Dietary Recommendations for Fibromyalgia Patients

The following is a series of practical dietary recommendations for the fibromyalgia patient written by Katie Holton, MPH.

It is no surprise that many people find it challenging these days to know how to eat healthy, much less how to lose weight. We are bombarded with conflicting information that we are left to wade through on our own. This article will give you some solid strategies that you can use no matter if your quest is to lose weight or just to improve your diet in the hopes of improving your fibromyalgia symptoms.

1. "Diet" just means "what you eat." There are plenty of diet fads being advertised these days that tell people how to drastically change their diets if they want to look like a model. If you go "on" a diet to lose weight, what do you expect to happen when you go "off" the diet? To optimize health and to lose weight, you really need to alter your thinking toward a gradual change of eating habits for the long-term.

2. The 90 percent-10 percent rule. Think about eating optimally 90 percent of the time, and that 10 percent of the time you can be a little more lax. Trying to lose weight is not like recovering from alcoholism. You cannot fall off the wagon! But what you do the majority of the time will drive your success or impede your progress.

3. Focus on balance. The fad weight-loss diets that tell you to remove one of the macronutrients (namely carbohydrates or fat) are easier to follow, not from an eating standpoint, but just by the simple fact that it is easy to tell if something is

"in" or "out." Unfortunately, your body needs all three macronutrients, and removing or increasing one of them will always result in an imbalance that puts your body at risk. Not all carbs, proteins, or fats are created equal, so the choices you make in each area matter. For carbohydrates, focus first on vegetables, whole fruit (not juice), and beans which are most nutrient dense. Then choose small amounts of whole-grain products, trying to limit/remove all foods containing refined grains like white flour and sugar. For fat, avoid trans fats, which are found in processed foods, and limit your intake of saturated fats, which are found in animal fat, such as lard, butter, cheese, whole milk, ice cream, and meat. Make low-fat choices for dairy and buy the leanest cuts of meat you can find. Increasing omega-3 fatty acids has been shown to benefit health greatly. So increase your consumption of cold-water fish like wild (not farm-raised) salmon, walnuts, grain products with ground flax seed, and eggs which are labeled higher in omega-3s. High-quality, nutrient-dense foods should be your goal.

4. Avoid additives. This point is very important! A quick and easy rule of thumb is to look at all ingredient lists, and if they are long and contain chemical names that are difficult to understand, don't eat it! There are many chemicals added to our food: preservatives, artificial colors and flavors, and flavor enhancers. These all could have long-term effects on health, and some will affect both cravings toward a food item and how you feel after eating them. Search for foods with very few ingredients that you can read without a PhD. Tip: Be wary of sauces and mixed spices. Try using simple vinaigrettes for your salad as opposed to processed dressings like ranch or Caesar.

5. Avoid artificial sweeteners. Our bodies adapt to exposures. If a person eats sugar on a daily basis, they will find themselves craving sugar on subsequent days. Artificial sweeteners are actually much sweeter than sugar and make the body crave sweetness even more than sugar. This increases cravings, which in turn hampers weight loss. By removing all artificial sweeteners from the diet and by limiting your intake of sugar (especially high-fructose corn syrup), you can actually increase your body's ability to taste sweetness in healthy foods, like vegetables and fruit. Watch out for gum, breath mints, and medications which all can be hidden sources of artificial sweeteners. You can find safe versions of these at your local health food store, but still be careful to read labels as not all items at the health food store are safe.

6. Keep a diary. Don't worry; you don't have to count calories! Simply keeping track of what you eat, when you eat it, and how you feel in the hours afterward can help you greatly in identifying patterns in your eating and reactions to certain foods. This is especially important for those with fibromyalgia, whether weight loss is a desired goal or not. This habit will help you be more aware of food-induced sensations (GI disturbance, fatigue, cravings, etc.) and will help reinforce how great you feel when eating whole, unprocessed foods like vegetables and fruits. When eating out, add the name of the restaurant and meal eaten in your diary to help you find places that aid you in your healthy eating.

7. Don't increase carbohydrate intake to increase energy levels. Everyone knows that carbs are the body's energy source, so many mistakenly think that increasing the amount of carbs they eat will give them more energy and ease the fatigue associated with fibromyalgia. This can lead to spikes in blood sugar that cause a corresponding "low" blood sugar period. In a state of hypoglycemia (low blood sugar) the body feels the need to regulate itself back to "normal." You may feel shaky and weak, have foggy thinking, and will crave simple sugars. If items with simple sugars are eaten, it can actually re-spike the blood sugar, with temporary relief, but then the same pattern continues. Instead, think of eating foods together in a balanced manner. Some examples of this would be eating an apple with natural peanut butter (short list of ingredients would be peanuts and salt), soybeans (which are naturally balanced), or eggs and fruit for breakfast. Think of aiming for a little protein, fat, and carbs (preferably high in fiber) at every meal and snack. This will help slow the rise in blood sugar and prevent the spikes and dips. The two hardest times of day for most people are breakfast and snacks. Many breakfast foods in the United States tend to be very high in simple sugars (cereals, pancakes, pastries, etc.) and should be avoided. Better choices are things like slow-cooking oatmeal with milk or plain yogurt with frozen berries and wheat germ added.

8. Careful with caffeine. It is common to want to try to self medicate with caffeine in order to attempt to improve fatigue symptoms. Be cautious of doing so, as it can lead you into a vicious cycle of poor sleep habits. If a person is feeling fatigued in the afternoon or evening and then has caffeine, it can keep the person from entering their deep sleep at night, which then results in increased tiredness (and need for sleep) the next day. This cycle can be perpetuated over time with gradual decreases in function caused by inadequate sleep. This can increase fibromyalgia symptoms and should be avoided.

9. Special note about medications. Many fibromyalgia medications cause gastrointestinal symptoms. Pay special attention to how you feel after taking medications and note effects on appetite and GI function. Some symptoms may be caused by your medication and may be alleviated with a change in your prescription. If you feel like you are having difficulty eating properly, you may also be deficient in many nutrients that your body needs on a daily basis, which inhibits healing, sleep, and daily function. If dietary changes result in improvements in your symptoms, you may be able to discuss weaning off medications with your health care provider.

Overall, remember that nothing influences your health as much as diet. And most important, it is something that is completely under your control. Take back your health using the approaches outlined earlier. Eating healthy is about making slow, steady changes in the right direction, not about suddenly starting a new

"diet" that won't be continued for the long run. Give yourself small goals like replacing all beverages during the day with water. Then add to this the next week with another small goal. And then reward yourself with a new outfit or a special trip to celebrate your weight loss or how great you feel!

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