Is There a Fibromyalgia Diet?

Sharon Clark PhD
(President of the Oregon Fibromyalgia Foundation)

There are as many diets for FM as there are people who “swear by theirs”.  Some of these are ones that at least one person has found to be of help.  Others are touted by those who have a magic product or a book to sell to you.  Sorting through these can be daunting.  To further muddy the waters; the answer to this question is yes, but not the same for all.  The reason is owing to the fact that each one of us is unique.

Each of us is unique; just like everyone else.

Searching the literature for the scientific studies relating nutrition to FM may take some time.  Reading the small number of articles found will not take much time. 

During this discussion we will explore how each person can use the information available in 2004 to develop an individual diet to aid in the management of their FM.

Firstly-the data:

1.       Azad et al reported on 37 subjects with FM enrolled in a vegetarian diet compared to 41 FM subjects who took amitriptyline.  A decrease in pain reported by the vegetarian group was smaller than by the amitriptyline group.

2.       Donaldson et al reported on 30 people with FM who participated in a dietary intervention of a raw pure vegetarian diet (raw fruits,salads,carrot juice,tubers,grain products,nuts,seeds,dehydrated barley grass juice product).  26 reported at 2 months; 20 reported at end of 4 months.  Improvement was reported at end of 2 and 4 months but not at 7 months.

3.       Kaartinen et al reported on a low salt vegan diet consumed over a 3 month period.  18 FM subjects ate the study diet; 15 continued their usual diet.  The vegan diet subjects had greater improvements in pain,sleep, general heath assessment than did the usual diet group.

4.       Smith et al reported on 4 persons with FM who eliminated MSG, or MSG and aspartame from their diet had improvement in symptoms.

There is little evidence base for changes in diet for persons with FM.  The scientific base is therefore more of hypotheses extracted from what we do know.  In 2004, we have sufficient evidence to support that central sensitization is a major physiological factor in FM.  Thus we will shift the focus to considerations related to central sensitization.

A possible link does exist between MSG and aspartame and central sensitization as they contain molecules glutamate and aspartate) that act as excitatory neurotransmitters that may “tweak” the nervous system relating to pain transmission.  It may, therefore be of benefit to eliminate them from your diet.  If not fully eliminated, consumption should be kept to a minimum.  In addition each has had symptoms reported related to their consumption.  The most commonly reported symptoms related to aspartame are headache, dizziness, change of mood, abdominal pain and change of vision.  The most products are diet soft drinks, sweeteners (Equal, Nutrasweet), puddings and gelatins.

Monosodium glutamate (MSG) found in soups, salad dressings, processed meats, some crackers, bread, canned tuna fish, most frozen entrees, ice cream and frozen yogurt.  MSG is in many low fat foods to make up for the flavor lost with the elimination of fat.

Another dietary consideration is those foods that cause bloating, abdominal pain.

GI SYSTEM AS PAIN GENERATOR   

                           Pain arising in from internal organs
                           is a potent "peripheral pain generator"
                           that will aggravate the "central sensitization"

                           of fibromyalgia

Foods on the  GI “suspect” list:

1.                   Gluten  

2.                   Dairy products

3.                   Corn

4.                   Sugar

5.                   Nightshade family

6.                   Tea

7.                   Coffee

8.                   Alcohol

9.                   Insoluble fiber

10.               Eggs

11.               Beef

12.               Simple carbohydrates

What about fiber?

Soluble and insoluble fibers tend to affect the GI system differently.  Soluble fibers help in transit time; insoluble fibers may worsen GI symptoms.

Headaches
 

Another potential relationship between food and the symptoms of fibromyalgia is with the foods known to aggravate headaches.

Foods on the headache “suspect” list

1.                                        Cheese

2.                              Chocolate                                        

3.                                        Citrus fruits

4.                              Hot dogs

5.                                        MSG (monosodium glutamate)

6.                                       Aspartame (artificial sweetener)

7.                                         Ice cream
                     Red wine

What about carbohydrates?

Favorable versus unfavorable, poor choices?

Net carbs

Hidden carbs

FAD DIETS

What is the right diet for me?

How to be your own study with a sample of one.

1. Food diary

2. Symptom association

3. Elimination

4. Challenge and  rechallenge testing