THE ROLE OF NUTRITION IN FIBROMYALGIA

The term fibromyalgia means pain in muscles and fibrous connective structures (ligaments and tendons). This condition is called "syndrome" because there is a complex of clinical signs and symptoms that are associated in order to configure the characteristic picture, which can be caused by different pathophysiological processes. Read this article to know what it is and what is the role of nutrition in this syndrome.

What is fibromyalgia?

Fibromyalgia (FM) is a complex, multifactorial syndrome characterized by widespread chronic pain and a constellation of somatic and psychological manifestations, including fatigue, joint stiffness, sleep disorders, depression, anxiety, gastrointestinal and cognitive disorders. The disease can arise at any age, with a prevalence in women. 

Currently, no predisposing gene has been found, but it has been reported that several environmental factors, such as psychological and physical trauma or certain infections, can trigger development and influence the severity of fibromyalgia through epigenetic mechanisms.

Can nutrition have effects on fibromyalgia?

Researchers hypothesize a potential beneficial use of probiotics in the treatment of fibromyalgia because there have been several studies to support the intake of vitamins and minerals in FM. In this regard, the scientific evidence focuses mainly on vitamins D, C, and E and on minerals, such as Magnesium and Iron. In particular, some evidence suggests that vitamin D supplementation should be considered in the management of FM in light of the fact that about 40% of FM subjects have been reported with vitamin D deficiency.

Antioxidant vitamins such as vitamin C and vitamin E can play a beneficial role in the management of certain typical symptoms of FM since they are useful for preserving the cerebellar functions, memory, emotive responses as well as muscle function.

Regarding the mineral status, magnesium deficiencies were largely associated with low-grade inflammation, muscle weakness, and paresthesia, which are typical symptoms of FM. A recent study has shown that low dietary magnesium intake is correlated with worsening pain threshold parameters in FM patients.

What are the benefits of a specific diet?

Specific diets can be useful to correct any nutritional deficiencies. The nutritional strategies most taken into consideration are the Mediterranean diet, vegetarian diet, gluten-free diet, and low-calorie diet.

• Mediterranean diet. Among the eating patterns mentioned above, only a little evidence is available on the possible beneficial effects of the Mediterranean diet on FM.
• Vegetarian diet. Otherwise, vegetarian diets are characterized by large amounts of plant foods rich in fiber, vitamins, minerals, and antioxidant elements, leading to the hypothesis that this dietary pattern may exert pain-relieving effects in FM patients, due to its antiinflammatory properties and absence (or reduction) of animal proteins.
• Gluten-free diet. An important observation is a correlation between FM and a gluten-free diet, for the improvement of gastrointestinal symptoms. FM patients often have gastrointestinal symptoms that significantly overlap with various gluten-related disorders such as nausea, abdominal pain, fatigue, tiredness, chronic pain, and mood disturbance, suggesting a possible coexistence of non-coeliac gluten sensitivity in such patients.
• Calorie restriction. Finally, calorie restriction is suggested as a winning strategy for reducing body weight, a situation that certainly plays an important role in some diseases related to inflammation.

And specific food?

Additionally, some foods such as olive oil and ancient grain products have been considered for the natural beneficial effects they could bring to fibromyalgia.

• Extra virgin olive oil is able to bring benefits to the disease by exploiting the antioxidant power, as well as the ability to protect DNA, proteins, and lipids from damage caused by exposure to reactive oxygen species (ROS), which in turn are increased in FM patients.
• Among the ancient grains, the Khorasan one has attracted attention for the higher content of macro and microelements, in particular magnesium, phosphorus, potassium, selenium, and zinc, as well as carotenoids and polyphenols, compared to modern wheat.
• It is useful to consume foods that are able to alkalize the intestinal environment and contain inflammation, such as vegetables in general, fruits and in particular red fruits with a high content of antioxidants.
• Another important aspect is to improve the intestinal microbiota by taking probiotics and prebiotics, so as to prevent harmful microorganisms, favored by the increased intestinal permeability typical of fibromyalgia, taking over or involving other organs.
• It is important to limit the intake of soft drinks, sugary drinks, and cocktails due to the sugar content. Pay attention to caffeine, present in drinks and coffee. They can be appreciated by many patients suffering from fibromyalgia as an important source of immediate energy to combat fatigue, but then they risk getting tired as soon as the temporary stimulating effect wears off.

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