The following article is part of conference coverage from the 8th Joint American Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) and European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) MSVirtual2020 event. Neurology Advisor‘s staff will be reporting breaking news associated with research conducted by leading experts in neurology. .


In individuals with relapsing-remitting multiple sclerosis (MS), Wahls elimination and Swank diets can help reduce disease-related fatigue. In addition, the Wahls elimination diet showed greater improvement in quality of life measures than the Swank diet, according to the study results presented at the 8th Joint ACTRIMS-ECTRIMS Meeting held virtually from September 11 to 13, 2020.

The investigators of this randomized, parallel-group study sought to compare the Wahls elimination diet and Swank diet on MS-related fatigue, overall quality of life, processing speed, and walking abilities. Over 36 weeks, patients with relapsing-remitting MS participated in a 12-week observation period, were randomly assigned and trained on the assigned diet with 5 telephone support calls by a registered dietitian, and had a final 12-week period without support calls. Study measures included the Fatigue Severity Scale, Modified Fatigue Impact Scale (MFIS), MS quality of life physical and mental health subscales, Symbol Digit Modalities Test-Oral, and the 6-Minute Walking Test, which were administered at 4 in-person visits (baseline and every 12 weeks).

In total, 77 participants completed 3 visits, and 72 participants completed 4 visits. At visits 3 and 4, participants in both the Wahls and Swank diet groups reported clinically significant improvement in Fatigue Severity Scale mean scores (Wahls -0.7, -1.3; Swank -0.9, -1.0; P <.01), MFIS (Wahls -14, -19; Swank -10, -11; P <.01) and quality of life physical health (Wahls 13, 13; Swank 10, 13; P <.01).

Improvement in quality of life mental health (Wahls 11, 14; P <.01; Swank 4 at visit 3; P =.14; Swank 6 at visit 4; P =.03) and Symbol Digit Modalities Test-Oral scores (Wahls 0.9 at visit 3; P =.27; Wahls 2.3 at visit 4; P =.01; Swank 2.9, 2.6; P <.01) was also reported for both groups. Improvement in the 6-Minute Walking Test was only observed at visit 4 (Wahls 120; P <.01; Swank 33; P =.13).

Overall, the Wahls diet group had better outcomes, including MFIS at visit 4 (-8.6; P =.02), quality of life mental health (7.5 at visit 3, 8.1 at visit 4; P =.05), and 6-Minute Walking test at visit 4 (87.1; P =.08).

Although both diet groups reported clinically important reductions in MS-related fatigue, the investigators suggest that the Wahls elimination diet was associated with better quality of life mental health outcomes as well as MFIS scores over the Swank diet.

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Reference

Wahls T, Darling W, Hoth K, et al. Effects of Wahls elimination and Swank dietary patterns on multiple sclerosis related fatigue, quality of life, processing speed and waking distance. Presented at: 8th Joint American Committee for Treatment and Research in Multiple Sclerosis and European Committee for Treatment and Research in Multiple Sclerosis MSVirtual2020 event; September 11-13, 2020; Abstract P0208