Tuesday, August 14, 2012

Fibromyalgia as Food's Revenge

Over the years I've met about a dozen people who excitedly announced to me that they had found the "cure" for fibromyalgia.  One woman total me she got total pain relief by going on a vegan raw foods diet. Another did a 10-day juice fast. And I've also known people who achieved pain relief when they went on all-natural diets, all-organic diets, aspartame-free diets, fast foods-free diet, and even the Atkins diet.

The sad fact is that each and every one of the people I've met who found their personal dietary treatment for fibromyalgia later told me the diet didn't work.  Two dieters just couldn't stick to their programs. One of the women who went on a raw foods diet found out that she had an addiction to Lay's Sour Cream Potato Chips, and the man who gave up aspartame found that he couldn't stop after having "just one" Diet Coke. But the others enjoyed pain relief for 10 days to 2 years until suddenly their diets just didn't work any more. They all thought the problem was their diets.  I have come to think that the problem was

their food, probably just one or two foods that act as triggers for pain. I'm not really basing my belief on solid scientific evidence. No American food manufacturer is ever going to fund a multi-center clinical trial to determine whether or not fibromyalgia patients should eat their products. Some European countries that have nationally funded health care plans, however, have looked at the general question of diet and pain.

French Fries and Fibromyalgia

One of the best-known studies of the connections between food and pain is the 1958 British Cohort Study. This survey follows the diet and health outcomes of people born in England, Scotland, and Wales during a single week in March 1958.

The National Health Service collected data on their diets at ages 33 and 42 and on their general health at the age of 45.  There were 8,572 people still alive and still available to the survey at the age of 45. Of the women in the study, 12%, or about 1 in 8, had been diagnosed by a doctor as having chronic widespread pain syndrome, which we refer to as fibromyalgia in the USA. Two features of diet stood out as statistically significant. The women who were most likely to have fibromyalgia were the most likely to eat one serving or less of vegetables per week. The women who were most likely to have fibromyalgia were also the mostly likely to eat one serving or more of French fries or potato chips per day.

Not eating vegetables and eating French fries and potato chips were not predictive of fibromyalgia in men, but that could just be due to the fact that fewer men in the study developed fibromyalgia and larger samples sizes are needed for statistical significance. Both men and women who developed fibromyalgia were more likely to have other chronic diseases (such as heart disease and cancer), more likely to be unemployed, and more likely to have worked at physically demanding jobs.

Before we jump to the headline-making conclusion that "French Fries Cause Fibromyalgia!" it is important to consider what kind of study this was. The 1958 British Cohort Study is an after-the-fact, correlational study. The data in the study show coincidence rather than causation.

They only lead to the question, "Which comes first, fibromyalgia or French fries?" If you have severe fibromyalgia, you may have difficulties getting to the market, buying vegetables (especially if you are on a limited income), washing them, dicing them up, putting them in the refrigerator, cooking them, eating them, and cleaning up. You may have just enough money and energy to creep down to the nearest fast food place.

It's possible that fibromyalgia causes excessive French fry consumption rather than the other way around. But maybe there's something in potatoes that triggers fibromyalgia attacks. That might explain why vegan and vegetarian diets sometimes fail.  One likely culprit is the chemical solanine.

This plant chemical is in all the nightshades, potatoes, tomatoes, eggplants, and peppers. Solanine accumulates in potato peel when potatoes are exposed to light and the peel begins to turn green. The green in the peel is actually chlorophyll.  The potentially toxic solanine is found throughout the potato.

Poisonous Potatoes Cause Fibromyalgia?

Solanine in small doses is so bitter that it can cause nausea and vomiting. It's the potato's way of ensuring it's not eaten in early spring. There is some debate just how much solanine a woman can consume in early pregnancy without risk of birth defects, but it's never a good idea for any woman who is or who could become pregnant to eat green or bitter-tasting potatoes.  But does solanine also trigger fibromyalgia?

The answer is a definite maybe. A letter to the British Medical Journal published in December of 1979 recounted the experience of 78 English public school boys who were fed boiled potatoes that had gone bad. Most only experienced nausea and vomiting, but two experienced what the physician writing the report called "central nervous depression." Several went into comas, and some developed uncontrollable twitching. It's important to note that this almost never is a problem for people who eat potatoes.

But "poisonous" potatoes only contain about 5 times as much solanine as "safe" potatoes. Maybe the problem for people who have fibromyalgia is that they are unusually sensitive to solanine. We may never know whether potatoes, tomatoes, eggplants, and peppers are generally a contributing cause of fibromyalgia, but if you have fibromyalgia, it's not that hard to find out if they are a contributing cause of fibromyalgia for you.

Simply eliminate them from your diet for two weeks. Don't make any other changes in your routine. If you feel markedly better--and feeling better is what it's all about--then keep them out of your diet for another two weeks. Don't let potatoes, tomatoes, eggplants, and peppers creep back into your diet.

If you decide to eat them, eat a lot. If your symptoms suddenly get worse, you'll know for sure that nightshades were a problem for you. Frying potatoes, tomatoes, eggplants, and peppers, by the way, lowers their solanine content, but probably not enough to compensate for excessive consumption. After all, if a "bad" potato only contains 5 times as much as solanine as a "good" potato, then eating five potatoes as French fries probably still delivers a toxic dose of the compound. Not to mention the 2000 calories and 180 grams of fat. Nightshades, of course, are only one of many possible trigger foods for fibromyalgia.

 Glutamate, MSG, Meat, NutraSweet, and Fibromyalgia

Nutrition experts often point their fingers at glutamate (the food form of the amino acid glutamic acid) as a contributing factor for fibromyalgia. When august experts in the field ran studies of glutamate consumption and sensitivity to pain, essentially by injecting volunteers with glutamate into their muscles and waiting for them to cry "Ouch," they not surprisingly found that glutamate does not have a statistically significant relationship to sensitivity to pain.

But they weren't looking at the right kind of glutamate. Or in the right places. Overdoses of monosodium glutamate, also known as MSG, don't cause birth defects. Otherwise, they tend to cause the full range of symptoms associated with solanine from potatoes and other nightshade vegetables.  It can take as little as 1 gram of MSG to trigger "Chinese restaurant syndrome."

It probably only takes 1 gram of MSG to trigger fibromyalgia symptoms. It's very easy to get that 1 gram of MSG. It isn't just powdered MSG and soups and stocks that are the problem. MSG is added to all kinds of products in major amounts. The third-listed ingredient in one fast food purveyor's "whole wheat" buns, for example, after white flour and sugar, whole wheat flour coming fourth, is MSG.

Tomatoes--which are also nightshades--contain large amounts of natural MSG, as do most of the cheeses used to make pizzas. And it may be that the researcher who injected glutamate into muscles and didn't note a pain response weren't testing it the right away.

Dr. Brian Cairns, a professor at the University of British Columbia, and Dr. Peter Svensson, a professor at the Royal College of Dentistry in Aarhus in the Denmark, believe that glutamate causes pain inside muscles by changing the chemical environment outside the muscle. If that's they case, it would explain why some people who have fibromyalgia get great results when they go on vegan diets.

Meat is loaded with natural glutamate, not the MSG kind. However, the body can also transform excesses of alanine and aspartate into glutamate. There's lots of alanine in meat and dairy, but there's also lots of alanine in soy, nuts, seeds, and yeast spreads. There's lots of aspartate in lunch meats, sausages, and wild game, but there's also lots of asparate in asparagus, avocados, oat flakes, molasses, and, of course, aspartame (Nutrasweet). All of these foods probably can trigger attacks of fibromyalgia.

Making Sense of Out of Diets for Fibromyalgia

 When you begin to look at how the body can transform one amino acid into another, some of the failings of diets for fibromyalgia begin to make sense. Giving up meat probably reduces fibromylagia triggers. But overdoing nuts, seeds, Vegemite, asparagus, and avocados can activate them anyway. Many people who have fibromyalgia have trouble tolerating Nutrasweet.

 Giving up nightshade vegetables (potatoes, tomatoes, eggplants, and peppers) probably reduces fibromyalgia triggers. But eating prepared foods that contain MSG probably cancels out the effects. I'm not going to tell anyone who pursues a vegan diet for ethical reasons to do otherwise.

But I will suggest that if you pursue a vegan diet, or any other kind of diet, for fibromyalgia, that what you really need to focus on is avoiding solanine and keeping glutamate and glutamic acid in moderation.

This means that if you eat meat, don't eat a lot. The excess protein gets converted into glutamic acid. If you eat potatoes, don't eat more than one serving a day. And make sure you don't eat potatoes that have green peels. If you eat all those healthy (and they really are healthy) nuts and seeds and avocados, don't overindulge. They can also be your triggers.

 People who pursue diets for fibromyalgia usually do have the willpower to stick to their programs. The problem usually is that "vegan" or "natural" or "organic" isn't what really makes a difference. It's foods that you need to limit, not diets that you need to follow.

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