Intermittent fasting (IF) has been explored in recent years as a potential intervention in multiple sclerosis (MS) due to the growing evidence on the possible links between diet, caloric intake and inflammation. IF is also relatively easy to implement, and can be readily monitored using urine ketones. Current evidence on IF in delaying MS progression is limited due to a lack of high-quality clinical trials, short duration of intervention, and heterogeneity in experimental design and parameters investigated. Imaging evidence from FLAIR MRI, a hallmark in MS diagnosis and the detection of disease progression, is mostly absent from the current literature.
The primary objective of the study was to review current evidence on intermittent fasting in the setting of MS. A secondary goal was to identify gaps in knowledge and barriers to the practical implementation of IF.
PUBMED and EMBASE datasets were queried on the studies of IF in MS. Clinical trials database was queried to identify active ongoing clinical trials.
Eight IF-related studies were identified. The advantages and disadvantages of each project were evaluated and reported.
Considering the current evidence, IF represents a useful dietary intervention. However, more studies are needed to demonstrate its clinical benefits to establish long-term feasibility, particularly in the early stages of MS. A new study of IF that includes patient compliance monitoring, magnetic resonance imaging, and biological markers evaluation in patients with clinically isolated syndrome (CIS) is proposed.