my advice to patients on the basis of this study, but am eager to see the results of a large phase 3 trial."

Reader Comments (3)

DrPhilip Siegel, MD Physician, Surgery, Specialized

add to prior comment on ketone as endpoint leaning towards an acidotic state creates an antioxidant effect important when superoxide dismutaes is absent

DrPhilip Siegel, MD Physician, Surgery, Specialized

neurosurgeon: interesting and may correlate with similar treating epileptics belief that ketones as end point of metabolism suggested are quiescent for CNS

paul helman,M.D North Shore health Systems Skokie , Il

I wonder how carefully controled the nominal "Low Carb" diet was? Was it truly ketogenic? This is a common failing of such dietary studies.

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