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Can a Periodic Fasting Meal Replacement Intervention Potentially Treat Autoimmune Disease?

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On 26 May 2016 the journal Cell Reports published a new article titled "Fasting diet mimicking as a treatment for multiple sclerosis" showing efficacy in both suppressing autoimmunity and promoting re-myelination.

Multiple Sclerosis (MS) is a disease that attacks myelin that protects nerve fibers connecting the brain and the spinal cord (Central Nervous System – CNS). The prevalence of multiple sclerosis (MS) is estimated about 2.5 million cases according to the Multiple Sclerosis Trust in the UK. According to this source, prevalence does not have an even distribution as most sufferers typically live away from the Equator. Some researchers attribute this to a deficiency in vitamin D, yet this finding is not fully confirmed. Alternatively, an infection caused by the Epstein-Barr virus (herpesvirus 4) and a cause of mononucleosis has also been linked as possible cause of the development of MS. The disease onset usually happens during ages 15-60 and prevalence is almost double in women than men. MS causes degeneration of the CNS, and where local antigens presenting cells (APCs) promote inflammation killing oligodendrocytes, producing demyelination and damaging axons that cause neurological damage. Standard treatment of care includes medications such as immunosupressives, steroids, physical therapy and other lifestyle intervention to delay the progression of the disease.

The quality of life of patients suffering from MS decreases as the disease progresses. Moreover, treatment costs can be significant. In the US, medications can average US$60,000 annually while in India can reach at least US$600 per month. The creation of global awareness of the disease is spearheaded by the MS International Federation that this year takes place on 25 May 2016. Patients can share their stories while caregivers and people concerned with MS spread the word via local community activities and social media.

Dietary interventions have included ketogenic, or very low calorie diets, as well as intermittent fasting to reduce inflammation. As described in the Cell Report article, scientists in the US and Germany carried out two studies to test the role of a fasting mimicking diet (FMD). One a mice model, experimental autoimmune encephalomyelitis (EAE), used for MS research. Three FMD cycles of 3 days only of FMD seemed more efficacious than a 30 days ketogenic diet in decreasing clinical symptoms of EAE mice models and uniquely induce re-myelinization of damaged axons, an indication of regeneration. The other consisting of a 6-month pilot trial on the safety and feasibility of a FMD in 60 relapsing-remitting MS (RRMS) patients.

Results from the mouse model also suggest that FMD may reduce inflammation and prevent demyelination and axonal damage. The human trial showed that a ketogenic diet and a 7-day FMD followed by a Mediterranean diet can be safe and feasible for patients, but larger clinical are needed to confirm efficacy.

This finding signals a new future for periodic fasting mimicking diets, which continues to move from a retail weight management and wellness solution to a potential therapeutic option for millions of consumers suffering from autoimmune diseases such as MS. For current and future sufferers of MS, scientific discoveries such as this one highlight hope in the future treatment of the disease. Most intriguing is the fact that a dietary intervention can influence cellular and systemic functions to potentially make a big difference in the treatment of serious diseases.

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