Optimal Nutrition for FibromyalgiaDr. Katie Holton

Importance of Diet

Nutrition is the single most important factor in optimizing your health

Positive vs. negative aspects to diet:

Positive Vitamins, Minerals, Protein, EFAs, Fiber

Negative Food additives, excess sugar, pesticides, herbicides, trans fats

Food Additives

ExcitotoxinsGlutamate, aspartate and L-cysteineFound under a myriad of names

Artificial sweetenersAspartame, acesulfame K, saccharin, sucralose

Artificial colors Interactions w/excitotoxins

GlutamateGlutamate – a non-essential, negatively charged AA from diet

The most ubiquitous excitatory neurotransmitter in mammals – very important!• Functions all over body (gut, immune system, pancreas, neuromuscular junction and brain)

• Precursor to the inhibitory neurotransmitter GABA

Disordered glutaminergic neurotransmission has been implicated in FM

Excess glutamate can lead to excitotoxicity• Also causes oxidative stress

Bound vs free glutamate• Meat versus soy sauce

Hidden ExcitotoxinsAcesulfame-K (Sunett, Sweet One)Aspartame (Equal, NutraSweet, Canderel)Autolyzed yeast (or autolyzed yeast extract)Barley malt extractBouillonBrothCalcium caseinateCarrageenanFlavoringGelatinHydrolyzed corn, wheat, or soy protein L-cysteineMalt extractMalt flavoringModified food starch (any type )Monopotassium glutamateMonosodium glutamate (MSG)

Natural flavoringNutritional yeastPlant protein extract Saccharin (Sweet’N Low)SeasoningSmoke flavoringSodium benzoateSodium caseinateSodium guanylateSodium inosinateSoy (only soybean oil /soy lecithin are OK to eat)Soy protein concentrateSoy protein isolateSpices (this term can hide other ingredients)StockSucralose (Splenda)Textured proteinWhey protein concentrateWhey protein isolateYeast extract

I also recommend avoiding all artificial colors, artificial

flavors, artificial sweeteners

Food Additives

Gelatin

Focus on REAL Food

Real Food – Food that is not highly processedLow in additives, no trans fatsHigh in nutrientsHigh in fiber

What Nutritional Factors are Important for Optimal Glutamatergic Function?

Adequate protein and low sugar

Antioxidants - Vitamins C & E

Vitamin D

Omega-3 Fatty Acids

Magnesium

Zinc

Protein and Sugar

Protein deficiency causes increased susceptibility to excitotoxicityHas been linked to increased prevalence of epilepsy in developing countries

Excess sugar in the diet also increases susceptibility to excitotoxicityKetogenic diet is used in epilepsy to counter this effect

Artificial sweeteners are not the answer!Hundreds of times sweeter than sugarCause increased cravings for sugar (& alter taste Rs)

Can also cause increased excitotoxicity themselves

Vitamin C

Synthesized in all green plants

Potent antioxidant•Protects against oxidative stress

Vitamin C saturates the brain first

Important for cartilage formation & immune function, improves endothelial function & lowers BP

Vitamin E

Important antioxidant

Has the ability to protect fatty acids from oxidation (i.e. functions in different areas than vitamin C)

Vitamin D

VS.

Synthesized from cholesterol• Inhibited by cholesterol lowering meds•Also inhibited by older age, northern latitude, season, sunscreen, clothing, dark skin, obesity

Important for calcium regulation, immune function,

serotonin synthesis

Reduces inflammation & protects against excitotoxicity

Omega-3 Fatty Acids

Important in maintaining fluidity of cell membranes to support cell-to-cell communication

Protects against excitotoxicity

Prevents inflammation

Alpha-linolenic acid is the basic essential omega-3 fatty acid in the diet• Found mainly in walnuts, flax seeds, and oils

DHA• Found in fish and fish oils• Farmed vs. wild fish

Magnesium

A very important mineral!

75% of the population does not meet the RDA of 420 mg

May be lost from GI tract in GI disorders

Stress can alter magnesium levels

Deficiency causes: Neuromuscular excitability, high BP, dizziness, constipation, seizures, tachycardia

Food sources of Magnesium

ZincAntioxidant Function

Can block NMDA receptors, protecting against excitoxicity

Deficiency caused by diets high in phytates and low in meatPhytates are

high in seeds, bran,

beans, & grainsSoaking

helps lessen phytate load

Prebiotics - Fiber

Benefits• Mucosal Barrier• Reduction in bowel pH• Synthesis of Vitamin K• Production of short

chain FAs• Lowering of

Cholesterol• Improved glucose

tolerance• Gut-brain axis

Probiotics - Yogurt

Diarrhea/Antibiotic Use

Greek yogurtSupplies beneficial probiotics (bacteria)High in proteinCan be consumed by those who are lactose intolerant

Activia is not needed (and contains additives)

Plain or vanilla recommended

Can add:Granola, wheat germFresh or dried fruitNuts, honeyLemon/orange cod liver oil

Mediterranean Diet

Bulgur

The End