The application of a fasting-mimicking diet in periodontitis. A feasibility study

Abstract

Objectives

The aim of this study was to test the feasibility of a fasting-mimicking diet on the systemic and periodontal response following non-surgical periodontal therapy.

Methods

Twenty patients with periodontitis were randomised to receive steps 1 and 2 of periodontal treatment alone (following their normal diet) or with an adjunctive 5-day course of fasting-mimicking diet (FMD). Blood and gingival crevicular fluid (GCF) samples were collected to study the levels of several inflammatory biomarkers, along with clinical parameters and patients-reported outcome measurements (PROMs). All patients were followed up at day-1, day-7 and 3 months post-treatment, and food diaries were completed to assess their compliance.

Results

Nineteen patients completed the 3-months follow-up. Only minimal adverse events including nausea, fatigue, weakness and dizziness were reported in the test group, with no differences in PROMs between groups. Test patients exhibited a non-statistically significant 3-months serum hs-CRP reduction of 0.20 ± 0.30 mg/l compared with 0.11 ± 0.52 mg/l in controls (p = 0.632) and a trend for lower GCF levels of MMP-8, IL-6 and IL-1β post-treatment compared with controls.

Conclusions

This study suggests that one cycle of adjunctive FMD is feasible and may modulate the inflammatory response post-non-surgical periodontal therapy. Larger studies are needed to test this hypothesis. (clinicaltrials.gov ID: NCT05684627).

Clinical relevance

For the first time, a 5-days cycle of FMD as an adjunct to non-surgical periodontal therapy was assessed in Turkish individuals with periodontitis stages III-IV. The findings showed that FMD is feasible and may reduce inflammatory markers one day post-treatment.