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 gut microbiome, 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 mice.
MS is a betrayal: A person’s own immune system 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, PhD – 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.