Investigation into the dietary habits and symptom severity in patients with fibromyalgia

Abstract

Fibromyalgia is a condition characterised by chronic widespread pain; however, the conditions full symptomology is extensive and variable, leading to a substantial impact on the individual's quality of life. Treatment of fibromyalgia has limited effectiveness which has led to a high prevalence of complementary and alternative treatments, including dietary interventions or changes. However, there is a lack of systematic research on the role of diet and its relationship with pain. Dietary intake, if found to be effective, could play a pivotal role in understanding the pathophysiology and treatment of fibromyalgia.

This PhD thesis includes the first known systematic review on the use of dietary interventions (inclusive of supplementation) in the treatment of fibromyalgia and concluded there to be a lack of sufficient evidence to support or negate any one dietary intervention. However, this thesis did consolidate hypothesised pathophysiological pathways in which nutrition could play a role in the possible treatment of fibromyalgia: amelioration of oxidative stress, a reduction of inflammatory markers, bolstering of energy production and immuno-neuromodulation. An online cross-sectional survey conducted among individuals with fibromyalgia demonstrated that self-reported dietary intake varied significantly from national guidelines. Specifically, self-reported consumption of vitamin A, vitamin D, selenium, and iron was significantly lower than UK dietary reference values; whilst self-reported consumption of vitamin B12, vitamin C, calcium, folate, and zinc was significantly higher. Three dietary patterns were recorded: “low-protein”; “healthy diet” and “typical Northern Irish diet”. A mild but statistically significant, and negative relationship was found between the "low-protein” dietary pattern and pain levels.

A single focus group and a series of telephone interviews were conducted to investigate the experiences individuals with fibromyalgia have with food, food related behaviours and beliefs. This resulted in themes: “unpredictability”, “seeking a panacea” and “impact on activities of daily living”. These key themes fed into a central tenet of a changing relationship with food.

This thesis demonstrates the beginning of a novel area of research into dietary intake and fibromyalgia. Subsequent research should focus dietary patterns, their potential influence on symptomology with comparisons to healthy controls; and the impact of food related behaviours and beliefs with respect to an individual’s symptomology and general health.

Date of Award	Nov 2022
Original language	English
Supervisor	Philip Allsopp (Supervisor), Emeir Mc Sorley (Supervisor), Daniel Kerr (Supervisor) & Joanne Marley (Supervisor)