Fibromyalgia: What to Eat, and What to Avoid

The foods you eat can have a big impact on how you feel, and that’s especially true when you are trying to manage a health condition like fibromyalgia.

Nutritional neuroscientist Kathleen Holton, PhD, a provost associate professor of health studies at American University in Washington, DC, has researched the effects of a variety of dietary components and nutrients on the brain, and she’s developed specific guidelines to help people with fibromyalgia better manage their condition through what they eat.

“No drug on the market is as important to optimal health as a well-balanced and healthy diet,” Dr. Holton says. “While many people like to call nutrition ‘alternative medicine,’ in reality it is the basis of all human health. We can’t be optimally healthy without giving our bodies the nutrients they need, and that applies to anyone with fibromyalgia.”

Holton’s research has focused largely on the effects of dietary excitotoxins, chemicals that “excite” neurons in the brain and which can be toxic if consumed in excess. The most common forms of dietary excitotoxins in the Western diet are additives that are used to enhance or sweeten the flavor of foods.

Glutamate is a neurotransmitter that occurs naturally in the body and in some foods, but which is also added to foods as a flavor enhancer.

The most common form of dietary glutamate is monosodium glutamate (MSG), which is required to be listed on the label when it’s included in foods.

Ingredients that include the terms “hydrolyzed,” “autolyzed,” “protein concentrate,” or “protein isolate” are also likely to contain naturally occurring monosodium glutamate.

In a past small study, people with fibromyalgia and irritable bowel syndrome — which is common in people with fibromyalgia — followed a diet free of added MSG and aspartame for four weeks. Most reported that more than 30 percent of their fibromyalgia symptoms resolved during that time. Those whose symptoms improved then consumed either MSG or a placebo for three consecutive days per week for two weeks. The group assigned to the MSG test experienced a significant return of symptoms.

Foods that commonly contain MSG include canned soups and vegetables, some types of chips and similar crunchy snacks, and processed meats. To avoid MSG and other sources of added glutamate, read food labels carefully, and don’t buy products that include MSG or other ingredients that are high in glutamate.

Steer clear of processed foods, and choose more whole foods instead, advises Holton.

Processed foods typically have more additives, unhealthy fats, added sugar, less fiber, and fewer nutrients, compared with unprocessed foods. Processed foods, such as packaged snacks, frozen meals, and sugary drinks, have been linked to inflammation in the body.

Researchers have been investigating the complex relationship between inflammation and fibromyalgia, and the evidence suggests a significant link between inflammation and the development of pain, fatigue, and other symptoms of the condition.

By contrast, dietary fiber from whole grains, fruits, vegetables, and other plant-based foods may alter gut microbiota in ways that ease fibromyalgia symptoms.

Refined carbohydrates — such as white flour, white pasta, and white rice — are examples of processed foods that have been stripped of naturally occurring nutrients. When choosing carbohydrate-containing foods for your meals, choose whole grains such as quinoa, amaranth, whole wheat berries, buckwheat groats, and brown or wild rice, or have a sweet potato or a plain potato in place of bread, pasta, and rice.

Both the DASH diet (Dietary Approaches to Stop Hypertension) and Mediterranean diet have been shown to have real health benefits, including lower blood pressure and cholesterol.

The two diets are slightly different in their specifics, but both are rich in fruits and vegetables, lean proteins, whole grains, nuts, seeds, legumes, and low-fat or nonfat dairy foods.

Many components of these diets reduce inflammation in the body, which research suggests can be helpful in controlling many chronic conditions, including fibromyalgia.

When you buy meat, avoid processed products with added salt or preservatives, as well as meats that have been smoked or cured. That includes canned meat, sausage, bacon, hot dogs, ham, deli meat, corned beef, and beef jerky.

Also beware of meat products with the words “natural flavor added” on the label. An example of such a product is turkey breast infused with broth (to give it more flavor). Natural flavors are derived from natural sources, such as plants, meats, and seafood, but they may be high in naturally occurring monosodium glutamate.

Research shows that vitamin D deficiencies are more prevalent in people with fibromyalgia, and lower levels of vitamin D are associated with higher levels of pro-inflammatory cytokines (proteins that trigger or increase inflammation).

A study involving 180 women with fibromyalgia found that 12 weeks of vitamin D supplementation reduced pain and improved quality of life.

You can get vitamin D naturally from swordfish, tuna, sockeye salmon, and eggs. And some foods, such as orange juice and milk, are often fortified with vitamin D. Vitamin D can also be taken as a supplement, including as cod-liver oil, which provides both vitamin D and omega-3 fatty acids.

Spending time outside also increases your body’s vitamin D levels, although too much sun exposure increases the risk of skin cancer and certain eye diseases.

Magnesium can reduce inflammation and pain associated with fibromyalgia, and people with fibromyalgia often have low magnesium levels. Research suggests that the benefits of magnesium are associated with the role it plays in preventing central sensitization, thought to be the primary mechanism underlying fibromyalgia.

While studies have had conflicting results, some research has shown that magnesium citrate and amitriptyline (a tricyclic antidepressant) supplementation can alleviate symptoms associated with fibromyalgia and that many people with fibromyalgia experience symptoms of magnesium deficiency.

“Magnesium is necessary for helping to prevent the excitotoxicity caused by glutamate,” says Holton.

Magnesium is found in many healthy foods, including legumes (dried beans and lentils), nuts and seeds, avocados, yogurt, bananas, fatty fish, dark chocolate, and dark, leafy greens.

Omega-3 fatty acids may reduce levels of oxidative stress. They may also lower inflammation and boost immunity. Oxidative stress takes place when the body has too many free radicals, or unstable molecules, that damage cells. It is implicated in the development of many medical conditions.

Omega-3s are abundant in wild-caught seafood, walnuts, chia seeds, and flaxseed. They can also be taken as a supplement.

However, omega-3 capsules are not recommended, since they contain gelatin, which contains the amino acid aspartate. Aspartate may activate a glutamate receptor on nerve cells that’s implicated in fibromyalgia. Gelatin also contains glycine, a coactivator of that receptor.

To combat the effects of dietary excitotoxins on fibromyalgia symptoms, you may need more antioxidants in your diet, as excitotoxins also create oxidative stress.

“To keep this simple, look for foods that add color to your diet, in the fruits and vegetables category,” says Holton. “Focus on increasing consumption of items with bright red, green, orange, yellow, and purple hues to give yourself an antioxidant boost.” Fruits and vegetables, beans, legumes, nuts, seeds, and whole grains are plant-based foods that are good sources of antioxidants.

If the ingredients list on a food packaging label is long and complex, put the product back on the shelf, Holton advises. You may not see “glutamate” on that label, but it may still contain other additives that include hidden glutamate. Pick products with labels that are short, easy to read, and only include ingredients that you could add to a dish when cooking.

Holton recommends avoiding artificial sweeteners such as aspartame, acesulfame-K, saccharin, and sucralose. Use regular sugar or honey, sparingly, to sweeten foods.

“It’s much easier to wean yourself off sugar if you aren’t using artificial sweeteners,” she says. “As you cut back on sugar, you’ll taste the sweetness in foods more easily. Even stevia is hundreds of times sweeter than sugar — which makes you want more sweetness in your food.”

For general good health, avoid high-fructose corn syrup. When you’re fatigued from fibromyalgia, don’t choose sugar or corn-syrup alternatives to boost energy. A high intake of added sugars increases the risk of weight gain, diabetes, and other inflammatory diseases, including heart disease and cancer.

“Research suggests excitotoxicity requires a great deal of energy in the body,” says Holton. “High sugar intake may ‘fuel’ this process.” Sugars and artificial sweeteners are also inflammatory.

Adopting a fibromyalgia-friendly diet — by focusing on whole, unprocessed foods and avoiding glutamate, cured meats, and artificial sweeteners — may help reduce your symptoms.
Eating approaches such as the DASH diet or Mediterranean diet can help you consume more nutrient-rich foods that support overall health, such as fish, as well as antioxidant-rich fruits and vegetables, beans, legumes, and nuts and seeds.
For maximum benefits, try to fill your meals with colorful, natural ingredients, including those that provide good amounts of omega-3 fatty acids.

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