Fasting-mimicking Diet in Treatment of Depressive Symptoms in IBD

The primary objective of this proof of principle study is to investigate the effects of a fasting mimicking diet on depressive symptoms in patients with inflammatory bowel disease.

The specific aims of this project include:

• Determine whether a fasting-mimicking diet is effective in ameliorating depressive symptoms in patients with Crohn's disease or ulcerative colitis
• Determine if beneficial effects seen during the interventional period are sustained following cessation of fasting
• Examine effects of the intervention on the gut microbiome and metabolome

Inclusion criteria

• Age ≥ 18 and ≤ 65 years at the time of screening
• Diagnosis of Crohn's disease in clinical remission or with mild-moderate disease with Harvey Bradshaw Index (HBI<8) or diagnosis of ulcerative colitis in clinical remission with partial Mayo (pMayo<7)
• Suffering from mild-moderate depression with PHQ-9 ≥5 and ≤ 19

Exclusion criteria

• Subjects who are reliant on partial or total parenteral nutrition
• Subjects with prior gastrointestinal surgery and consequences such as short bowel syndrome, ostomy of small or large intestine, total colectomy, proctocolectomy, or ileoanal pouch
• Subjects with diabetes or celiac disease
• Subjects with a body mass index (BMI) lower than 18
• Subjects suffering from malnutrition or at high risk of malnutrition assessed by a score of ≥6 on the abridged patient generated subjective global assessment (PGSGA)
• Subjects allergic to nuts
• Subjects currently on a fasting/intermittent type caloric restricted diet
• History of psychotic or bipolar disorders or experiencing suicidal thoughts
• Pregnant women, women who are breast feeding, or women planning on becoming pregnant
• Subjects with immune-compromised condition other than inflammatory bowel disease (e.g. AIDS, lymphoma)
• Subjects with severe uncontrolled cardiovascular or respiratory disease or active malignancy
• Unable to read English or provide informed consent