Fatigue as a modifier of diet quality in adults with Charcot Marie Tooth disease

Charcot Marie Tooth disease (CMT) is a neurological condition characterised by fatigue alongside motor and sensory impairments. CMT also has a high prevalence of lifestyle dependent co-morbidities, despite which there are limited dietary guidelines for those with CMT. The present study aimed to determine whether diet quality and nutrient intake differed between CMT and control, and whether this may be associated with fatigue and mobility. Age matched participants [n = 25 CMT aged 53.6(15.3) years, n = 27 controls aged 51.5(12.0) years] completed 3-day food diaries, and online surveys. Food diaries were assessed using daily nutrient targets (Recommended daily intake, RDI), micronutrient-based scoring (MyNutritionIndex, MNI), food group-based scoring (healthy eating index, HEI-2020) and ultraprocessed food (UPF) intake. Survey outcomes included fatigue, quality of life (QoL), and mobility. CMT participants met none of the RDI targets of 32 nutrients, with 16 sufficiency nutrients lower than controls based on RDI and MNI (P < 0.05). MNI and HEI-2020 were not different between CMT and control. Minimally processed food intake was 27% lower in the CMT group, with UPF contributing double the caloric intake in CMT than controls (P < 0.05). In CMT, QoL domains were 36% lower than control (P < 0.05), fatigue severity and mobility were 56% and 11% worse than controls, respectively (P < 0.05). Fatigue severity was negatively associated with HEI-2020 in CMT and controls (P < 0.05). In the present study, diet quality using RDI was lower in CMT compared to controls. In both CMT and controls, fatigue severity was associated with worse diet quality based on micronutrient and food group analysis.