{"doi":"10.1177/20552173231209147","title":"Diet-induced changes in functional disability are mediated by fatigue in relapsing-remitting multiple sclerosis: A secondary analysis of the WAVES randomized parallel-arm trial","abstract":"Background People with multiple sclerosis (MS) often report dietary modifications; however, evidence on functional outcomes remains sparse. Objective Evaluate the impact of the low-saturated fat (Swank) and modified Paleolithic elimination (Wahls) diets on functional disability among people with relapsing-remitting MS. Methods Baseline-referenced MS functional composite (MSFC) scores were calculated from nine-hole peg-test (NHPT), timed 25-foot walk, and oral symbol digit modalities test (SDMT-O) collected at four study visits: (a) run-in, (b) baseline, (c) 12 weeks, and (d) 24 weeks. Participants were observed at run-in and then randomized at baseline to either the Swank ( n = 44) or Wahls ( n = 43) diets. Results Among the Swank group, MSFC scores significantly increased from −0.13 ± 0.14 at baseline to 0.10 ± 0.11 at 12 weeks ( p = 0.04) and 0.14 ± 0.11 at 24 weeks ( p = 0.02). Among the Wahls group, no change in MSFC scores was observed at 12 weeks from 0.10 ± 0.11 at baseline but increased to 0.28 ± 0.13 at 24 weeks ( p = 0.002). In both groups, NHPT and SDMT-O z-scores increased at 24 weeks. Changes in MSFC and NHPT were mediated by fatigue. Discussion Both diets reduced functional disability as mediated by fatigue. Trial Registration Clinicaltrials.gov Identifier: NCT02914964","journal":"Multiple Sclerosis Journal - Experimental Translational and Clinical","year":2023,"id":383894,"datarank":0.20638798578753514,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.041596142487318674,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.041596142487318674,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":1,"citers_with_citation_signal":1,"citers_with_endowment":1,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9549,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT02914964"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1082695,"name":"Solange M. Saxby","orcid":"0000-0002-2599-4828","position":1,"is_corresponding":false},{"id":1082694,"name":"Farnoosh Shemirani","orcid":"0000-0003-0164-6498","position":2,"is_corresponding":false},{"id":1150895,"name":"Babita Bisht","orcid":"0000-0002-1883-237X","position":3,"is_corresponding":false},{"id":873732,"name":"Christine Gill","orcid":"0000-0002-8577-3509","position":4,"is_corresponding":false},{"id":722788,"name":"Linda M. Rubenstein","orcid":null,"position":5,"is_corresponding":false},{"id":274745,"name":"Patrick Ten Eyck","orcid":"0000-0002-5041-0708","position":6,"is_corresponding":false},{"id":758403,"name":"Lucas J. Carr","orcid":"0000-0001-5462-073X","position":7,"is_corresponding":false},{"id":739578,"name":"Warren G. Darling","orcid":"0000-0001-9928-2922","position":8,"is_corresponding":false},{"id":24973,"name":"Karin F. Hoth","orcid":"0000-0002-4261-5308","position":9,"is_corresponding":false},{"id":386211,"name":"John Kamholz","orcid":null,"position":10,"is_corresponding":false},{"id":243123,"name":"Linda Snetselaar","orcid":"0000-0002-6615-0779","position":11,"is_corresponding":false},{"id":717051,"name":"Tyler J. Titcomb","orcid":"0000-0002-8162-4768","position":12,"is_corresponding":false},{"id":418779,"name":"Terry L. Wahls","orcid":"0000-0001-6059-7994","position":13,"is_corresponding":false},{"id":1151221,"name":"Landon J Crippes","orcid":null,"position":0,"is_corresponding":true}],"reference_count":36,"raw_metadata":null,"created_at":"2026-07-19T01:17:29.050285Z","pmid":"37916030","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}