(OR01-04-26) Confirmation of a Food Is Medicine Approach for Treating Neurological, Psychiatric, and Gastrointestinal Symptoms in Veterans

Objectives: In prior research, the low glutamate diet (LGD), which reduces exposure to excitotoxic food additives and increases consumption of whole foods high in specific micronutrients, was shown to significantly improve the symptoms of Gulf War Illness (GWI). GWI is a chronic disorder characterized by a wide range of neurological, psychiatric, and gastrointestinal symptoms. A phase III clinical trial was conducted to confirm dietary effectiveness.

Methods: Veterans with GWI were recruited from across the US (N=100, 55% male, age 59(5) yrs). Participants completed a baseline visit, were randomized into immediate dietary intervention or waitlisted control groups (following their own diet for 1-month before receiving intervention), received a 2-hr diet training with materials, followed LGD for 1-month, then completed a post-diet visit. At each visit, blood/urine were collected, a pain exam was conducted, and questionnaires were completed. Dietary compliance was assessed with an Excitotoxin FFQ, plasma glutamate and nutrient levels. Improvement was defined as a report of “much” or “very much” improved on the Patient Global Impression of Change scale, or remission of ≥30% of symptoms. Independent sample t-tests/Wilcoxon Signed Rank tests were used to compare change scores between intervention/control groups. Effect size was calculated using Cohen’s d.

Results: Dietary compliance was strong and correlated with symptom improvement (r=0.27, p=0.009). After 1-month on the diet, significant improvements were observed for all measures (all p< 0.001); and 72% of subjects met criteria for improvement. Total symptom number reduced from 19(6) to 13(7), with a large effect size (d =0.87) when compared to waitlisted controls. Symptom remission was observed across all symptoms, and those remaining, all reduced in severity. Pain exam measures (myalgic score, tenderpoint number, pain threshold), and quality of life significantly improved. Chalder Fatigue Scale and metabolites related to mitochondrial function (alanine/lactate/alpha-ketoglutarate) also significantly improved (all p< 0.05).

Conclusions: The LGD is an effective Food is Medicine approach for treating the entire spectrum of widespread symptoms associated with Gulf War Illness in veterans.

Funding Sources: Department of Defense