Intermittent fasting is a popular diet trend for weight loss and other health benefits – but scientists are finding it can potentially help improve multiple sclerosis (MS) symptoms.
Dr. Yanjiao Zhou, assistant professor of medicine at UConn Health, is using information from the gut microbiome to determine how intermittent fasting can play a role in managing MS symptoms. Zhou is part of a research study led by Laura Piccio at the Washington University School of Medicine.
MS is a chronic condition where the immune system attacks the nervous system, making it difficult for the brain to send signals to the rest of the body. This can cause muscle weakness, numbness, tremors, vision loss, difficulties speaking, and fatigue.
Intermittent fasting involves water-fasting, or eating very little, followed by periods of eating normally. In this trial, participants ate 500 calories two days per week, and they ate normally every other day.
“Intermittent fasting is a very popular diet regimen because the diet has such a broad impact on the physiology of the human body,” Zhou says. “This will be very important for multiple sclerosis because it’s a complex disease that affects multiple systems.”
This team conducted the first clinical trial of intermittent fasting in MS patients. But studies in mice found that intermittent fasting significantly repressed the autoimmune response and thus improved MS symptoms, providing the researchers with a promising foundation.
Now that the clinical trial has concluded, Zhou is analyzing samples from the patients to determine how the intermittent fasting regime changed their gut microbiomes.
The microbiome is a collection of bacteria and other microorganisms that live in and on us. The gut is the largest microbiome in the human body. The organisms there play a critical role in functions including metabolism, immune responses, and even mood. The microbiome can regulate T-cell immune response. These immune cells are the ones that attack the nervous system and cause MS to progress.
Zhou recently published her findings on the significant differences in the gut microbiomes between MS patients and healthy control samples. She identified changes decreased amounts of bacteria including Prevotella copri, Bacteroides thetaiotaomicron, Bifidobacteria longum and Faecalibacterium prausnitzii. She also identified positive association between Collinsella aerofaciens, Phascolarctobacterium succi- natutens, Sutterella wadsworthensis and disability scale (a measure of severity of MS symptoms such as ability to walk and other vital functions) in MS patients.
With the human stool samples from the intermittent fasting trial, Zhou will look for similar changes in the makeup of the microbiome.
Zhou and her team also found transplanting fecal matter from mice put on an intermittent fasting diet into other mice allowed healthier microbiota colonies to establish in the mice who did not fast.
Zhou will compare baseline data from before patients began the trial with their samples after the 12-week trial. Zhou hopes this can tell if the baseline can predict how someone will respond to intermittent fasting, or if they will respond at all.
“I expect a very individualized microbiome response,” Zhou says.
Zhou will also look at how any changes in the microbiome are associated with changes in the patient’s immune response. She will consider clinical factors like disability score and depression.
This work will help MS patients better understand what strategies can help them manage this complicated and highly individualized disease.