Intermittent fasting for 8 weeks shows benefits in MS in pilot study

RRMS patients found to adhere to eating plan's limited timeframe

Patricia Valerio, PhD avatar

by Patricia Valerio, PhD |

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An eight-week intermittent fasting intervention for people with relapsing-remitting multiple sclerosis (RRMS) led to significant improvements in cognition and manual dexterity for these patients, who also tended to have lower fatigue and pain scores at the program’s end, an exploratory study showed.

Importantly, according to researchers, participants stuck with the intervention, showing high levels of adherence and acceptability to the time-restricted eating plan.

During the study period, the participants could only eat their meals within an eight-hour window and fasted for the other 16 hours of the day.

“Our future studies will focus on completing longer interventions with an appropriate control group and a time frame adequate for full assessment of the efficacy of [time-restricted eating] for people living with MS,” the researchers wrote.

The study, “Feasibility and acceptability of time-restricted eating in a group of adults with multiple sclerosis,” was published in Frontiers in Neurology.

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Intermittent Fasting in MS Leads to Immune Cell, Metabolic Changes

Multiple sclerosis (MS) is a neurological disorder marked by excessive inflammation in the central nervous system — comprised of the brain and spinal cord — that causes damage to nerve cells.

There are a number of environmental and lifestyle factors, including diet, that influence the development of the disease and also impact the severity of symptoms and disease progression.

“The mechanisms underlying the relationship between diet and MS are not well-understood,” the researchers wrote, but diet is known to impact factors like body weight, cardiovascular and bone health, and the gut microbiome.

Thus, while there is no single diet universally recommended for people with MS, patients are generally recommended to stick to a healthy and well-balanced eating plan to help ease their symptoms.

Intermittent fasting is a type of dietary approach in which people limit food consumption during certain times of the day or week, while the rest of the time eating according to their normal habits, without cutting out any specific food type.

One of the most popular types of intermittent fasting is time-restricted eating, dubbed TRE, in which all food intake is restricted to a certain period during the day — usually less than 10 hours. This approach has been shown to reduce inflammation and improve immune and nerve function.

Now, researchers in the U.S. conducted a pilot study (NCT04389970) to investigate the feasibility and acceptability of this dietary intervention in adults with RRMS. 

The study included 12 patients, with a mean age of 46, most of whom were women (83%). White patients comprised just over half (58%) of the group.

All were instructed to eat their meals within an eight-hour window every day for eight weeks, fasting — drinking only water, unsweetened tea, or black coffee — for the remaining 16 hours.

Participants were asked to report their adherence to the intervention through electronic food logs and questionnaires. They also reported the number of days per week that they ate in the eight-hour window on a satisfaction survey given halfway through and again at the end of the study.

Among the 12 participants, 11 completed the intervention and follow-up measures; one dropped out during the trial.

In general, patients reported eating within the specified window for a mean of 6.8 days per week after four weeks, and 6.5 days per week at the end of the intervention. Throughout this period, the participants did not change their daily energy or nutritional intake.

Two participants noted sleeping better as a positive benefit of the dietary pattern. Additional benefits included having more energy, feeling better overall, weight loss, reduced acid reflux, and drinking more water.

However, two patients reported a negative effect from the intervention, noting they had to schedule their social life, working hours, and family schedule around their eating window. Other side events included headaches, constipation, and weight gain, noted by one participant each.

Our data suggest that it is worth testing the hypothesis that [time-restricted eating] reduces pain and fatigue and improves cognition in a large-scale trial in people with MS.

After the 8-week intervention, participants were assessed for changes in clinical outcomes. Findings showed that intermittent fasting significantly improved cognition and hand and finger dexterity. Scores of pain and fatigue also lowered, and although the differences were not statistically significant, they were deemed “clinically significant.”

“Intermittent fasting is believed to impact pain specifically through reduction in inflammatory [small proteins],” the researchers wrote.

Altogether, the pilot study results indicate that intermittent fasting may be a potentially low-cost, highly scalable dietary intervention for adult RRMS patients, the team concluded.

“Our data suggest that it is worth testing the hypothesis that [time-restricted eating] reduces pain and fatigue and improves cognition in a large-scale trial in people with MS,” they wrote.

The team noted that this dietary pattern only focuses on meal timing and not quantity or type of food, which may benefit long-term adherence more than traditional dietary prescriptions based on calorie or nutritional restriction.