ALSUntangled #76:华尔斯协议

Xiaoyan Li, Paul Wicks, Andrew Brown, Akhil Shivaprasad, Maxwell Greene, Jesse Crayle, Benjamin Barnes, Sartaj Jhooty, Dylan Ratner, Natasha Olby, Jonathan D Glass, Carlayne Jackson, Nicholas Cole, Carmel Armon, Javier Mascias Cadavid, Gary Pattee, Christopher J Mcdermott, Vincent Chang, Nicholas Maragakis, Tulio Bertorini, Robert Bowser, Richard Bedlack
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摘要

华氏饮食法是一种改良的旧石器时代饮食法,强调深绿色叶菜、多彩水果、优质动物蛋白和欧米加-3 多不饱和脂肪酸,同时限制谷物、豆类、乳制品、糖和含有促炎性欧米加-6 脂肪酸的加工食品。华氏饮食法可以减少炎症、氧化应激和线粒体功能障碍,并具有减缓肌萎缩性脊髓侧索硬化症(ALS)进展的合理机制。然而,在 ALS 动物模型中对其膳食成分的研究结果却相互矛盾。虽然多项队列研究表明,胡萝卜素、欧米茄-3 脂肪酸和水果的高摄入量与 ALS 风险的降低有关,但在病例研究或临床试验中,饮食及其成分均未被证实能减缓 ALS 的进展。相反,在多发性硬化症临床试验中,华尔斯饮食(一种限制性、低碳水化合物和低血糖指数饮食)导致体重平均减轻了 7.2% BMI,这对肌萎缩侧索硬化症(PALS)患者来说是一个重大问题,因为体重减轻与 ALS 进展加快和生存期缩短有关。综上所述,我们不能赞同用沃尔斯饮食法来延缓 ALS 的进展。
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ALSUntangled #76: Wahls protocol.

The Wahls diet is a modified Paleolithic diet that emphasizes dark green leafy vegetables, colorful fruits, high-quality animal proteins, and omega-3 polyunsaturated fatty acids, while limiting grains, legumes, dairy products, sugar, and processed foods containing proinflammatory omega-6 fatty acids. The Wahls diet may reduce inflammation, oxidative stress, and mitochondrial dysfunction and has plausible mechanisms for slowing amyotrophic lateral sclerosis (ALS) progression. However, research on its dietary components in the ALS animal models has yielded conflicting results. Though multiple cohort studies suggest high carotenoids, omega-3 fatty acids and fruit intake are associated with reduced ALS risks, neither the diet nor its components has been demonstrated to slow down ALS progression in case studies or clinical trials. On the contrary, the Wahls diet, a restrictive, low-carbohydrate and low glycemic index diet, caused an average weight loss of 7.2% BMI in multiple sclerosis clinical trials, which is a significant concern for people living with amyotrophic lateral sclerosis (PALS) as weight loss is associated with faster ALS progression and shorter survival. Considering the above, we cannot endorse the Wahls diet for slowing ALS progression.

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ALSUntangled #76: Wahls protocol. Graph theory network analysis reveals widespread white matter damage in brains of patients with classic ALS. Alteration in ornithine metabolism due to mutation in ALDH18A1 masquerading as ALS in pregnancy. Multistep modeling applied to a Malaysian ALS registry. Assessing disease progression in ALS: prognostic subgroups and outliers.
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