(P03-015-24) Intermittent Fasting Leads to Sustained Weight Loss Without Caloric Restriction in Patients With Rheumatoid Arthritis

Objectives: Intermittent fasting (IF), or time-restricted eating (TRE), has emerged as a compelling dietary regimen garnering attention for its potential health benefits. It has been suggested that these benefits mainly stem from an implicit reduction in caloric intake. Furthermore, IF has been demonstrated to influence the composition of the gut microbiome, with decreased diversity correlating with aspects of rheumatoid arthritis (RA) pathology, such as disease duration and autoantibody levels.

Methods: Within the framework of the ExpoBiome study, this project was set out the effects of 12 months of IF following a week-long period of prolonged fasting (PF) in patients diagnosed with rheumatoid arthritis. By meticulously analyzing 24-hour food recalls (24FR) and food frequency questionnaires (FFQ), we aimed to discern any inadvertent dietary alterations that may occur. Integrating nutritional data with anthropometric measurements, routine blood chemistry analyses, and cytokine profiling, were planned to elucidate the intricate mechanistic interplay between nutrition and the immune system, thereby potentially identifying underlying factors that sustain the beneficial effects of fasting interventions on RA.

Results: Preliminary results in subjects that have completed the 24FR and took part in the PF and IF interventions for a total period of 12 months show a sustained significant reduction in weight while the caloric intake is only significantly decreased at week 2 of the study. This observation is accompanied by a significant improvement in RA disease activity (HAQ) and significant changes in several clinical markers (e.g. CRP, TSH).

Conclusions: Therefore, we conclude that the beneficial effects of TRE may not be driven by caloric restriction but rather by complex interactions with the gut microbiome and the immune system.

Funding Sources: This project has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation program (grant agreement number 863664). This work was supported by the Luxembourg National Research Fund (FNR) under grant PRIDE/11823097.