The Myalgic Encephalomyelitis / Fibromyalgia Society of Alberta

~Fibromyalgia Network, July 2008

Trying to lose weight by following fad diets or taking supplements from manufacturers who make outrageous claims? It may be time to step back and look at a bigger, healthier picture.

The U.S. Department of Agricul- ture recently modified its recom- mended “food pyramid” to emphasize fruits, vegetables, whole grains, and milk products. But patients with fibromyalgia (FM) who try to eat healthy, may be making themselves sicker. After all, if FM patients are hypersensitive to medications, physical exertion, weather changes, hormonal fluctuations, pain, and infections, then an unbalanced diet may be causing more problems. So, what is “the proper” diet for FM patients?

Joel S. Edman, DSc, FACN, a clinical nutritionist in private practice has been working with patients for more than 18 years. He has developed diet and lifestyle programs for people with a wide range of medical issues, including FM, and focuses on reason- able dietary plans that are individually tailored for each patient’s needs.

In a small pilot study with FM patients on a food elimination diet, half reported a significant reduction in pain. Three-quarters reported improvements with a variety of symptoms including headaches, fatigue, gastrointestinal discomfort, shortness of breath, sleep disturbances, and hives.l “The data suggests that food intolerances can significantly affect FM pain as well as other symptoms,” says Edman, who is also director of the Integrative Nutri- tion Program at the Jefferson-Myrna Brind Center in Philadelphia.

Tests for Food Allergies

Food allergy tests can be expen- sive, unreliable, and seldom covered by insurance. The most accurate and dependable way to confirm food allergies is through a food elimination! challenge diet.2 In the diet, you eliminate all suspected food culprits and then reintroduce them one by one to determine how your body responds. It may take up to two or three months to complete the diet, but the benefits should be worth your time.

Out of Balance

Allergic reactions to foods are not the only dietary factors that impact your health. Edman says FM patients should be aware of the important influences that blood sugar regulation and anti- inflammatory effects have on diet. Indeed, some foods may work as “good medicine” to help reduce pain and inflammation, while others may do the opposite. For example, saturated fats (solids) tend to promote inflam- mation while omega-3 fatty acids tend to be anti-inflammatory.

“If a person’s blood sugar drops, extra adrenaline and stress hormones are released into their bloodstream,” says Edman. “This puts stress on the entire system, which may influence immune function and a person’s food intolerance threshold.”

When under stress, certain foods can contribute to a toxic load or allergenic threshold, throwing the body out of balance, says Edman. Once the level of tolerance or threshold is breached, the imbalance often is conveyed as gastrointestinal distress, headaches, fatigue, and pain. After your systems are leveled out, certain foods or food groups that seem to cause problems can be reintroduced back into the diet in moderation or enjoyed on special occasions.

The Bigget Picture

In addition to food and nutrition, Edman emphasizes that a more holistic approach to well-being should precede any food elimination therapy, as dietary restrictions are often stressful. “People with FM can be very sensi- tive. The level of tolerance in someone.

A Step by Step Approach

• Consult with your doctor, nutritionist, or other health practitioners.
• Incorporate physical activity and relaxation therapy to reduce stress.
• Prepare to shop and plan meals more appropriately.
• Restrict and Rotate Level I foods (sugar, dairy, wheat, alcohol, and caffeine).
• Eliminate Level I foods.
• Discuss with your practitioner whether to continue to the next level.
• Restrict and Rotate Level II foods (peanuts, soy, other gluten grains like barley and rye, citrus, eggs, and com).
• Eliminate Level II foods.
• The Challenge: Incorporate foods back into your diet one by one and note any symptoms.
• Maintenance: When your symptoms flare, return to a more restrictive diet.
• Cleanse out your system a couple times a year to re-establish a good foundation.