In the mouse model of multiple sclerosis ( MS ), a positive effect of modified fasting and ketogenic nutrition (KD) on disease development and clinical course has been shown in several studies.
Author: Dr. Markus Bock, Charité Universitätsmedizin Berlin
Dr. med. Markus Bock from the Charité Universitätsmedizin Berlin has published the results of his research group for the German Multiple Sclerosis Society, Bundesverband eV. med. Friedemann Paul and Prof. dr. med. Andreas Michalsen, summarized in a report:
” Multiple sclerosis is the most common chronic, non-traumatic, neurological disease of the central nervous system with unexplained aetiology . Mainly young adults, women more often than men, are affected by the western world. It is expected that no curative therapy will be available in the foreseeable future.
Background of the study
In the mouse model of MS , experimental autoimmune encephalomyelitis ( EAE ), positive effects of modified fasting and ketogenic nutrition on disease onset and clinical course in animals have been observed in several studies.
Due to the fact that no human studies could be researched on this promising therapeutic approach, the “IGEL” study (A randomized controlled pilot study comparing the effects of intermittent fasting and the ketogenic low-glycemic diet on the quality of life in multiple sclerosis) was brought to life. This study aimed to elucidate the feasibility of the aforementioned nutritional interventions in MS patients. Sixty patients, 48 of whom were finally evaluated, were randomized to 3 groups (1st control group – mixed diet without nutritional change, 2nd seven-day juice fasting followed by mixed diet and 3. Adapted ketogenic diet) in a controlled setting over a period of studied six months. The primary endpoint of the study was health-related quality of life.
Short-term (7-10 days), modified therapeutic fasting is an established therapy for the symptomatic treatment of chronic inflammatory diseases. Clinically, fasting therapy for rheumatoid arthritis, chronic inflammatory bowel disease and arteriosclerotic sequelae is used with good empirical success. Such positive effects of reduced food intake are also observed in neurological diseases and have their roots in the 19th century. Since that time, it has been known that fasting lowers the seizure frequency in people with epilepsy.
It also shows in retrospective studies. phased fasting is associated with a decreased incidence of M. Alzheimer’s and Parkinson’s disease. These results suggest that fasting nerve cell degeneration could be prevented or slowed down. The underlying principles of action are currently being studied intensively , but are still largely unknown. The observed effects are probably not due to individual mechanisms but to complex changes. This is also the direction of animal studies.
Therapy using adapted ketogenic nutrition
As regards the background of this form of nutrition, it is important to understand the important finding of the 19th century that the seizure frequency of persons suffering from epilepsy declines sharply during fasting. However, since the symptoms start to reappear at the beginning of the diet, a permanent diet was sought, which mimics the fasting – without fasting typical of the intestinal activity and without caloric restriction. Thus, the concept of ketogenic nutrition with a switch to a high fat content (80%) with extremely low sugar content appeared in 1921 at the latest. Instead of glucose, the ketone bodies, which are derived from fatty acids in the liver and brain, are offered to the brain as an alternative energy source, as is the case with starvation. Similar to fasting, the cells now mainly feed on fats.
The low-sugar, carbohydrate-reduced diet can be well received under the guidance in everyday life. Like fasting, nerve cell protecting properties are very likely. The fundamental changes in brain metabolism under ketogenic diet lead to increased energy production and reduced radical formation. The ketogenic diet continues to be very successfully used in patients with epilepsy when drug therapy previously failed. MS patients could benefit from the increased energy supply to the brain, which also results in improved nerve cell protection.
In our study, we were able to show that the interventions investigated in MS patients lead to a clinically relevant improvement in the quality of life measured by the Multiple Sclerosis Quality of Life questionnaire. In addition, in the ketogenic group a significant reduction of the fasting measured serum triglyceride concentration and the LDL / HDL cholesterol quotient at the end of the study was found. Further results are about to be published and will also be announced here.
Larger study with MRI as endpoint necessary
Before the new findings may find their way into treatment, they need to be backed up in a clinical trial with larger numbers of patients and MRI as the endpoint. This new study is scheduled for the end of 2016. The test subject will be published in spring 2016. ”
Link to the scientific article ” Conference Paper: Ketogenic diet and prolonged fasting improve health-related quality of life and lipid profiles in multiple sclerosis -A randomized controlled trial ”
Source: Communication on the congress contribution ECTRIMS 2015
Editor: DMSG Bundesverband eV – 18.01.2016