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

J Dent. 2025 May:156:105644. doi: 10.1016/j.jdent.2025.105644. Epub 2025 Feb 19.

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.

Keywords: C-Reactive Protein; Diet; Fasting; Gingival crevicular fluid; Inflammation; Periodontitis; Serum.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Biomarkers / analysis
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Diet Records
  • Fasting*
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Gingival Crevicular Fluid / chemistry
  • Humans
  • Inflammation Mediators / analysis
  • Interleukin-1beta / analysis
  • Interleukin-1beta / blood
  • Interleukin-6 / analysis
  • Interleukin-6 / blood
  • Male
  • Matrix Metalloproteinase 8 / analysis
  • Matrix Metalloproteinase 8 / blood
  • Middle Aged
  • Patient Compliance
  • Periodontitis* / blood
  • Periodontitis* / diet therapy
  • Periodontitis* / therapy
  • Treatment Outcome

Substances

  • C-Reactive Protein
  • Matrix Metalloproteinase 8
  • Interleukin-6
  • Biomarkers
  • Interleukin-1beta
  • Inflammation Mediators
  • MMP8 protein, human

Associated data

  • ClinicalTrials.gov/NCT05684627