Relationship between the composition of dietary fiber intake and the prognosis of Korean patients with amyotrophic lateral sclerosis

Abstract

The gut microbiota has been suggested to play a role in the pathogenic mechanisms of amyotrophic lateral sclerosis (ALS). This study aimed to investigate the hypothesis that the intake of different kinds of dietary fiber was associated to the disease progression rate (∆FS) and survival time. A total of 272 Korean sporadic ALS patients diagnosed according to the revised EI Escorial criteria were recruited during 2011-2019 and were followed until the occurrence of events or the end of September 2020. The events included percutaneous endoscopic gastrostomy, tracheostomy, and death. Dietary fiber intake was estimated using the 24-hour recall, and classified according to five major fiber-rich foods: vegetables, fruits, grains, legumes, and nuts/seeds. Among the total participants, the group with ∆FS values lower than the mean ∆FS (0.75) was noted in the highest tertiles of total, vegetables, and nuts/seeds fiber intake. Kaplan–Meier analysis showed that participants in the highest tertile for vegetable fiber intake showed longer survival. Cox regression analysis showed that intake of vegetable fiber was negatively associated with risk for events after adjustment. Interestingly, vegetable fiber intake was negatively correlated with pro-inflammatory cytokine (interleukin (IL)-1β, IL-6, and monocyte chemoattractant protein-1) levels in the cerebrospinal fluid. In conclusion, this study suggested that vegetable fiber intake could influence the disease progression rate and survival time. However, further clinical trials are needed to confirm whether dietary fiber supplementation improves the prognosis of ALS.