Fasting-like Diet Reduces Multiple Sclerosis Symptoms
neuroscientistnews.com
neuroscientistnews.com
- 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
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...
"Modified human fasting mimicking diet.
A single cycle of the modified fasting mimicking diet consist of Day 1 – pre-fasting followed by Day 2-8 – very low calorie diet. Day 1-prefasting consists of an 800 kcal (about 40% of normal caloric intake similar to mouse Day1 FMD) monodiet (fruit, rice, or potatoes) by preference of individuals. On the following day patients were recommended to use an oral laxative, Natrium Sulfuricum (20-40 g). FMD consisted of 100 ml vegetable broth or vegetable juice with 1 tablespoon of linseed oil 3 times daily, plus additional calorie-free liquids. The daily calorie intake was predefined with 200 – 350 kcal (10-18% of normal caloric intake similar to mouse Day 2-3 FMD). Patients were advised to drink 2-3 L of unsweetened fluids each day (water, and herbal teas) and to use an enema if tolerated. After the 7-day fasting period solid foods were stepwise reintroduced for three days, starting with a steamed apple at day 8. After the fasting and refeeding period a normocaloric, plant-based Mediterranean diet was maintained until study end."
[0] http://www.cell.com/cell-reports/pdfExtended/S2211-1247(16)3...
Also interesting is that I have had some severe digestive issues for years; antibiotics helped for a month or two and eating about 3000 kcal over five days has been just as helpful for a couple of weeks now and seems likely to be at least as effective as the antibiotics. However, one or two days of calorie restriction does not have that effect on me. If this fasting result holds for MS, the effect of fasting on gut bacteria could potentially be part of how it works.
- 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)3...
[1] https://clinicaltrials.gov/ct2/show/NCT01538355?term=NCT0153...
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.
First, one study doesn't tell us that fasting "reliably" produces this effect. Secondly, if it was a placebo effect then fasting would not reliably produce it. You would likely be able to produce no placebo effect by telling patients that there will very likely be no effect whatsoever on their symptoms.
>But here, since it is immeasurable...is it possible to call it a placebo effect?
If it is a placebo effect, you would probably be able to measure it by testing various other non-fasting diets. The difficulty lies in the inability to have a sham fasting diet, but you could likely mitigate that by telling patients there will likely be no effect on their symptoms from fasting.
[1] http://www.scientificamerican.com/podcast/episode/placebos-w...
I guess my point is more theoretical. Let's say it was reliable, and let's say that other non-fasting diets didn't produce the effect. Further, let's say that telling them it had no effect didn't prevent it either.
Now, given all that, it's still possible that there is, in some sense, a psychological component (i.e. how you 'feel' when fasting) that causes you to get better in some way. I have always thought this about Airborne and such, for instance. They are total bullshit products that absolutely, categorically do not work. But I drink them when i'm sick anyway, because the effervescence and the flavor feel to me like something that works, so I feel like their placebo effect is better than other things.
I suppose what i'm getting at is that there are some activities/experiences that can engineer better placebo effects than others due to the subjective experience they produce. And I wonder then in what sense is that separable from the thing itself.
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/ and several years, with 7 being the highest that I've seen 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.
Iirc though there are some studies that showed that progression is in general more benign than initially estimated in most cases.
Besides, never seen anyone loosing weight during Ramadan. Many eat from iftar to sunrise non-stop.
"All disease begins in the gut," as someone wise has said in the past.
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.
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.
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!