3-Day Dietary Manipulation in Multiple Sclerosis: Impact on Exercise Performance and Fatigue
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Multiple Sclerosis (MS) is a disease characterized by inflammation of the central nervous system (CNS) leading to tissue damage. Symptoms of MS are vast and can lead to a sedentary lifestyle, fatigue, reduced exercise tolerance and quality of life (QoL). There is growing interest in nutrition as a treatment of symptoms and potentially progression in MS. This dissertation utilizes both a cross sectional design and a blinded crossover randomized control study to explore the impact of nutrition on function, fatigue and QoL in MS. The cross sectional study demonstrated that persons with MS (pwMS) who had a long-term diet higher in fats had improved functional ability and QoL. We also found that pwMS had lower resting metabolic rates (RMR) when compared to a control group and predicted RMR. The interventional study included 12 participants with MS between the ages of 20 - 45 years with an expanded disability status scale (EDSS) between 2.0 - 5.0 and 12 age/sex-matched controls. After dietary manipulation with a low and high fat diet, pwMS showed an inability to switch between carbohydrate and fat oxidation with changing substrate availability. Under both dietary conditions, pwMS favored carbohydrate oxidation. In contrast to the CON group, the MS group demonstrated no change in fat oxidation with dietary manipulation.