Fibromyalgia Diet

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There is considerable focus generally placed on diet and different dietary factors relative to both Fibromyalgia symptoms and the treatment of Fibromyalgia, but there is not however significant corresponding research evidence to support any single dietary factor as either a definitive cause of Fibromyalgia nor as a proven effective treatment approach. In fact, research evidence tends to suggest that more important than specifically what foods are eaten is overall health and in particular maintaining a healthy body weight. It may be that the best Fibromyalgia diet is any diet that is healthy and that facilitates the management of a healthy body weight.

Emerging evidence suggests that overweight and obese individuals have an increased incidence of Fibromyalgia compared to those who maintain a medically healthy weight (Ursini et al., 2011; Bennett et al., 2007; Neumann et al., 2008). In addition, research has also shown a detrimental relationship between obesity or being overweight and both the number and severity of various Fibromyalgia symptoms (Yunus et al., 2002; Neumann et al., 2008; Kim et al., 2011; Okifuji et al., 2010). Unfortunately, there are no universally promoted or proven dietary recommendations for Fibromyalgia patients (Friedlander et al., 2011); however, this does not mean Fibromyalgia patients cannot incorporate weight management into their comprehensive treatment plans. Along with exercise, diet must play a key role in these efforts. Patients must work with their care providers, possibly even a dietician, to develop weight management strategies that fit their lifestyle, preferences, and goals. In addition, as with all Fibromyalgia treatments, patients must continually monitor the effects (good and bad) that these strategies have on their symptoms and overall quality of life. By doing so, informed changes can be made if needed, to maximize the benefit to the patient. The best Fibromyalgia diet will vary from individual to individual and as with most Fibromyalgia treatment options determining the best individual Fibromyalgia diet will require ongoing testing through a process of trial and error.

Specific Research Regarding Diet and Fibromyalgia

Beyond the important role that diet has in weight maintenance, Fibromyalgia patients often report that specific aspects of their diet contribute to their symptoms. For example, many patients report symptom exacerbation following ingestion of certain foods (Haugen et al., 1991), and many change their diets in an effort to improve their symptoms (Arranz et al., 2011). Despite these frequent anecdotal reports from patients, there is a lack of research regarding specific foods (or ingredients) that may play a role in triggering Fibromyalgia or exacerbating its symptoms. There are, however, a few exceptions.

Aspartame is an artificial sweetener used as a sugar substitute in countless foods and beverages. It is also available as a dietary supplement. Historically, aspartame has been a source of controversy within the scientific community, as many researchers have investigated its possible role in the development of cancer and other diseases. However, the U.S. Food and Drug Administration (FDA) maintains that aspartame is safe for human consumption and therefore it is still available for use in foods and supplements in the U.S. In 2010, researchers from France published a paper regarding two separate patients who had a history of taking aspartame supplements. The first patient was a 50 year old woman who was diagnosed with Fibromyalgia following a 10 year history of widespread pain and fatigue. The second patient was a 43 year old man with a three year history of pain in his forearms, wrists, and hands. When both patients discontinued their aspartame supplements, their symptoms stopped completely. The woman later resumed supplementation with aspartame and found that her symptoms returned. Based on these observations, the authors of this paper suggest that physicians ask patients who suffer from Fibromyalgia about their intake of aspartame and consider the dietary elimination of aspartame as part of the comprehensive management of Fibromyalgia (Ciappuccini et al., 2010).

A compound known as monosodium glutamate, or MSG, is a flavor enhancer frequently used in Chinese cooking, as well as in the commercial canning of vegetables, soups, and processed meats. MSG has also been controversial despite its classification by the FDA as “generally recognized as safe.” The controversy surrounding MSG centers around many decades’ worth of anecdotal reports of adverse reactions to foods that contain MSG. Similar to aspartame, MSG has been associated with Fibromyalgia and Fibromyalgia-like symptoms. In 2001, Smith et al. published a paper describing the cases of four female Fibromyalgia patients (two of whom were sisters). All patients had repeatedly tried conventional Fibromyalgia treatments (including antidepressant medications, injections, pain medications, physical therapy, counseling, and various alternative therapies), however none were consistently or profoundly successful for any of the patients. Under varying circumstances, two women eliminated MSG from their diets while the other two eliminated both MSG and aspartame. For all four patients, Fibromyalgia symptoms improved dramatically and in some instances, completely, following elimination of these substances from their diet. In their discussion, the authors note that MSG, in addition to aspartame, are toxic to certain nerve cells and suggest that MSG may also play a role in disrupting the body’s ability to process pain signals correctly (Smith et al., 2001).

Apart from the role of specific food ingredients, the role of vegetarian and vegan diets on improving Fibromyalgia symptoms has also been investigated. However, the number of studies are small and they are limited by size and design. Nevertheless, the existing literature regarding vegetarian and vegan diets and their impact on Fibromyalgia suggests that such diets may be beneficial at improving some symptoms (Donaldson et al., 2001; Hostmark et al., 1993; Kaartinen et al., 2000). Additional studies that are larger in scope and better designed are needed to elaborate on these findings. Learn more about this research study and the impact of a Vegetarian diet on Fibromyalgia HERE.

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References

1.        Arranz LI, Canela MA, Rafecas M. Dietary aspects in Fibromyalgia patients: results of a survey on food awareness, allergies, and nutritional supplementation. Rheumatol Int. 2011 Jul 22. [Epub ahead of print]

2.        Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L. An internet survey of 2,596 people with Fibromyalgia. BMC Musculoskelet Disord. 2007;8(27).

3.        Ciappuccini R, Ansemant T, Maillefert JF, Tavernier C, Ornetti P. Aspartame-induced Fibromyalgia, an unusual but curable cause of chronic pain. Clin Exp Rheumatol. 2010;28(6 Suppl 63):S131-133.

4.        Donaldson MS, Speight N, Loomis S. Fibromyalgia syndrome improved using a mostly raw vegetarian diet: an observational study. BMC Complement Altern Med. 2001;1(7):Epub Sept 26.

5.        Friedlander JI, Shorter B, Moldwin RM. Diet and its role in interstitial cystitis/bladder pain syndrome (IC/BPS) and comorbid conditions. BJU Int. 2012;109(11):1584-1591.

6.        Haugen M, Kjeldsen-Kragh J, Nordvåg BY, Førre O. Diet and disease symptoms in rheumatic diseases–results of a questionnaire based survey. Clin Rheumatol. 1991;10(4):401-407.

7.        Hostmark AT, Lystad E, Vellar OD, Hovi K, Berg JE. Reduced plasma fibrinogen, serum peroxides, lipids, and apolipoproteins after a 3- week vegetarian diet. Plant Foods Hum Nutr. 1993;43:55-61.

8.        Kaartinen K, Lammi K, Hypen M, Nenonen M, Hanninen O, Rauma AL. Vegan diet alleviated Fibromyalgia symptoms. Scand J Rheumatol. 2000;29:308-313.

9.        Kim CH, Luedtke CA, Vincent A, Thompson JM, Oh TH. The association of body mass index with symptom severity and quality of life in patients with Fibromyalgia. Arthritis Care Res (Hoboken). 2011;Oct 3. Doi: 10.1002/acr.20653. Epub ahead of print.

10.     Neumann L, Lerner E, Glazer Y, Bolotin A, Shefer A, Buskila D. A cross-sectional study of the relationship between body mass index and clinical characteristics, tenderness measures, quality of life, and physical functioning in Fibromyalgia patients. Clin Rheumatol. 2008;27(12):1543-1547.

11.     Nutrition and health eating. What is MSG? Is it bad for you? The MayoClinic. April 3, 2012; Accessed May 18, 2012.

12.     Okifuji A, Donaldson GW, Barck L, Fine PG. Relationship between Fibromyalgia and obesity in pain, function, mood, and sleep. J Pain. 2010;11(12):1329-1337.

13.     Smith JD, Terpening CM, Schmidt SO, Gums JG. Relief of Fibromyalgia symptoms following discontinuation of dietary excitotoxins. Ann Pharmacother. 2001;35(6):702-706.

14.     Ursini F, Naty S, Grambiale RD. Fibromyalgia and obesity: the hidden link. Rheumatol Int. 2011;31:1403-1408.

15.     Ursini F, Naty S, Grambiale RD. Fibromyalgia and obesity: the hidden link. Rheumatol Int. 2011;31:1403-1408.

16.     Yunus MB, Arslan S, Aldag JC. Relationship between body mass index and Fibromyalgia features. Scand J Rheumatol. 2002;31:27-31.

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