Dietary Intake, Mediterranean Diet Adherence and Caloric Intake in Huntington’s Disease: A Review

Abstract

Decades of research and experimental studies have investigated Huntington’s disease (HD), a rare neurodegenerative disease. Similarly, several studies have investigated whether high/moderate adherence to the Mediterranean Diet and specific macro and micronutrients can decrease cognitive loss and provide a neuroprotective function to neurons. This review systematically identifies and examines studies that have investigated Mediterranean Diet adherence, micro- and macronutrients, supplementation and caloric intake in people with HD, in order to identify if dietary exposures resulted in improvement of disease symptoms, a delay in age of onset or if they contributed to an earlier age of onset in people with HD. A systematic search of PubMed, Directory of open access journal and HubMed was performed independently by two reviewers using specific search terms criteria for studies. The identified abstracts were screened and the studies were included in the review if they satisfied predetermined inclusion criteria. Reference screening of included studies was also performed. A total of 18 studies were included in the review. A few studies found that patients who had high/moderate adherence to Mediterranean Diet showed a slight improvement in their Unified Huntington’s Disease Rating Scale and Total Functional Capacity. In addition, people with HD who had high Mediterranean Diet adherence showed an improvement in both cognitive and motor scores and had a better quality of life compared to patients who had low Mediterranean Diet adherence. Furthermore, a few studies showed that supplementation with specific nutrients, such as triheaptanoin, L-acetyl-carnitine and creatine, had no beneficial effect on the patients’ Unified Huntington’s Disease Rating Scale score. A few studies suggest that the Mediterranean Diet may confer a motor and cognitive benefit to people with HD. Unfortunately, there was little consistency among study findings. It is important for more research to be conducted to have a better understanding of which dietary exposures are beneficial and may result delaying age of onset or disease progression in people with HD.

Dietary fasting and time-restricted eating in Huntington’s disease: therapeutic potential and underlying mechanisms

“…It is also worth emphasizing that, although fasting habits have revealed great health potential, the dietary strategy may have limited efficacy, specifically in neurodegenerative diseases, if it is not combined with adequate consumption of highly nutritious foods that are associated with neurologic health and longevity [ 141 , 142 ]. For example, recent literature has uncovered an association between gut dysbiosis and HD pathogenesis, highlighting the importance of promoting healthy gut microbiota through dietary management, probiotic consumption, and avoidance of ultra-processed foods [ 143 – 145 ].…”

“…In addition, lipid homeostasis, which depends on diet composition, appears to be compromised in HD, where sphingolipids may serve as mediators of cellular stress response and HD pathology [ 146 ]. Consumption of foods high in healthy unsaturated fats, omega-3 fatty acids, fiber, and antioxidants, and low in refined sugars and saturated fats, such as the Mediterranean diet, may be associated with improved clinical outcomes in HD and could potentially augment the benefits of TRE [ 141 ]. Considering the multifactorial metabolic deficits present in HD and the resulting risks of muscle wasting, the maintenance of body composition and skeletal muscle mass depends heavily on sufficient caloric and, more specifically, protein intake—an important consideration if TRE is applied to persons with HD [ 147 ].…”

Huntington’s Disease: Current Advances and Future Prospects

“…As the HD progress the dysphagia occurs. Hence it is recommended that a person with HD and their carers seek professional advice to make sure their diet is nutritious, with lots of calories and easy to eat [27].…”

The role of nutrition in preventing chronic diseases: an urgent need for public health education

“…To prevent chronic diseases, the Mediterranean Diet (MD) proved to be beneficial as it encourages a diet that includes fruits, vegetables, nuts, whole grains, and healthy fats and is rich in minerals and vitamins. Therefore, intake of MD along with specific nutrients such as triheptanoin, L-acetyl-carnitine, and creatine could prevent HD, a rare neurodegenerative disorder associated with low MD adherence [3] . Extra virgin olive oil, often considered a component of MD, is used in the treatment of CKD due to its antioxidant and anti-inflammatory effects [4] .…”