Calorie-restricted, keto diets may reduce biological age in multiple sclerosis

Key takeaways:

• Calorie-restricted and keto diets led to a reduction in metabolomic age among patients with relapsing-remitting MS.
• The diets additionally led to reduction in biomarkers indicative of accelerated biological aging.

WEST PALM BEACH, Fla. — A 6-month ketogenic diet and 2-month calorie-restricted diet were associated with significant reductions in biological age in patients with relapsing-remitting multiple sclerosis, according to a poster at ACTRIMS.

“It’s been shown that biological age is accelerated in people with MS and that could be a core feature of pathophysiology of the disease,” Fatemeh Siavoshi, MD, postdoctoral fellow in the department of neurology at Johns Hopkins University School of Medicine, told Healio. “We wanted to see if we could provide a biomarker to capture accelerated aging; the first one that captured our attention was fasting-mimicking diets.”

Siavoshi and colleagues investigated whether MS-related accelerated aging could be slowed or reversed through fasting-mimicking diets, such as intermittent fasting and ketogenic diets, in a small cohort of adults with relapsing-remitting MS, at Johns Hopkins (JHU) and the University of Virginia (UVA).

At JHU, the study included 36 patients who were randomly assigned on a 1:1:1 basis into three diet groups: daily calorie restrictions (22% reduction of normal daily caloric needs); intermittent (75% calorie reduction of normal daily needs twice a week); and weight-stable controls (100% of normal daily needs). The participants recorded an Expanded Disability Status Scale (EDSS) score of less than six and received a stable regimen of IV therapy for at least 6 months prior to enrollment or did not receive any prior disease-modifying therapies (DMTs). Individuals also submitted a blood sample for flow cytometry at baseline and the 8-week mark to determine biologic age, as measured by metabolomic age.

At UVA, the study included 39 individuals with an EDSS of less than six who were administered various DMTs and showed no clinical relapses or new MRI lesion activity for 6 months prior to enrollment. These individuals were instructed to follow a modified Atkins diet for 6 months while restricting net carbohydrates to less than 20 g per day to increase healthy fat consumption.

According to results of the JHU study, those on the calorie-restricted diet demonstrated a mean reduction in metabolomic age of 6.58 years compared with patients in the control groups.

Further, data showed that patients who had higher biological age acceleration at baseline recorded greater T-cell reduction as well as a greater increase in CD4-naive cells than patients with lesser acceleration.

For the UVA study, researchers reported that 6-month adherence to the ketogenic diet led to a mean reduction of 1.06 years per month in metabolomic age.

“We have seen a beneficial effect in people with MS,” Siavoshi told Healio. “We could see that biologic age, measured by metabolomic age, could be reversed with calorie restriction in a fasting diet and ketogenic diet.”