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Article History

Received: 20 August 2024

Accepted: 15 September 2025

First Online: 27 October 2025

Declarations

:

: Ethical approval was obtained from the University of Iowa Institutional Review Board (IRB identifier 202104639). Informed consent is obtained from all study participants.

: This consent form constitutes a component of the informed consent procedure, obtainable upon request from the corresponding author.

: The author(s) declare the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Conflict of Interest Disclosures: Dr. Terry Wahls personally follows and promotes the Wahls™ diet. She has equity interest in the following companies: Terry Wahls LLC; TZ Press LLC; The Wahls Institute, PLC; FBB Biomed Inc; Levels Health Inc., Foogal Inc. and the website . She also owns the copyright to the books Minding My Mitochondria (2nd Edition) and The Wahls Protocol, The Wahls Protocol Cooking for Life, and the trademarks The Wahls Protocol® and Wahls™ diet, Wahls Paleo™ diet, and Wahls Paleo Plus™ diets and Wahls Behavior Change™ model. She has completed grant funding from the National Multiple Sclerosis Society for the Dietary Approaches to Treating Multiple Sclerosis Related Fatigue Study. She has financial relationships with Vibrant America LLC, Standard Process Inc., MasterHealth Technologies Inc., Foogal Inc., Well Theory Technologies Inc., Vibrant America LLC, and the Institute for Functional Medicine Inc. She receives royalty payments from Penguin Random House. Dr Wahls has conflict of interest management plans in place with the University of Iowa and the Iowa City Veteran’s Affairs Medical Center. All other authors report no personal or financial conflicts of interest in this work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.