Relationship between Dietary Fiber Intake and the Prognosis of Amytrophic Lateral Sclerosis in Korea.

Haelim Yu,Seung Hyun Kim,Yongsoon Park,Min-Young Noh,Sanggon Lee

doi:10.3390/nu12113420

Haelim Yu, Seung Hyun Kim + Show 3 more

Open Access

https://doi.org/10.3390/nu12113420

Copy DOI

Abstract

The gut microbiota has been suggested as an important factor in the pathogenic mechanisms of amyotrophic lateral sclerosis (ALS). This study aimed to investigate whether the intake of different kinds of dietary fiber was related to the disease progression rate (∆FS) and survival time. In total, 272 Korean sporadic ALS patients diagnosed according to the revised EI Escorial criteria were recruited starting in March 2011 and were followed until the occurrence of events or the end of September 2020. The events included percutaneous endoscopic gastrostomy, tracheostomy, and death. Dietary fiber intake was calculated based on a 24-h dietary recall and classified according to five major fiber-rich foods: vegetables, fruits, grains, legumes, and nuts/seeds. Among the total participants, the group with ∆FS values lower than the mean ∆FS (0.75) was noted in the highest tertiles of total and vegetable fiber intake. Participants in the highest tertile for vegetable fiber intake showed longer survival in the Kaplan–Meier analysis (p = 0.033). Notably, vegetable fiber intake was negatively correlated with pro-inflammatory cytokine (interleukin (IL)-1β, IL-6, and monocyte chemoattractant protein-1) levels in the cerebrospinal fluid. This study showed that vegetable fiber intake could influence the disease progression rate and survival time. Further clinical trials are needed to confirm whether dietary fiber supplementation improves the prognosis of ALS.

Highlights

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the progressive degeneration of motor neurons, leading to dysphagia, limb paralysis, and death due to respiratory failure [1]
Since the daily recommended intake for fiber is 20–25 g/d according to the dietary reference intake for Koreans [29], our results suggest that at least 20 g/d of dietary fiber could be recommended for amyotrophic lateral sclerosis (ALS) patients
We previously reported that ALS patients consuming more vegetables had higher ALSFRS-R scores, which measure physical performance including bulbar, respiratory, and motor function in ALS patients [11]

Summary

Introduction

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the progressive degeneration of motor neurons, leading to dysphagia, limb paralysis, and death due to respiratory failure [1]. The gut microbiota has been suggested to play a role in the pathophysiology of ALS by fermenting dietary fiber and producing short-chain fatty acids (SCFAs) [3]. Previous studies have reported that patients with ALS had intestinal dysbiosis and reduced levels of butyrate-producing bacteria compared with healthy controls [4,5]. In ALS mice treated with butyrate, the main SCFA, the gut microbiome was observed to be restored and disease progression was delayed, suggesting that butyrate could modulate intestinal homeostasis in ALS [6]. Paganoni et al (2020) [7]

Objectives

Methods

Discussion

Conclusion