7 ms·

Fasting-like Diet Reduces Multiple Sclerosis Symptoms

98 points by brahmwg 10y ago

orangegrain 10y ago
Isn't this obvious to anyone who follows that diet <-> autoimmune disease? Also adrenal hormones increase during fasting, as can be commonly seen with high cortisol levels in those who fast. "All disease begins in the gut," as someone wise has said in the past.
- pizza 10y ago
  'Obvious' considered harmful, though.
  - kjhljjg 10y ago
    agreed. nothing is obvious, everything needs to be tested
- Lxr 10y ago
  It's usually "obvious" to people who are not affected by autoimmune disease, but diet control is generally disappointingly ineffective in reality for most patients. The truth is autoimmune disease is incredibly complex and we still don't have satisfactory treatment, diet or otherwise.
  - andy_ppp 10y ago
    Can you point to some references to back up your claim that diet control is disappointing? It seems to me that diet has such an enormous effect on our bodies that it should do something; I would say compliance is more the issue than its effectiveness from my reading of things.
    - deleted 10y ago
      [deleted]
- jeffdavis 10y ago
  So what kind of diet cures, say, type I diabetes?
horsecaptin 10y ago
What about ALS?
- adjwilli 10y ago
  That's only cured by watching people splash themselves with cold water.
  - curiousgal 10y ago
    You're just bummed because no one challenged you! /s
ams6110 10y ago
What is a "fasting-like" diet? It is presumably not absolute fasting otherwise no need for the "like" qualifier.
- dualogy 10y ago
  Technically a fast-mimicking diet would be: ad-libitum fat, barely sufficient protein (such that protein recycling is maintained --- no idea how to calculate this individually), near-zero (ie. only trace) carbohydrate. I suppose zero protein would most mimick fasting if done for just a few weeks tops but once all degenerate/damaged/mutated/malfunctioning proteins have been degraded for protein recycling or gluconeogenesis, lean tissue gets catabolized and this isn't desirable.) So sounds like: - a normal-size piece of meat or a box of eggs (or whatever concoctions the vegetationists prefer) - unlimited ghee/tallow/lard (or whatever oils one's belief system suggests) - water or 0kcal drinks - and if prolonged over more than a week or 2, perhaps micronutrient supplementation
  - jdpigeon 10y ago
    Well, that sounds just like a ketogenic diet. They actually investigate keto alongside their fasting diet and find similar benefits in many areas, just not to as large a degree.
- geocar 10y ago
  No. It's not absolute fasting, although I do that some times. I've been doing alternate-day fasting or a 3/5 diet, for around 6-8 months at a time, for the last several years because it makes me feel better. There was a great program on the BBC[1] about "fasting-like diets", which generally consist of extreme caloric restriction for some time -- where what counts as "extreme" and "some time" varies from programme to programme -- and when it got to Michael's own experiments with fasting, the description of the feelings are what encouraged me to give it a try. [1]: http://www.dailymotion.com/video/xvdbtt_eat-fast-live-longer-hd_shortfilms http://www.dailymotion.com/video/xvdbtt_eat-fast-live-longer...
  - tomp 10y ago
tansey 10y ago
This seems pretty likely to be placebo effect, at least in the human trials which are the only parts of the paper I read. The paper cited [0] pre-registered on clinicaltrials.gov [1] -- which is great and everyone in the field should do so. However, looking at what they pre-registered, we have: - Two different diet treatment regimes: fasting-like for 3 months followed by Mediterranean diet (FMD), and ketogenic diet (KD). - Control diet was simply telling people to eat the same way as usual. So there's no real accounting for how well a placebo would do here. - Measurements included a 54-question survey, adverse event counts, and various lab measurements. These measurements were taken at start, 1-month, 3-month, and 6-month intervals. The problem then is that what was report was: - Results of the first half of the first treatment (fasting-like for 3 months) for a subset of the measurements. What if things only worked in the second half? Or if things worked only for KD? So many implicit comparisons here. - Comparison against the control group at 3 months, with reported p-values. Even though one of the reported measurements was the overall survey results, all of the values reported are p-values without any mention, that I can find, of multiple hypothesis testing across all measurements. This comes despite the fact that for all of the mouse results, they explicitly state they used Bonferroni correction. - Baseline performance which involved no placebo. How many people would have improved if simply given some bullshit diet? Or if they had simply been given a diet that was vegetarian, or something that gave them the impression it was a treatment? Especially in surveys, placebo effect is a huge thing to look out for. Their more hard metrics like lab results show a more mixed bag with WBC dropping for fasting subjects. Sure, it returns once the 3 months is over, but then the supposed quality of life scores drop; so you can't have it both ways, though their writing makes it sound that way. I'm not saying it isn't a great result from a bio standpoint. I'm sure the Cell reviewers found the mouse model results compelling. I just don't see any way to conclude the broad sweeping title of the article from the actual content of the paper, and it's unethical to do so without strong evidence. [0] http://www.cell.com/cell-reports/pdfExtended/S2211-1247(16)30576-9 http://www.cell.com/cell-reports/pdfExtended/S2211-1247(16)3... [1] https://clinicaltrials.gov/ct2/show/NCT01538355?term=NCT01538355&rank=1 https://clinicaltrials.gov/ct2/show/NCT01538355?term=NCT0153...
- darawk 10y ago
  There is a somewhat interesting philosophical question here. What does it mean for this result to be the 'placebo effect'? That is, supposing it is in some sense caused by the psyche, and fasting reliably produces that effect...is there a sense in which fasting is not its cause? Clearly for sugar pill vs drug we can measure the component which is 'placebo'. But here, since it is immeasurable...is it possible to call it a placebo effect? Or should we refer to effects derived psychologically from unique subjective experiences in another way.
nikolay 10y ago
Food is so yesterday!
- nikolay 10y ago
  Why all the downvotes? You can't handle a joke?! So pathetic!
  - kaoD 10y ago
    Jokes are usually frowned upon in Hacker News. It keeps the conversation focused and meaningful instead of derailing into chains of puns à la Reddit. It's not that the community can't handle a joke, it's just trying to avoid the slippery slope. There are other places for more lighthearted discussion. Mentioning downvotes is also frowned upon. Disclaimer: I didn't downvote you, just explaining.
    - nikolay 10y ago
      On the contrary - unsubstantiated, silent, cowardly downvotes turn HN into Reddit. And my comment was both a joke and a serious statement. As with everything, you need to find the golden mean, and people today are overeating their way into chronic disease! We don't need as much food and as quality food as we think. In fact, fasting outweighs careful food selection as you can't go wrong with fasting, but you could and eventually would by following conflicting and ever-changing dietary guidelines. There is much wisdom in my single short sentence! But I start to think that the audience here is incapable of reading between the lines, which is sad given the HN claims for superior intelligence. In fact, the San Fran crowd is addicted to food, and based on my personal experience here; it goes postal when you dare to say something against their questionable eating habits!
tkyjonathan 10y ago
The Swank diet and later the McDougall diet have been halting and sometimes slightly regressing MS symptoms in most cases, for decades now. The Swank diet in particular, has kept people alive with the disease for 34 years. https://www.youtube.com/watch?v=kZ5NGLM1k90 https://www.youtube.com/watch?v=kZ5NGLM1k90
- j-pb 10y ago
  > The Swank diet in particular, has kept people alive with the disease for 34 years. It's not an achievement to keep people with MS alive. People with MS have an average life expectancy that is very close to that of healthy people (literature varies between a couple of months http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069023/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069023/ and several years, with 7 being the highest that I've seen http://www.nationalmssociety.org/What-is-MS/MS-FAQ-s http://www.nationalmssociety.org/What-is-MS/MS-FAQ-s). It's the quality of life that sucks for MS patients. Uninformed statements like these make you sound even more snake oily than you already sound.
  - easytiger 10y ago
    Also a highly varied disease that can have almost no effects vs almost immediately chronic ones.
    - j-pb 10y ago
      Yeah the spectrum is huge, however disease progression is also hard to predict, so a person with some very heavy relapses at onset might be relapse free for years afterwards and vice versa. Iirc though there are some studies that showed that progression is in general more benign than initially estimated in most cases.
rikta 10y ago
Ramadan is coming :) 20+ hours fasting for 30 days :)
- throwawa998877 10y ago
  PM me your location so I can get lots of people to eat in front of you for 20+ hours for 30 days :)))))
- gokhan 10y ago
  ~17 hrs in London in the first day. Besides, never seen anyone loosing weight during Ramadan. Many eat from iftar to sunrise non-stop.
deleted 10y ago
[deleted]
JamieAli 10y ago
Losing weight is 80% diet and 20% exercise, there's no point in doing hours and hours of cardio and weight training if you're still eating junk food, because you will not lose any weight, sure you may get fitter but you won't lose any fat. Also, if you can't fit 30 minutes of cardio in a day, 7 minutes will do the trick tremendously, well that's only if you're doing 7 minutes of HIIT (High Intensity). Do at least a 20 second sprint then a 20 second run, alternate for 7 minutes, everyday, you will feel great and revitalized after. Be careful in which guides you follow, there are TONS of fad diets and lies. Here's a great weight loss program I used to lose weight and permanently keep it off: http://thehealthspecialists.com http://thehealthspecialists.com

98 points by brahmwg 10y ago

Isn't this obvious to anyone who follows that diet <-> autoimmune disease? Also adrenal hormones increase during fasting, as can be commonly seen with high cortisol levels in those who fast. "All disease begins in the gut," as someone wise has said in the past.

pizza 10y ago
'Obvious' considered harmful, though.
- kjhljjg 10y ago
  agreed. nothing is obvious, everything needs to be tested
Lxr 10y ago
It's usually "obvious" to people who are not affected by autoimmune disease, but diet control is generally disappointingly ineffective in reality for most patients. The truth is autoimmune disease is incredibly complex and we still don't have satisfactory treatment, diet or otherwise.
- andy_ppp 10y ago
  Can you point to some references to back up your claim that diet control is disappointing? It seems to me that diet has such an enormous effect on our bodies that it should do something; I would say compliance is more the issue than its effectiveness from my reading of things.
  - deleted 10y ago
    [deleted]
jeffdavis 10y ago
So what kind of diet cures, say, type I diabetes?

horsecaptin 10y ago

What about ALS?

adjwilli 10y ago
That's only cured by watching people splash themselves with cold water.
- curiousgal 10y ago
  You're just bummed because no one challenged you! /s

ams6110 10y ago

What is a "fasting-like" diet? It is presumably not absolute fasting otherwise no need for the "like" qualifier.

dualogy 10y ago
Technically a fast-mimicking diet would be: ad-libitum fat, barely sufficient protein (such that protein recycling is maintained --- no idea how to calculate this individually), near-zero (ie. only trace) carbohydrate. I suppose zero protein would most mimick fasting if done for just a few weeks tops but once all degenerate/damaged/mutated/malfunctioning proteins have been degraded for protein recycling or gluconeogenesis, lean tissue gets catabolized and this isn't desirable.) So sounds like: - a normal-size piece of meat or a box of eggs (or whatever concoctions the vegetationists prefer) - unlimited ghee/tallow/lard (or whatever oils one's belief system suggests) - water or 0kcal drinks - and if prolonged over more than a week or 2, perhaps micronutrient supplementation
- jdpigeon 10y ago
  Well, that sounds just like a ketogenic diet. They actually investigate keto alongside their fasting diet and find similar benefits in many areas, just not to as large a degree.
geocar 10y ago
No. It's not absolute fasting, although I do that some times. I've been doing alternate-day fasting or a 3/5 diet, for around 6-8 months at a time, for the last several years because it makes me feel better. There was a great program on the BBC[1] about "fasting-like diets", which generally consist of extreme caloric restriction for some time -- where what counts as "extreme" and "some time" varies from programme to programme -- and when it got to Michael's own experiments with fasting, the description of the feelings are what encouraged me to give it a try. [1]: http://www.dailymotion.com/video/xvdbtt_eat-fast-live-longer-hd_shortfilms http://www.dailymotion.com/video/xvdbtt_eat-fast-live-longer...
- tomp 10y ago

tansey 10y ago

This seems pretty likely to be placebo effect, at least in the human trials which are the only parts of the paper I read. The paper cited [0] pre-registered on clinicaltrials.gov [1] -- which is great and everyone in the field should do so. However, looking at what they pre-registered, we have: - Two different diet treatment regimes: fasting-like for 3 months followed by Mediterranean diet (FMD), and ketogenic diet (KD). - Control diet was simply telling people to eat the same way as usual. So there's no real accounting for how well a placebo would do here. - Measurements included a 54-question survey, adverse event counts, and various lab measurements. These measurements were taken at start, 1-month, 3-month, and 6-month intervals. The problem then is that what was report was: - Results of the first half of the first treatment (fasting-like for 3 months) for a subset of the measurements. What if things only worked in the second half? Or if things worked only for KD? So many implicit comparisons here. - Comparison against the control group at 3 months, with reported p-values. Even though one of the reported measurements was the overall survey results, all of the values reported are p-values without any mention, that I can find, of multiple hypothesis testing across all measurements. This comes despite the fact that for all of the mouse results, they explicitly state they used Bonferroni correction. - Baseline performance which involved no placebo. How many people would have improved if simply given some bullshit diet? Or if they had simply been given a diet that was vegetarian, or something that gave them the impression it was a treatment? Especially in surveys, placebo effect is a huge thing to look out for. Their more hard metrics like lab results show a more mixed bag with WBC dropping for fasting subjects. Sure, it returns once the 3 months is over, but then the supposed quality of life scores drop; so you can't have it both ways, though their writing makes it sound that way. I'm not saying it isn't a great result from a bio standpoint. I'm sure the Cell reviewers found the mouse model results compelling. I just don't see any way to conclude the broad sweeping title of the article from the actual content of the paper, and it's unethical to do so without strong evidence. [0] http://www.cell.com/cell-reports/pdfExtended/S2211-1247(16)30576-9 http://www.cell.com/cell-reports/pdfExtended/S2211-1247(16)3... [1] https://clinicaltrials.gov/ct2/show/NCT01538355?term=NCT01538355&rank=1 https://clinicaltrials.gov/ct2/show/NCT01538355?term=NCT0153...

darawk 10y ago
There is a somewhat interesting philosophical question here. What does it mean for this result to be the 'placebo effect'? That is, supposing it is in some sense caused by the psyche, and fasting reliably produces that effect...is there a sense in which fasting is not its cause? Clearly for sugar pill vs drug we can measure the component which is 'placebo'. But here, since it is immeasurable...is it possible to call it a placebo effect? Or should we refer to effects derived psychologically from unique subjective experiences in another way.

nikolay 10y ago

Food is so yesterday!

nikolay 10y ago
Why all the downvotes? You can't handle a joke?! So pathetic!
- kaoD 10y ago
  Jokes are usually frowned upon in Hacker News. It keeps the conversation focused and meaningful instead of derailing into chains of puns à la Reddit. It's not that the community can't handle a joke, it's just trying to avoid the slippery slope. There are other places for more lighthearted discussion. Mentioning downvotes is also frowned upon. Disclaimer: I didn't downvote you, just explaining.
  - nikolay 10y ago
    On the contrary - unsubstantiated, silent, cowardly downvotes turn HN into Reddit. And my comment was both a joke and a serious statement. As with everything, you need to find the golden mean, and people today are overeating their way into chronic disease! We don't need as much food and as quality food as we think. In fact, fasting outweighs careful food selection as you can't go wrong with fasting, but you could and eventually would by following conflicting and ever-changing dietary guidelines. There is much wisdom in my single short sentence! But I start to think that the audience here is incapable of reading between the lines, which is sad given the HN claims for superior intelligence. In fact, the San Fran crowd is addicted to food, and based on my personal experience here; it goes postal when you dare to say something against their questionable eating habits!

tkyjonathan 10y ago

The Swank diet and later the McDougall diet have been halting and sometimes slightly regressing MS symptoms in most cases, for decades now. The Swank diet in particular, has kept people alive with the disease for 34 years. https://www.youtube.com/watch?v=kZ5NGLM1k90 https://www.youtube.com/watch?v=kZ5NGLM1k90

j-pb 10y ago
> The Swank diet in particular, has kept people alive with the disease for 34 years. It's not an achievement to keep people with MS alive. People with MS have an average life expectancy that is very close to that of healthy people (literature varies between a couple of months http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069023/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069023/ and several years, with 7 being the highest that I've seen http://www.nationalmssociety.org/What-is-MS/MS-FAQ-s http://www.nationalmssociety.org/What-is-MS/MS-FAQ-s). It's the quality of life that sucks for MS patients. Uninformed statements like these make you sound even more snake oily than you already sound.
- easytiger 10y ago
  Also a highly varied disease that can have almost no effects vs almost immediately chronic ones.
  - j-pb 10y ago
    Yeah the spectrum is huge, however disease progression is also hard to predict, so a person with some very heavy relapses at onset might be relapse free for years afterwards and vice versa. Iirc though there are some studies that showed that progression is in general more benign than initially estimated in most cases.

rikta 10y ago

Ramadan is coming :) 20+ hours fasting for 30 days :)

throwawa998877 10y ago
PM me your location so I can get lots of people to eat in front of you for 20+ hours for 30 days :)))))
gokhan 10y ago
~17 hrs in London in the first day. Besides, never seen anyone loosing weight during Ramadan. Many eat from iftar to sunrise non-stop.

deleted 10y ago

[deleted]

JamieAli 10y ago

Losing weight is 80% diet and 20% exercise, there's no point in doing hours and hours of cardio and weight training if you're still eating junk food, because you will not lose any weight, sure you may get fitter but you won't lose any fat. Also, if you can't fit 30 minutes of cardio in a day, 7 minutes will do the trick tremendously, well that's only if you're doing 7 minutes of HIIT (High Intensity). Do at least a 20 second sprint then a 20 second run, alternate for 7 minutes, everyday, you will feel great and revitalized after. Be careful in which guides you follow, there are TONS of fad diets and lies. Here's a great weight loss program I used to lose weight and permanently keep it off: http://thehealthspecialists.com http://thehealthspecialists.com