Dietary Habits and Participant-Led Adaptations to Diet for Pain Management in Fibromyalgia Sufferers: a Cross-Sectional Study

Abstract Fibromyalgia is a disorder characterised by chronic widespread pain that has been present for more than 3 months and can be elicited by palpitation of specific touch points. It is associated with a wide range of co-morbidities including chronic fatigue and gastrointestinal disorders. Although widely accepted by wider populations to have an impact on the condition, there is limited nutritional information and associated evidence to cater specifically for the disease with widespread anecdotal and non-professional websites providing sources for dietary change. The aim of the study is to investigate the association between dietary intake and quality on pain and symptoms, in individuals with fibromyalgia. Method A cross sectional study was conducted. We explored the association between pain and symptoms in fibromyalgia, (Revised Fibromyalgia Impact Questionnaire, FIQR; General Anxiety Disorder, GAD-7 and Patient Health Questionnaire, PHQ-9) and markers of metabolic health (anthropometry) against dietary intake (EPIC Food Frequency Questionnaire, FFQ), diet quality (Healthy Eating Index 2015, HEI-2015) and self-reported dietary changes. Results Participants were adults (n = 381) with fibromyalgia and were recruited using social media platforms including Facebook, Twitter and specific online fibromyalgia support groups. Higher pain and symptom scores (FIQR) were associated with higher BMI, higher energy intake and lower diet quality (p’s <0.05). Participants with lower pain scores (FIQR <49) had significantly close adherence to dietary recommendations across 7 out of 11 components of diet quality (total fruit, whole fruits, dairy, protein, fatty acids, refined grains, saturated fats), iron intakes (p=0.18) and vitamin D (p<0.001), with significantly lower carbohydrate intake (P=0.019). No significant results were noted for other selected nutrients (Ca, Mg). Participants who report engaging with dietary modification presented with significantly lower for FIQR, BMI and energy intake (p’s <0.05). Conclusion This study suggests a link between diet quality, dietary intakes and pain in fibromyalgia. Lower diet quality, greater BMI and higher energy intake was related to higher pain and symptoms whilst reported dietary modification resulted in lower pain and symptoms, alongside lower BMIs. Iron and vitamin D consumption were higher in participants with lower pain. Future research is needed to assess the impact of specific nutrients as well as whole dietary change on pain and symptoms in fibromyalgia via nutritional intervention studies for this patient group.