Association between dietary intake and function in amyotrophic lateral sclerosis

Jeri W. Nieves, Chris Gennings, Pam Factor-Litvak, Jonathan Hupf, Jessica Singleton, Valerie Sharf, Björn Oskarsson, J. Americo M.Fernandes Filho, Eric J. Sorenson, Emanuele D'Amico, Ray Goetz, Hiroshi Mitsumoto, Jess Singleton, Christa Campanella Beck, David Merle, Tejal Shah, Meredith Pasmantier Kim, Yei Won Lee, Georgia Christodoulou, Kate DaltonJessica Kidd, Erin Gilbert, Mary Kilty, Daragh Heitzman, Wendy Rodriguez, Shari Hand, Michelle Washington, Brent Spears, Brandie Burson, Richard S. Bedlack, Karen Grace, Candace Boyette, Jonathan S. Katz, Robert G. Miller, Dallas Forshew, Joni Beemsterboer, Will Harris, Shelley McCoy, Thaïs Zayas-Bazan, Chow Saephanh, Richard J. Barohn, April L. McVey, Mazen M. Dimachkie, Mamatha Pasnoor, Yunxia Wang, Maureen Walsh, Laura Herbelin, Joann Miller, Kristy Anderson, Sherry Klingerman, Delana Weis, Nanette Joyce, Steffany Lim, Michelle Cregan, Edward J. Kasarskis, Kathie Vanderpool, Deborah Taylor, Samantha Thomas, Jason King, Robert Wells, Catherine Lomen-Hoerth, Jennifer Murphy, Y. Nhy Duong, Dennis Robins, Claudia Villerme, Yvonne D. Rollins, Steven P. Ringel, Dianna Quan, Elizabeth Whitethorn, Tahseen Mozaffar, Annabel K. Wang, Veronica Martin, Brian Minton, Patricia Tully, Denise Davis, Pariwat Thaisetthawatkul, Cindy Cowardin, Russell Herstein, Andrea J. Swenson, Decontee Jimmeh-Fletcher, Heena Olalde, Jeri Sieren, Sharon P. Nations, Jeffrey Elliott, Jaya Trivedi, Nina Gorham, Jeremy M. Shefner, Mary Lou Watson, Jennifer Moore, Katie Markis, Megan Grosso, Jinsy A. Andrews, Agnes Koczon-Jaremko, Janet Bowen

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


IMPORTANCE There is growing interest in the role of nutrition in the pathogenesis and progression of amyotrophic lateral sclerosis (ALS). OBJECTIVE To evaluate the associations between nutrients, individually and in groups, and ALS function and respiratory function at diagnosis. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional baseline analysis of the Amyotrophic Lateral Sclerosis Multicenter Cohort Study of Oxidative Stress study was conducted from March 14, 2008, to February 27, 2013, at 16 ALS clinics throughout the United States among 302 patients with ALS symptom duration of 18 months or less. EXPOSURES Nutrient intake, measured using a modified Block Food Frequency Questionnaire (FFQ). MAIN OUTCOMES AND MEASURES Amyotrophic lateral sclerosis function, measured using the ALS Functional Rating Scale-Revised (ALSFRS-R), and respiratory function, measured using percentage of predicted forced vital capacity (FVC). RESULTS Baseline data were available on 302 patients with ALS (median age, 63.2 years [interquartile range, 55.5-68.0 years]; 178 men and 124 women). Regression analysis of nutrients found that higher intakes of antioxidants and carotenes from vegetables were associated with higher ALSFRS-R scores or percentage FVC. Empirically weighted indices using the weighted quantile sum regression method of "good" micronutrients and "good" food groups were positively associated with ALSFRS-R scores (β [SE], 2.7 [0.69] and 2.9 [0.9], respectively) and percentage FVC (β [SE], 12.1 [2.8] and 11.5 [3.4], respectively) (all P < .001). Positive and significant associations with ALSFRS-R scores (β [SE], 1.5 [0.61]; P = .02) and percentage FVC (β [SE], 5.2 [2.2]; P = .02) for selected vitamins were found in exploratory analyses. CONCLUSIONS AND RELEVANCE Antioxidants, carotenes, fruits, and vegetableswere associated with higher ALS function at baseline by regression of nutrient indices and weighted quantile sum regression analysis.We also demonstrated the usefulness of the weighted quantile sum regression method in the evaluation of diet. Those responsible for nutritional care of the patient with ALS should consider promoting fruit and vegetable intake since they are high in antioxidants and carotenes.

Original languageEnglish (US)
Pages (from-to)1425-1432
Number of pages8
JournalJAMA neurology
Issue number12
StatePublished - Dec 1 2016

ASJC Scopus subject areas

  • Clinical Neurology


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