A Summary of Recently Published Research from Dr. Terry Wahls

Dr. Terry Wahls is a clinical professor of medicine at the University of Iowa Carver College of Medicine, where she teaches internal medicine residents in their primary care clinics. She also does clinical research and has published over 60 peer-reviewed scientific abstracts, posters, and papers. Dr. Wahls has been an inspiration for me since I first saw her “Minding Your Mitochondria” TED talk in 2011. It blew my mind. I’ve read so many arguments for so many different diets, and that was the first time that I ever heard someone explain things in a concisely scientific way that made so much sense to me. I’ve been informally studying diet, nutrition, and healthy lifestyle protocols for decades. I am now two years into a bachelor’s degree in biology with a chemistry minor that will lead to a masters degree program in either nutrition, integrative medicine research, or public health, so I love reading studies related to human nutrition.

Ever since discovering Dr. Terry Wahls, I periodically check in on what she’s up to, and if she’s published any research relevant to my interests. One of her most recent articles was published on June 18, 2019 in the peer-reviewed journal PLOS One and is titled “Lipid profile is associated with decreased fatigue in individuals with progressive multiple sclerosis following a diet-based intervention: Results from a pilot study.” There were multiple authors and investigators also responsible for this article, and you can find the full citation of the study at the bottom of this blogpost. The goal of the study was to investigate associations between lipid profiles and fatigue in a population diagnosed with progressive MS after administering a diet-based multimodal intervention.

This was a pilot study, which is a small scale preliminary study done in order to evaluate many factors of the study design before a full-scale research project is performed. Because it was a pilot study, there were only 18 subjects used, 16 with secondary progressive MS and two with primary progressive MS. This was a longitudinal one-year study that monitored subjects’ MS-related fatigue symptoms following a diet-based multimodal intervention that included exercise, neuromuscular electrical stimulation, and stress reduction. Fatigue was defined in the study as “a subjective lack of physical and/or mental energy that is perceived by the individual or caregiver to interfere with usual or desired activities.”

The dietary recommendations included a high intake of vegetables and fruits, animal and plant protein, and excluded gluten-containing grains, dairy, and eggs. Specifically, these recommendations included three daily servings of green leafy vegetables, sulfur-rich vegetables, and deeply colored fruits and vegetables. Foods that were excluded were gluten-containing grains, dairy, and eggs. Additional foods that were encouraged to be consumed were daily servings of 4 ounces of animal protein, 4 ounces of plant protein, 2 tablespoons of omega-3 oils, a choice of non-dairy milks such as soy, almond, rice and coconut, 1 tablespoon of nutritional yeast, 1/4 teaspoon powder or two capsules of kelp, and ¼ to 1 teaspoon or four to eight capsules of spirulina/chlorella/Klamath blue–green algae. Only two servings of gluten-free grains or starchy foods were allowed each week.

The Fatigue Severity Scale (FSS) was used to measure fatigue every three months for the duration of the 12-month study. A lipid profile was obtained on fasting blood samples, first at baseline before the study began, then again at 12 months (when the study was over). The profile consisted of the following markers: high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC) and triglycerides (TG).

The results of the study showed that FSS scores decreased from a baseline of 5.51 to a mean of 3.03. There was an increase in HDL-C, and a decrease in BMI, LDL-C, TC, TG to HDL-C ratio, and TC to HDL-C ratio. The discussion section of the article did a good job of connecting other research to this study. The study concluded that there was a significant association between changes in mean nutrient intake and changes in mean lipid profiles, and that some of those lipid profile changes were associated with decreases in FSS. From this study, a new hypothesis was formed: “We hypothesize that skeletal muscle could be an important but overlooked organ for potential interactions between diet-induced lipid profile changes, metabolic activity and fatigue, because it is a key effector organ at which MS physical disability, fatigue and weakness manifest to patients.”

While the results of this study were impressive, there were multiple independent variables involved in the intervention protocol that may make it difficult to isolate the diet alone as the main factor that contributed to those results. To know for sure, a much larger study that tests each independent variable alone would be necessary to determine which variable was most effective. These results could then be compared to results that came from the original multimodal protocol to see whether there was any interaction between the independent variables that may have led to greater desirable results.

One of the reasons why studying human nutrition and lifestyle for the purpose of finding the “best” protocols for health is so difficult is because there are so many variables to consider. I am grateful for the contributions that Dr. Wahls and her team are making, and for their commitment to further our understanding of health and how it relates to chronic illnesses like MS.

References

Fellows Maxwell, K., Wahls, T., Browne, R. W., Rubenstein, L., Bisht, B., Chenard, C. A., ... Ramanathan, M. (2019). Lipid profile is associated with decreased fatigue in individuals with progressive multiple sclerosis following a diet-based intervention: Results from a pilot study. PLOS ONE, 14(6), 1–19. https://doi.org/10.1371/journal.pone.0218075

Wahls, T. [TEDx Talks]. (2011, November 30). Minding your mitochondria | Dr. Terry Wahls | TEDxIowaCity. Retrieved from https://www.youtube.com/watch?v=KLjgBLwH3Wc