Metabolomic Changes Associated with a Time-Restricted Diet in People with Multiple Sclerosis

Thursday, May 31, 2018
Exhibit Hall A (Nashville Music City Center)
Samantha N Roman, B.S. , Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
Kathryn C Fitzgerald, Sc.M., Sc.D. , Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
Ellen M Mowry, MD, MCR , Neurology, Johns Hopkins School of Medicine, Baltimore, MD


Fasting-mimicking diets have shown promise in ameliorating the symptoms of experimental autoimmune encephalitis (EAE), the mouse model of multiple sclerosis (MS), but whether similar dietary changes in people with MS improves clinical outcomes remains unclear. Implementing and maintaining strict fasting or calorie restriction protocols is difficult. Time-restricted feeding (consumption of all calories within a <12-hour window each day) may have similar biological impacts. We previously conducted a trial of intermittent calorie restriction in people with MS in which untargeted metabolomics were used to assess the impact of the intervention on the metabolome.


To conduct a pilot trial of time-restricted feeding to evaluate if metabolomic changes are similar to those observed with fasting-mimicker diets.


We recruited patients with MS who were receiving monthly natalizumab infusions, had a body mass index (BMI) <25 (or ≥25 and refused enrollment in a concurrent calorie restriction study), and met other inclusion/exclusion criteria. Participants were randomized to either time-restricted feeding (TRF) (limiting food intake to an 8-hour calorie consumption interval [CCI] each day), or control (no dietary change). Participants submitted photos of all food on two randomly-selected days each week, and CCI was calculated using photo time stamps. At months 0, 3 and 6, plasma samples were collected, processed and stored using the same protocol until metabolomic analysis could be completed.


24 patients were enrolled in the study; 12 were randomized to the TRF group and 12 to the control group. Participants were 83.3% female (n=20), mean age 41.6 years, and mean BMI 25.1 kg/m2. 10 patients in each group submitted sufficient data to analyze daily CCI. Based on average CCI, 90% of TRF participants were adherent to the 8-hour goal. Metabolomics data analysis from plasma samples is currently underway for the baseline, 3- and 6-month plasma samples; final results will be presented at the CMSC annual meeting.


Fasting-mimicking diets have an interesting theoretical role in improving outcomes for people with MS. Strict fasting protocols are difficult to implement and maintain. Time-restricted feeding may be easier to implement and maintain than strict fasting protocols, and may lead to similar effects on metabolism.