Fibromyalgia: what diet is recommended?

People with  fibromyalgia  often suffer greatly from their condition. Since there are different treatment approaches but no uniform therapy concept, many of those affected wish to be able to do something themselves. The internet is often the first port of call. Here you will find numerous tips and advice that often deal with the topic of nutrition in fibromyalgia syndrome. From recipes to “forbidden” foods and  therapeutic fasting  to “healing through diet” – many guides promise relief through a change in diet. But what does science say about which diet is best for fibromyalgia?

Multimodal therapy in fibromyalgia

Fibromyalgia syndrome is a chronic disease in which, in addition to pain in different parts of the body (often muscle pain), numerous other symptoms such as  sleep disordersdepression  or problems in the gastrointestinal tract can occur. The causes of fibromyalgia are still not fully understood and a complete cure is currently considered unlikely.

The treatment is often based on the so-called “multimodal therapy”, which includes physical training in combination with relaxation therapy and psychotherapeutic procedures. Medications such as painkillers or antidepressants can sometimes be used temporarily.

Influence of diet in fibromyalgia not clarified

While the effectiveness of physical training and exercise therapy has been scientifically proven, there is still a lack of reliable study data on the influence of nutrition in the treatment of fibromyalgia.

A few small studies have been carried out that have examined the effect of different forms of nutrition on the symptoms of patients with fibromyalgia. However, the results did not provide any reliable proof of an effect, so that the S3 guideline for the treatment of fibromyalgia as of 2017 does not recommend a special diet. 1

Despite individual success reports, there is no special fibromyalgia diet that can help with certainty. If you still want to try out whether certain diets or foods help to relieve the pain in an individual case, you should consult a doctor if in doubt, for example to avoid deficiency symptoms caused by an unbalanced diet.Fibromyalgia: plant-based diet might help

Those affected often read the recommendation  to eat vegetarian  or  vegan  . In fact, studies were conducted in which pain relief was observed in patients who ate a vegetarian diet: In one study, the effect of vegetarian food was compared with that of the active ingredient  amitriptyline  . 2  Here, however, amitriptyline had a greater pain-relieving effect than diet.

In another study, some of the participants ate a low-salt, raw vegan diet and were compared with a control group that did not change their diet. 3  A positive effect of the change in diet on the symptoms was observed.

A 2021 meta-study systematically analyzed six studies on vegan or vegetarian diets in fibromyalgia. The results indicate that a predominantly plant-based diet could have positive effects on biochemical parameters, sleep quality, pain at rest, quality of life and general health. 4

Antioxidant diet in fibromyalgia

Another frequent recommendation is based on the assumption that the so-called oxidative stress is increased in people with fibromyalgia syndrome. An antioxidant diet could therefore help to neutralize free radicals and reduce oxidative cell stress. Fruit and vegetables in particular are rich in antioxidants, for example kiwis,  berries , tomatoes or beetroot, but also green  tea . However, scientific evidence for the effects of antioxidant nutrition in fibromyalgia syndrome is still lacking.Testing for intolerances may make sense

Another common piece of advice for fibromyalgia sufferers is to avoid certain foods, such as sugar. With regard to such generally forbidden foods, there are no studies that have examined their effectiveness in fibromyalgia.

In an American study, however, a test for food intolerance was carried out on a group of patients and, based on the results, a nutritional program was created with the avoidance of certain food components such as gluten. 5  In contrast to the no-diet control group, those in the diet-adjusted group reported that their pain was reduced by half.Study results should be viewed critically

In order to interpret these results correctly, however, one has to take a closer look at the structure of the studies: In the American study, the two groups compared consisted of 40 and eleven patients, respectively. In the two studies on vegetarian and vegan nutrition, the number of participants was similarly small. The researchers also pointed out that the results of the meta-study should be viewed with caution due to qualitative deficiencies and small numbers of participants in the analyzed studies.

One factor that contributes to the fact that the results of a study can lead to scientific evidence and thus to universally valid recommendations is a sufficiently large number of people who take part in the study. Therefore, the research results to date can at best provide indications of a possible influence of the investigated forms of nutrition on the symptoms of fibromyalgia.

In summary, it can be said that although some study data indicate that those affected could benefit from a predominantly plant-based diet, the data situation is not sufficient to enable reliable statements to be made.

Dietary supplements not recommended

Fibromyalgia sufferers are often advised to take supplements containing vitamins, L-carnitine (an amino acid compound) or magnesium. However, experts agree that no positive effect on the symptoms of fibromyalgia is to be expected.

In addition, certain preparations for dietary supplements can have side effects or be accidentally overdosed. You should therefore not take dietary supplements on your own, but only after consulting a doctor – for example, if a  vitamin deficiency  has been detected  by a  blood test . This is often the case when nutrient absorption   is impaired , for example by irritable bowel syndrome , or when pain in the masticatory muscles makes it difficult to eat.Fibromyalgia syndrome: try what is good for you

Even if the study situation so far does not allow any specific recommendations, many patients report positive experiences with a change in diet. Affected people can certainly benefit from changing their eating habits or from not eating certain foods, for example if they have intolerances or irritable bowel syndrome or if they are overweight.

For example, not eating cabbage can  reduce bloating  . Constipating or laxative foods can help with symptoms such as  diarrhea  or  constipation  . Eating late in the evening or drinking alcohol can also impair the quality of sleep, which is why adjusting meal times or avoiding alcohol can also have a positive effect.

However, there is  no universal meal plan  or “right” food and drink for fibromyalgia. Rather, everyone has to test for themselves what is good for them in culinary terms. However, extreme forms of nutrition, such as the restriction to low-salt, vegan raw food, carry the risk of an undersupply of nutrients.A balanced mixed diet is also recommended for fibromyalgia

In order to do something good for their health, fibromyalgia sufferers – like everyone else – should eat a healthy, balanced diet that can also contain sugar and animal products in moderation. Experts recommend a balanced, predominantly plant-based mixed diet based on the general recommendations of the German Society for Nutrition (DGE):

  1. Fruits and vegetables should make up the majority of your diet.
  2. It is better to use whole grain products than white flour.
  3. Sugar,  chocolate  and alcohol should only be consumed in moderation.
  4. Meat should only be on the table twice a week. Lean beef or poultry is better than fatty pork. Sea fish is recommended, fish should be eaten twice a week.
  5. Fat should also be consumed sparingly. Vegetable fats with a high proportion of polyunsaturated fatty acids are the best choice here.
  6. The need for protein should be covered by both dairy products and vegetable protein sources such as legumes.
  7. Drink enough, at least two liters a day is recommended.
  8. Be careful   not to drink too much coffee either. Many sufferers reach for the drink to drive away the constant tiredness. In larger quantities, however, coffee can have side effects and promote the development of osteoporosis or  restless legs syndrome  (RLS).

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