Fasting Can Modulate Microbiome and Improve IBD

Inflammatory bowel disease (IBD), includes two conditions, Cronh’s disease and ulcerative colitis. Both conditions are associated with acute and chronic inflammation of the intestine. 

Some risk factors to develop IBD include genetic predisposition and factors that alter gut microbiota, such as antibiotics. The effect of nutrition in IBD remains poorly understood, but diets that cause proinflammatory changes in the gut microbiota have consistently been associated with IBD pathogenesis. 

Periodic fasting (PF) and fasting-mimicking dietas (FMDs) have been effective in increasing healthy lifespan or as therapies in mouse models for different conditions. 

A fasting-mimicking diet (FMD) is low in calories, sugars, and protein, but high in unsaturated fats.

In a study published in the journal Cell Reports, researchers evaluated the effect of cycles of low-calorie and low-protein FMD in the treatment of IBD and its effects on inflammatory markers in humans. 

Decreased Inflammation and Symptoms 

The research team used a mice model of IBD, and found that cycles of fast-mimicking diet ameliorate intestinal inflammation, promote intestinal regeneration, and stimulate the growth of protective gut microbial populations. They also found that FMD is safe and effective in reducing systemic inflammation and the consequent high levels of immune cells in humans. 

To evaluate the effects of FMD cycles on systemic inflammation in the chronic IBD mice model, the researchers monitored changes in splenocytes and peripheral blood mononuclear cells. Increased levels of circulating CD4+ and CD8+ T cells have been associated with IBD in patients.

The overall percentages of splenic CD45+ leukocytes and CD45+ CD19+ B cells were reduced in the group with the FMD cycles when compared to the control group. 

When assessing severity of colon inflammation the team observed that in the control group the mice had a decrease in crypt number, which was reversed by 2 cycles of FMD in the other group. 

Using a mice model for IBD, the study showed that two cycles of a 4-day FMD followed by a normal diet are sufficient to mitigate some, and reverse other, IBD-associated pathologies or symptoms. In contrast, water-only fasting only caused some of the effects of the FMD cycles, indicating that some nutrients in the FMD contribute to microbial and antiinflammatory changes.

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Sources:

Rangan P, Choi I, Wei M, et al. Fasting-Mimicking Diet Modulates Microbiota and Promotes Intestinal Regeneration to Reduce Inflammatory Bowel Disease Pathology. Cell Rep. 2019;26(10):2704-2719.e6. doi:10.1016/j.celrep.2019.02.019

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