article published June 2022
A nutritious, well-balanced diet combined with other healthy lifestyle choices is the foundation of good health not only for people with MS, but also for the general public. There is evidence that eating certain foods and nutrients, and avoiding others, may help a person’s MS symptoms and disease activity. As we discussed in our August 2019 newsletter, several dietary strategies are being promoted for people with MS, however there is currently insufficient evidence to recommend any of them.
Intermittent fasting (IF) is one strategy that has shown promise in mouse models of MS. Researchers are taking a closer look at whether food deprivation may also benefit people living with the disease.
IF is an eating pattern during which an individual switches between periods of normal eating and extreme calorie cutting. It has been around for ages, either because food was scarce and humans had to hunt and gather, or due to religious practices. According to doctrine, Muslims fast from sunrise to sunset during Ramadan and Jewish people fast on Yom Kippur. Hunger strikes have also been used as a form of political protest. More recently, IF has become a popular way to lose weight. It has also been linked with other improvements in health, such as lowering blood pressure, improving blood sugar and lipid levels, repairing damaged cells and protecting brain health.
There are many different types of IF. Each involves not eating (or eating less) during specific hours of the day or specific days of the week.
How IF might help individuals living with MS is an emerging area of research. A number of studies have looked at the effect of Ramadan fasting in people with MS with mixed results. A 2009 study followed 80 adults with relapsing remitting MS and mild disability for 6 months. Half of the participants fasted during Ramadan and the other half did not. Results showed fasting had no effect on MS disease course over the short term (there were no changes in EDSS as a result of fasting and no difference in the frequency of clinical relapses between the two groups). A 2016 study looked at the effect of Ramadan fasting on 218 people with MS. Results showed there was no beneficial effect on fatigue, however there was a significant improvement in quality of life after fasting. In both studies, investigators state that more research is necessary to confirm their findings. Researchers at the Washington University School of Medicine (WU) and the University of Connecticut Health Center (UConn) are also studying this eating pattern. Initially, the
Researchers at the Washington University School of Medicine (WU) and the University of Connecticut Health Center (UConn) are also studying this eating pattern. Initially, the team worked with a mouse model of MS, called experimental autoimmune encephalomyelitis (EAE). In this study, some animals were on a fasting regimen, in which they were fed every other day for a period of four weeks. Another set of mice was allowed to eat freely over the same period. All of the mice then received a type of immunization meant to trigger symptoms consistent with MS. Following these steps, all of the rodents continued their respective diet regimens for an additional seven weeks. The researchers found that the mice that fasted every other day were less likely to develop symptoms of neurological damage such as difficulty walking, limb weakness and paralysis. Some of the fasting mice did develop MS-like symptoms, but they appeared later and were less severe than in the mice that ate their fill every day.
Further analysis showed that IF in EAE mice changed blood levels of molecules that relate to inflammation. They had lower levels of pro-inflammatory cells (T helper 17 cells), and higher levels of immune cells that help keep the immune response in check (regulatory T cells). Levels of the anti-inflammatory hormone corticosterone (cortisol) were nearly twice as high in the fasting mice. As discussed in our September 2017 newsletter, the gut microbiome (the collection of microorganisms that live in the intestinal tract) doesn’t just help digest food, it also helps regulate the immune system. A change in the type of microorganisms in the gut can alter whether the immune system has a pro- or anti-inflammatory response. Data showed that fasting mice appeared to have a more diverse gut
microbiome and higher levels of Lactobacillus, a probiotic bacteria whose abundance in the gut has been linked to less severe MS symptoms. When the researchers transferred gut bacteria collected from the fasting mice to the guts of the non-fasting ones, they noticed that the latter became more resilient to MS-like symptoms.
Read complete article, found here
——————