Dietary Interventions in the Management of Fibromyalgia: A Systematic Review and Best-Evidence Synthesis

• Published in: Nutrients 2020-08, Vol.12 (9), p.2664
• Main Authors: Lowry, Ethan, Marley, Joanne, McVeigh, Joseph G, McSorley, Emeir, Allsopp, Philip, Kerr, Daniel
• Format: Article
• Language: English
• Subjects: Acetyl-L-carnitine; Acetylcarnitine - pharmacology; Algae; Aquatic plants; Ascorbic acid; Ascorbic Acid - pharmacology; Carbohydrates; Carnitine; Chlorella - metabolism; Chronic fatigue syndrome; Clinical trials; Coenzyme Q10; Diet; Diet, Vegan; Dietary Supplements; Fermented Foods; Fibromyalgia; Fibromyalgia - diet therapy; Fibromyalgia - drug therapy; Heterogeneity; Humans; Intervention; Irritable bowel syndrome; Mental health; Nigella sativa - chemistry; Nutrition research; Pain; Pain - diet therapy; Pain - drug therapy; Pathophysiology; Phytotherapy; Polyols; Quality; Quality of Life; Randomized Controlled Trials as Topic; Review; Saccharides; Seeds - chemistry; Sleep; Systematic review; Treatment Outcome; Ubiquinone - analogs & derivatives; Ubiquinone - pharmacology; Veganism; Vegetarian diet; Vitamin E - pharmacology
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu12092664

Fibromyalgia syndrome (FMS) is characterised by chronic widespread pain alongside fatigue, poor sleep quality and numerous comorbidities. It is estimated to have a worldwide prevalence of 1.78%, with a predominance in females. Treatment interventions for fibromyalgia have limited success, leading to many patients seeking alternative forms of treatment, including modifications to their diet and lifestyle. The effectiveness of dietary changes in fibromyalgia has not been widely researched or evaluated. This systematic review identified twenty-two studies, including 18 randomised control trials (RCTs) and four cohort studies which were eligible for inclusion. In total these studies investigated 17 different nutritional interventions. Significant improvements in reported pain were observed for those following a vegan diet, as well as with the low fermentable oligo di-mono-saccharides and polyols (FODMAP) diets. Supplementation with green algae, coenzyme Q10, acetyl-l-carnitine or a combination of vitamin C and E significantly improved measures of pain. Interpretation of these studies was limited due to the frequent poor quality of the study design, the wide heterogeneity between studies, the small sample size and a high degree of bias. Therefore, there is insufficient evidence to recommend any one particular nutritional intervention for the management of fibromyalgia and further research is needed.