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Fasting and Autoimmune Disease

Feb 27, 2023 ● By Meena Malhotra, M.D.
Woman on yoga mat eating.

Photo credit v pexels-mikhail-nilov-6740520

More than 100 known autoimmune disease types affect hundreds of millions of people worldwide, and their prevalence is increasing. Some of the more prevalent include Type 1 diabetes, rheumatoid arthritis systemic lupus erythematosus and inflammatory bowel disease (IBD).

For a patient with a history of chronic systemic inflammation, precursors like an inflammatory diet or a psychological stressor can act as a trigger to precipitate the onset of autoimmune disease or a flare-up.

Genetic and environmental factors have long been understood to trigger autoimmune disease. In 2000, a third element—intestinal permeability (leaky gut)—which allows passage of antigens such as macromolecules, toxins and food proteins from the gut into the body, was found. Zonulin is the master regulator of intestinal permeability that opens the door to several chronic inflammatory conditions. It is found in abundance in rheumatoid arthritis, systemic lupus erythematosus, IBD and other autoimmune diseases.

Using zonulin as a biomarker for leaky gut is linked to age-related inflammation and frailty (decreased muscle strength). Pathogenic bacteria and gliadin are major triggers that cause the release of zonulin. Lactobacillus rhamnosus GG inhibits gliadin from altering intestinal permeability. This research contributes to a growing body of evidence showing the efficacy of healthy bacteria in treating the chronic inflammation implicated in autoimmune diseases.

Dysbiosis of gut microbiota has been closely linked to several diseases such as obesity, Type 2 diabetes, hypertension, necrotizing enterocolitis and inflammatory bowel diseases. Healthy lifestyle factors, including a diversified diet, limited consumption of processed and refined foods, and consumption of adequate dietary fiber, may all promote a healthy microbiome.

Foods and nutrients that potentially boost immune function also tend to promote gut health. For example, consuming a diverse array of fruits and vegetables rich in antioxidants, anti-inflammatory nutrients and phytochemicals may reduce oxidative stress, support the liver to promote efficient biotransformation and detoxification, and boost overall immune system function. These same fruits and vegetables also contain soluble fibers that “feed” the commensal microbial community in the colon to optimize gut balance and health and insoluble fibers that assist in the efficient processing and elimination of waste from the intestinal tract.

Fasting is the quickest way to bring autoimmunity under control. After 72 hours of water-only fasting, autophagy and apoptosis change in a favorable direction. In addition, components of the innate immune system are boosted compared to baseline measurements. Time restricted eating (TRE), where we consume three meals per day within an eight-hour time frame at 1 p.m., 4 p.m. and 8 p.m., is another way to benefit the immune system. After 12 months of TRE, inflammatory markers interleukin 6, interleukin 1-beta, and TNF-alpha are reduced, and both insulin sensitivity and lipid profiles significantly improve. Intermittent fasting enhances beneficial gut bacteria and increases short-chain fatty acids that promote healthy immune function.

Consult with a physician before engaging in any kind of fasting routine because the extent of fasting and support should be personalized for optimum outcomes.

Dr. Meena Malhotra is the medical director of Heal n Cure. For more information, call 847-686 4444, email [email protected] or visit