I'm Fasting For Science: Will It Help Tame My Multiple Sclerosis?
When I told my coworker that I was participating in a study that involved fasting, she laughed until she nearly cried.
My boyfriend, ever supportive, asked hesitantly, "Are you sure you want to try this?" Note the use of "try" instead of "do."
When I told my father over the phone, the line went silent for a moment. Then he let out a long, "Welllllll," wished me luck, and chuckled.
Turns out, luck might not be enough.
I like to eat. Often and a lot. Now, however, my eating habits have become more than a source of amusement for friends and coworkers. Now they are data in a study focusing on people with multiple sclerosis, like me.
The pilot study, led by Dr. Ellen Mowry at the Johns Hopkins University in Baltimore, is looking at the impact of intermittent fasting on our microbiomes — the universe of trillions of microbes, mainly bacteria, that live in our guts.
Intermittent fasting is pretty much what it sounds like. For six months, participants are allowed to eat during an 8-hour period each day. The remaining 16 hours we are limited to water, tea and coffee. No added sugar, cream, honey or sweetener.
Several studies have suggested that the predominant bacteria in the guts of people with MS tend to be different than those in the guts of those without the chronic autoimmune inflammatory disease, according to Samantha Roman, the study's research coordinator. Depending on their makeup, bacteria have the ability to soothe or trigger inflammation, potentially affecting the symptoms of MS and other diseases. Exactly how gut bacteria and inflammation are related, though, is not well understood.
What researchers do know, Roman says, is that intermittent fasting is one of many ways to change the makeup of the microbiome, and it can quell the inflammatory symptoms of MS — at least in mice.
To help shed light on the relationships between fasting and the microbiome and inflammation and multiple sclerosis in humans, researchers at Hopkins will inspect gut bacteria in study participants, before, during and after the six-month period of fasting. Two random mornings a week, Roman sends text messages, asking participants to photograph all of our food intake for the day.
As a part of this study, I like to think that every bite I take may bring doctors one data point closer to easing the abdominal spasms that ebb and flow like a wave of knives, occasionally sending me to the emergency room. Every embarrassingly audible gurgle of hunger could be a signal that my microbial cohabitants are calming my immune system, muting the burning sensation that at times covers my skin from eyelids to toe-tips. Each late-night snack that I decline may help reduce the inflammation that has left my brain and spinal cord dotted with lesions that lead to those and other symptoms.
It is a noble endeavor, I told myself as I prepared that first stool sample, and I have continued to remind myself of this lofty motivation every morning at 10 a.m. when inevitably, my stomach begins to growl. I'll likely repeat the mantra at the end of the study, when I'll need to prepare a second stool sample for comparison.
Like so many such endeavors, this one isn't easy.
I took Roman up on her suggestion, and scheduled my periods of eating between noon and 8 p.m. I get home at about 7 p.m. several evenings a week after strength training, and there is no way I could go 16 hours without eating after the ordeal my trainer puts me through. I only started eating breakfast in the past few years. I figured I would slip back into that routine fairly easily.
My first few days of fasting coincided with the presidential election and my car breaking down. These were gut-wrenching events. As it turned out, a little gut-wrenching helped out quite a bit. Thanks to the knot in my stomach, I had to force myself to eat. "This is going to be a breeze," I thought.
Then came Saturday. After running several food-related errands — the butcher, the coffee shop, the grocery store — I was famished. So I did the sensible thing and bought a grilled cheese sandwich that was stuffed with crab dip. When I got home at about 2:30 p.m., I devoured it, then promptly fell asleep. I woke up two hours later in a panic — I only had a few hours left to eat! I wasn't hungry, but just to play it safe, I ate a taco and some ice cream.
In the first month and a half of the study, my symptoms have not changed much. I'm still fatigued, my hands and feet often feel as though they are on fire, and I have occasional muscle spasms in my feet.
Still, things had been going well. I lost about 8 pounds (my regular diet includes more vegetables, less crab-dipped-stuffed grilled cheese), set a new PR at the gym, and slipped into a comfortable eating routine.
Until my trip to Chicago.
It was a wedding! What was I supposed to do? The answer, apparently, is drink. I did keep my food intake between noon and 8 p.m. But there was the snowy Christkindlmarket with its fragrant, sweet, hot mulled wine. And champagne toasts! And whiskey! Over three nights, I drank alcohol beyond my 8-hour limit three times.
And then, in the most unexceptional place, for the most basic of foodstuffs, I hit rock bottom. After two hours of sleep, in Terminal E of O'Hare Airport at 7 a.m., I ate a bagel. I needed that bagel. I regret nothing.
During that weekend, for the first time, Roman sent text messages two days in a row. Hesitantly, shamefully, I confessed to everything. The point of the texts is, after all, to determine how well participants stick to the program, as well as to have data to help determine if what we eat has any effect over and above when we eat.
I have become the very reason I tend to side-eye studies that rely on self-reported data! I want to do better, for the opportunity to improve my health and for the integrity of the study. I'll have to continue to remind myself of the nobility of this scientific endeavor, particularly in January, when I spend a week at the beach in Mexico.
Brandie Michelle Jefferson is a communications manager and freelance reporter who loves a good science story. She's on Twitter, too: @b_m_jefferson.