The Fibromyalgia Diet (Part 2): Food Type

Note: This is the second article in an ongoing series. Make sure to check out the other articles after finishing this one:
Hippocrates said: “Let food be thy medicine and medicine be thy food.” While fibromyalgia wasn’t a known condition in his time, the wisdom of a bygone era may be helpful in modern times.
Fibromyalgia (FM) is a common cause of chronic widespread musculoskeletal pain. It is often accompanied by fatigue, brain fog, and depression. What’s most confusing about fibromyalgia is that despite symptoms of pain affecting the muscles, ligaments, and tendons there is no evidence of any swelling or inflammation in those tissues. (1) Instead, the inflammation seems to be generalized. Meaning that it is not located in one specific area of the body.
Could certain food types be triggering the generalized inflammatory pathways commonly seen in fibromyalgia?
Current medical research suggests that the best way to treat fibromyalgia is to combine therapies. Treatment of fibromyalgia has not been effective using only one therapy — be it medication, diet, or mindfulness practice. Instead, these therapies should be combined to ensure the best chance of success. Among drug-free treatments, dietary intervention is a promising approach. (2)
While your doctor may prescribe medication useful for alleviating pain, combining that medication with an anti-inflammatory diet will likely increase the success rate. Below, I’ll describe the best foods avoid in order to successfully treat fibromyalgia.
Nutrition 101
The general rule to follow in nutrition is that there is no general rule.
Each of us has a unique genetic background. The areas where your ancestors inhabited is likely different from mine. The geographical location of our ancestors dictated the foods they had available. After eating the same foods for many generations, their genes have adapted to consume a very specific group of foods. These are the genes they have passed down to you. The foods they thrived on are the same foods you will thrive on.
Being exposed to specific types of food for long periods of time eventually creates an adaptation. This is why some cultures like the Inuit First Nations consumed a diet that was nearly ninety percent animal products. (3) Contrast this with the Tukisenta tribe of New Guinea where their diet consisted almost solely of carbohydrates. (4) You can imagine that the genetics for each culture is different. Both have adapted to thrive on a diet native to their geographic location.
The same holds true today. There are foods we tolerate well and others that do not fit our genetic makeup. Remember, these are unique to you. In order to best determine the foods you tolerate, food sensitivity testing or a performing a reset diet are recommended. This can help fine-tune the specific foods your body tolerates.
What foods cause inflammation?
For those with fibromyalgia, the initial dietary changes don’t need to be super specific. Instead, there are general categories of foods that are known to cause inflammation. If you have been diagnosed with fibromyalgia, it is recommended that these foods be completely eliminated from your diet. (5)
Below, I detail the common culprits found in a typical North American diet:
Foods with a high GI index
Glycemic index (GI) relates to the ability of a food (carbohydrates specifically) to increase blood sugar level.
Diets with relatively high glycemic index (GI) and glycemic load (GL) have been associated with elevated risk of coronary heart disease, stroke, and type 2 diabetes mellitus, particularly among overweight individuals. (6)
I talk about how foods affect blood sugar extensively in this post. When the body is challenged to regulate blood sugar, large amounts of stress hormones (like cortisol) are released in response.
This stress-response can create an environment that challenges the body from healing itself.
In general, foods with a high GI will be prone to causing inflammation. (7) For those with fibromyalgia, eating foods with a lower GI index is always a good plan. Sticking to low GI foods will also help reduce the number of refined and processed products you consume.
You can find a list of the glycemic index of common foods here.
Processed & artificial sugars
Simple, refined sugars greatly affect blood sugar levels. In turn, this affects insulin and cortisol levels. For more detail on the pathways involved, please read this post. Altered cortisol levels have been shown to increase pain. (8)
It goes without saying that for those suffering from chronic pain, such as fibromyalgia, limiting the intake of sugars is paramount to successful management of the condition.
Keep in mind that grains (especially refined grains like bread) are metabolized very similarly to sugars. This would also include organic unprocessed grains.
More and more research is being published on the negative effects of artificial sweeteners. Unfortunately, using them in place of refined sugars is not the panacea we originally thought. In this post, I shed light on the negative aspects of using artificial sweeteners.
For those with fibromyalgia, stick to natural sweeteners like maple syrup and honey.
Fat type
In general, fats come in 4 different types:
- Saturated fat
- Butter and coconut oil
- Unsaturated fat
- Both monounsaturated and polyunsaturated fats are a type of unsaturated fat.
- Monounsaturated fat
- Olive and avocado oil
- Polyunsaturated fat
- Vegetable oils
Like carbohydrates and proteins, fats are an essential macronutrient found in our diet. Fats are composed of fatty acids. Think of fatty acids as building blocks to fat. (9)
You’re likely familiar with fatty acids in the form of Omega-3 and omega-6 fatty acids. These are called polyunsaturated fatty acids. They’re called omega because their chemical structure ends in an “omega”. More on that here.
Ideally, the ratio of omega-3 to omega-6 fat intake is 1:1. However, the average Canadian ratio is 10:1. (10) The Institute of Medicine (IOM) recommends levels be no higher than 5:1.
An imbalance in the omega-3:omega-6 ratio in tissues and blood can have adverse effects, including the release of inflammatory proteins. The end result is low-grade, chronic inflammation. (11)
The easiest way to improve your ratio is by eating more omega-3 fats. Some of the best sources of omega 3 fats include:
- Flaxseeds
- Walnuts
- Fatty fish (salmon, mackerel, herring)
- Fish oils (cod liver oil)
- Hemp seeds
- Egg yolks (from
In the beginning, try to add at least one serving 3x/week of any of the above-listed sources. This can be as simple as eating fish for dinner once a week and adding hemp or flax seeds to your morning breakfast.
Nightshades
There is a lot of controversy over whether nightshades cause inflammation. For those of you not familiar with nightshades, they’re members of the Solanaceae family.
Some common examples of nightshades include:
- White potatoes
- Eggplant
- Tomatoes
- Peppers (both chilies and bell peppers)
- Spices made from peppers (paprika, red pepper flakes, and cayenne pepper)
At the time of this writing, there are no scientific studies done on whether nightshades help with chronic illnesses. However, there are thousands of anecdotal reports claiming that the removal of nightshades improved symptoms. (10,11)
An elimination diet focused on nightshades may be enough to determine if their removal helps your symptoms. Try eliminating nightshades from your diet for 30–60 days. Then, reintroduce 1 nightshade back into the rotation. Make notice of change in symptoms. If there are no changes after 3 days, add another nightshade back into your diet.
Continue in this way until all varieties of nightshades are back in your diet. If your symptoms remain the same, it’s likely that nightshades are not a contributing factor.
General dietary guidelines for fibromyalgia
Ok, now you know the types of food best avoided for those with fibromyalgia. Below, I’ll outline the general dietary recommendations we implement at the clinic for those dealing with chronic pain.
- Eat a moderate-carbohydrate diet:
Many patients with fibromyalgia have adrenal fatigue. Those with adrenal fatigue (or, hypothalamic pituitary adrenal axis dysfunction) often face problems with blood sugar regulation, resulting in low blood sugar, or sometimes a combination of high and low blood sugar.
Focus on a moderate carbohydrate diet, which means about 15 to 30 percent of your calories coming from carbohydrates (100 grams of carbohydrates on a 2,000-calorie diet or 125 grams on a 2,500-calorie diet).
- Adopt a gluten-free diet
Fibromyalgia and irritable bowel syndrome share some sort of relationship. Though, at the time of this writing, we’re not exactly sure what that is. However, fibromyalgia is present in 20–32% of people with IBS. (12,13) IBS has been found in 32–70% of people with fibromyalgia. (14)
In a year-long study involving eating a diet free from gluten, it was found that fibromyalgia sufferers improved their symptoms by nearly thirty percent. Just from adopting a gluten free diet. (15)
Suffice it to say, going gluten-free is likely to help your symptoms. For a deeper dive on gluten’s relationship to fibromyalgia, see next week’s post.
- Eat adequate protein, especially in the morning:
Higher-protein diets reduce food cravings and have a regulating effect on blood sugar. You should eat at least 15 percent of total calories as protein (75 grams of protein on a 2,000-calorie diet or 95 grams on a 2,500-calorie diet). You should also eat a high-protein breakfast (40 to 50 grams). This has a stabilizing effect on blood sugar throughout the day.
- Eat frequently throughout the day:
To keep blood sugar levels stable, you should either eat five or six small meals per day or three regular meals with snacks in between. Choose whichever approach suits your preference and lifestyle best. Snacks and meals should always have some protein and fat, never just carbohydrates alone.
The exception to this rule occurs if you have high blood sugar. In this case, stick to 3 meals per day.
- Avoid caffeine and alcohol:
Caffeine is a stimulant, and it places additional stress on the body. Alcohol stresses the liver, which often functions sub-optimally in fibromyalgia. It’s best to avoid caffeine entirely and either limit alcohol consumption to 2–3 drinks per week or avoid it completely.
Ok, now you know which foods are best to avoid while healing from fibromyalgia.
Now I want to hear from you!
What foods have you found trigger your symptoms?
Originally published at Flourish Clinic.
