Can fasting improve MS symptoms?

July 9, 2018 by Tamara Bhandari, Washington University School of Medicine
Laura Piccio, M.D., talks with DeAnna Clark during a checkup. Clark, who has MS, is participating in a study led by Piccio to evaluate whether partial fasting can benefit people with MS. Credit: Tim Parker

People with multiple sclerosis (MS) can find an abundance of conflicting advice suggesting that special diets—everything from avoiding processed foods to going low-carb—will ease their symptoms. But the evidence is scanty that dietary changes can improve fatigue or other MS symptoms.

"People hear these miraculous stories about patients recovering the ability to walk after they started on this diet or that, and everyone wants to believe it," said Laura Piccio, MD, an associate professor of neurology at Washington University School of Medicine in St. Louis. "All we have right now are anecdotes. The fact is that diet may indeed help with MS symptoms, but the studies haven't been done."

That's why Piccio is putting one dietary intervention to the test. She has launched a trial to evaluate whether drastically cutting calories twice a week can change the body's immune environment and the , and potentially change the course of the disease. The study is rooted in her own research that shows that fasting can reduce MS-like symptoms in .

MS is a betrayal: A person's own turns against his or her nervous system. Depending on which nerves are damaged in the assault, signs and symptoms vary greatly but can include fatigue, numbness or weakness in the limbs, dizziness, vision problems, tingling and pain. Patients with relapsing-remitting MS—the most common form—can be stable for months or years between bouts of illness.

Piccio and colleagues are recruiting patients with relapsing-remitting MS for a 12-week study. Half will stay on their usual Western-style diet seven days a week, while the other half will maintain such a diet five days a week but limit themselves to 500 calories of vegetables the remaining two days.

The trial is based on findings from a mouse study Piccio and Yanjiao Zhou, MD, Ph.D. - an assistant professor at the University of Connecticut who studies microbiome-based therapeutics—published earlier this month in the journal Cell Metabolism. The study showed that intermittent fasting reduces MS-like symptoms. In the study, mice were either allowed to eat freely or fed every other day for four weeks before receiving an immunization to trigger MS-like symptoms. Both groups of mice then continued on their same diets for another seven weeks.

The mice that fasted every other day were less likely to develop signs 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.

In addition, the fasting mice's immune systems seemed to be dialed down. As compared with mice that took daily meals, those that ate every other day had fewer pro-inflammatory immune cells and more of a kind of immune cell that keeps the immune response in check.

"There are several possible ways fasting can affect inflammation and the immune response," Piccio said. "One is by changing hormone levels. We found that levels of the anti-inflammatory hormone corticosterone were nearly twice as high in the fasting mice. But it also could act through the gut microbiome."

The gut microbiome—the community of microbes in the intestine—doesn't just help us digest our food and synthesize vitamins and amino acids. It also helps our immune systems develop and mature. A change in the makeup of the gut community could alter whether the immune system has a pro- or anti-inflammatory bent, the researchers said.

After four weeks, the mice that fasted sheltered a more diverse ecosystem in their guts than mice that ate every day. In particular, the fasting mice had more of the soothing probiotic bacteria Lactobacillus, which other studies in mice have linked to milder MS-like symptoms.

In addition, transferring gut bacteria from fasting mice to nonfasting mice made the recipients less susceptible to developing MS-like symptoms, suggesting that something in the microbial community was protecting the mice.

These results were encouraging enough for Piccio and colleagues to launch a human study of 40 to 60 people. Each participant will undergo a neurological assessment and provide blood and stool samples at the start, midpoint and end of the study. Participants already taking injectable medications for MS will continue their prescribed drug regimens, and anyone who relapses during the study will receive appropriate treatment. Participants receive up to $265 for taking part in the study.

"We're not looking for clinical benefit, although we certainly hope to see an improvement," Piccio said. "Because MS is so variable and people with relapsing-remitting MS can be stable and nearly -free for long periods, you'd need a huge study to see any benefit. Instead, what we want to find out is whether people on limited fasts undergo changes to their metabolism, and microbiome similar to what we see in the mouse."

A pilot study with 16 people limiting their calories every other day for two weeks found immune and microbiome changes that echo the ones seen in mice. The current study is designed to more closely analyze those shifts—and perhaps set the stage for an even larger study to find out whether skipping meals can ease symptoms for people with MS.

"I don't think any physician working with this disease thinks you can cure MS with diet alone," Piccio said. "But we may be able to use it as an add-on to current treatments to help people feel better."

Explore further: On-and-off fasting helps fight obesity

More information: Francesca Cignarella et al, Intermittent Fasting Confers Protection in CNS Autoimmunity by Altering the Gut Microbiota, Cell Metabolism (2018). DOI: 10.1016/j.cmet.2018.05.006

Related Stories

On-and-off fasting helps fight obesity

October 17, 2017
Up to sixteen weeks of intermittent fasting without otherwise having to count calories helps fight obesity and other metabolic disorders. Such fasting already shows benefits after only six weeks. This is according to a study ...

Antibiotic use increases risk of severe viral disease in mice

March 27, 2018
People infected with West Nile virus can show a wide range of disease. Some develop life-threatening brain infections. Others show no signs of infection at all. One reason for the different outcomes may lie in the community ...

Fasting-like diet reduces multiple sclerosis symptoms

May 26, 2016
Evidence is mounting that a diet mimicking the effects of fasting has health benefits beyond weight loss, with a new USC-led study indicating that it may reduce symptoms of multiple sclerosis.

Intermittent fasting found to increase cognitive functions in mice

December 12, 2017
(Medical Xpress)—The Daily Mail spoke with the leader of a team of researchers with the National Institute on Aging in the U.S. and reports that they have found that putting mice on a diet consisting of eating nothing every ...

Strain of intestinal bacteria can stop high-salt diet from inducing inflammatory response linked to hypertension

November 15, 2017
Microbes living in your gut may help protect against the effects of a high-salt diet, according to a new study from MIT.

Fasting-mimicking diet may reverse diabetes

February 23, 2017
A diet designed to imitate the effects of fasting appears to reverse diabetes by reprogramming cells, a new USC-led study shows.

Recommended for you

Antifungal agent found to be possible treatment for porphyria

September 24, 2018
A large team of researchers from Spain, France and the U.S. has found that a common antifungal agent might be useful as a treatment for a rare type of porphyria. In their paper published in the journal Science Translational ...

New findings on the muscle disease Laing early-onset distal myopathy

September 24, 2018
New avenues are now being opened toward treatment of Laing distal myopathy, a rare disorder that causes atrophy of the muscles in the feet, hands and elsewhere. In a study published in the journal PNAS, researchers have identified ...

Insulin shows great potential against chronic colitis

September 24, 2018
Diabetes is not the only disease on which insulin has an effect, it appears. In a new study using tests on mice, researchers from the University of Copenhagen, among others, have discovered a new method for treating chronic ...

A new approach to developing a vaccine against vivax malaria

September 21, 2018
A novel study reports an innovative approach for developing a vaccine against Plasmodium vivax, the most prevalent human malaria parasite outside sub-Saharan Africa. The study led by Hernando A. del Portillo and Carmen Fernandez-Becerra, ...

Pre-clinical success for a universal flu vaccine offers hope for third generation approach

September 21, 2018
Researchers from the University of Oxford's Department of Zoology have demonstrated pre-clinical success for a universal flu vaccine in a new paper published in Nature Communications.

Researchers define possible molecular pathway for neurodegeneration in prion diseases

September 21, 2018
A new study has shed light on the mechanisms underlying the progression of prion diseases and identified a potential target for treatment.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.