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Gkouvi A, Tsiogkas SG, Bogdanos DP, Gika H, Goulis DG, Grammatikopoulou MG. Proteomics in Patients with Fibromyalgia Syndrome: A Systematic Review of Observational Studies. Curr Pain Headache Rep 2024:10.1007/s11916-024-01244-4. [PMID: 38652420 DOI: 10.1007/s11916-024-01244-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE OF REVIEW Fibromyalgia syndrome (FMS) is a disease of unknown pathophysiology, with the diagnosis being based on a set of clinical criteria. Proteomic analysis can provide significant biological information for the pathophysiology of the disease but may also reveal biomarkers for diagnosis or therapeutic targets. The present systematic review aims to synthesize the evidence regarding the proteome of adult patients with FMS using data from observational studies. RECENT FINDINGS An extensive literature search was conducted in MEDLINE/PubMed, CENTRAL, and clinicaltrials.gov from inception until November 2022. The study protocol was published in OSF. Two independent reviewers evaluated the studies and extracted data. The quality of studies was assessed using the modified Newcastle-Ottawa scale adjusted for proteomic research. Ten studies fulfilled the protocol criteria, identifying 3328 proteins, 145 of which were differentially expressed among patients with FMS against controls. The proteins were identified in plasma, serum, cerebrospinal fluid, and saliva samples. The control groups included healthy individuals and patients with pain (inflammatory and non-inflammatory). The most important proteins identified involved transferrin, α-, β-, and γ-fibrinogen chains, profilin-1, transaldolase, PGAM1, apolipoprotein-C3, complement C4A and C1QC, immunoglobin parts, and acute phase reactants. Weak correlations were observed between proteins and pain sensation, or quality of life scales, apart from the association of transferrin and a2-macroglobulin with moderate-to-severe pain sensation. The quality of included studies was moderate-to-good. FMS appears to be related to protein dysregulation in the complement and coagulation cascades and the metabolism of iron. Several proteins may be dysregulated due to the excessive oxidative stress response.
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Affiliation(s)
- Arriana Gkouvi
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
| | - Sotirios G Tsiogkas
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
| | - Dimitrios P Bogdanos
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece.
| | - Helen Gika
- Center for Interdisciplinary Research and Innovation (CIRI-AUTH), Biomic_AUTh, Balkan Center Thermi B1.4, GR-57001, Thessaloniki, Greece
- Laboratory of Forensic Medicine and Toxicology, School of Medicine, Aristotle University of Thessaloniki, GR-54124, Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria G Grammatikopoulou
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Proietti E, Rapallo F, Molinari E, Mucci V, Marinelli L, Borgarelli C, Burlando B, Pisciotta L, Demori I. Online Questionnaire with Fibromyalgia Patients Shows Negative Correlations between Disease Severity and Adherence to Mediterranean Diet. Nutrients 2024; 16:1078. [PMID: 38613111 PMCID: PMC11013287 DOI: 10.3390/nu16071078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
Fibromyalgia (FM) is a multidimensional disorder in which intense chronic pain is accompanied by a variety of psychophysical symptoms that impose a burden on the patients' quality of life. Despite the efforts and the recent advancement in research, FM pathogenesis and effective treatment remain unknown. Recently, the possible role of dietary patterns and/or components has been gaining attention. The current study aimed to investigate a potential correlation between adherence to the Mediterranean diet (MedDiet) and FM severity in a sample of Italian FM patients. An online survey was designed, composed of customized questions and validated questionnaires with the aim of investigating the intensity and type of pain, the presence of other psychophysical symptoms, the overall impact of FM, general food and lifestyle habits, and adherence to the MedDiet. The collected responses were analyzed for descriptive statistics, linear regression, and propensity score analyses. The results show that, despite considerable use of pharmaceuticals and supplements, FM participants suffered from a high-severity grade disease. However, those with good adherence to the MedDiet experienced a lower pain intensity and overall FM impact. A propensity score analysis indicates a positive influence of the MedDiet against FM severity, thus unveiling the need for well-designed intervention studies to evaluate the therapeutic potential of different dietary patterns.
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Affiliation(s)
- Elisa Proietti
- Department of Internal Medicine (DIMI), University of Genova, Viale Benedetto XV, 6, 16132 Genova, Italy; (E.P.); (C.B.); (L.P.)
| | - Fabio Rapallo
- Department of Economics (DIEC), University of Genova, Via Vivaldi, 5, 16126 Genova, Italy;
| | - Elena Molinari
- Clincal Psychology Center, Division of Neurology, E.O. Ospedali Galliera, Via Mura delle Cappuccine 14, 16128 Genova, Italy;
| | - Viviana Mucci
- School of Science, Western Sydney University, Penrith, NSW 2750, Australia;
| | - Lucio Marinelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Largo P. Daneo 3, 16132 Genova, Italy;
- IRCCS Ospedale Policlinico San Martino, Department of Neuroscience, Division of Clinical Neurophysiology, Largo R. Benzi 10, 16132 Genova, Italy
| | - Consuelo Borgarelli
- Department of Internal Medicine (DIMI), University of Genova, Viale Benedetto XV, 6, 16132 Genova, Italy; (E.P.); (C.B.); (L.P.)
| | - Bruno Burlando
- Department of Pharmacy (DIFAR), University of Genova, Viale Benedetto XV 3, 16132 Genova, Italy;
| | - Livia Pisciotta
- Department of Internal Medicine (DIMI), University of Genova, Viale Benedetto XV, 6, 16132 Genova, Italy; (E.P.); (C.B.); (L.P.)
- IRCCS Ospedale Policlinico San Martino, Department of Internal Medicine, Operative Unit of Dietetics and Clinical Nutrition, Largo R. Benzi 10, 16132 Genova, Italy
| | - Ilaria Demori
- Department of Pharmacy (DIFAR), University of Genova, Viale Benedetto XV 3, 16132 Genova, Italy;
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Almirall M, Casellas F, Dot J, de Torres I, Segurola H, Marsal S. Prevalence of non-coeliac gluten sensitivity and assessment of the response to gluten-free diet in a cohort of patients with fibromyalgia. Rheumatology (Oxford) 2023; 62:1069-1077. [PMID: 35900154 DOI: 10.1093/rheumatology/keac434] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/22/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To establish the prevalence of non-coeliac gluten sensitivity (NCGS) in a cohort of fibromyalgia patients and to evaluate their clinical response to a six-week gluten-free diet (GFD), the improvement in their symptoms, the percentage of diet responders who did not fulfil the diagnostic criteria for NCGS and the baseline characteristics that were associated with diet response and diagnostic criteria fulfilment. METHODS Uncontrolled prospective experimental study in a cohort of patients with fibromyalgia from a specialized hospital unit. The percentage of patients that fulfilled the Salerno Experts' Criteria, that responded to GFD, that improved their symptomatology and baseline characteristics associated with GFD response and diagnostic criteria fulfilment was analysed. RESULTS In total, 142 patients were selected and a NCGS prevalence of 5.6% was observed. A total of 21.8% responded to GFD due to their improvement in intestinal symptoms. In total, 74.2% of the responders did not fulfil the Salerno Experts' Criteria. The presence of diarrhoea and intraepithelial lymphocytosis and lower levels of anxiety were predictive factors of GFD response. No predictive factors of NCGS criteria fulfilment were found due to the low number of discriminators between gluten and placebo. CONCLUSIONS A NCGS prevalence similar to that estimated in the general population was found. A GFD cannot be systematically recommended to all patients with fibromyalgia, although it could be evaluated in those with diarrhoea or intraepithelial lymphocytosis to evaluate if there are improvements in their intestinal symptoms.
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Affiliation(s)
- Miriam Almirall
- Department of Rheumatology, Hospital Universitari Vall d'Hebron.,Rheumatology Research Group, Vall d'Hebron Research Institute
| | | | | | - Inés de Torres
- Department of Pathology, Hospital Universitari Vall d'Hebron.,Department of Morphological Sciences, Autonomous University of Barcelona
| | - Hegoi Segurola
- Nutritional Support Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Sara Marsal
- Department of Rheumatology, Hospital Universitari Vall d'Hebron.,Rheumatology Research Group, Vall d'Hebron Research Institute
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Erkilic B, Dalgic GS. The preventive role of vitamin D in the prevention and management of Fibromyalgia syndrome. Nutr Health 2023; 29:223-229. [PMID: 36591895 DOI: 10.1177/02601060221144801] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Aim: Vitamin D deficiency is a prevalent condition among the general population, all around the world. Vitamin D deficiency is defined as serum levels of 25-hydroxy vitamin D lower than 20 ng/ml (50 nmol/ml). It is a known actor in the skeletal system through the regulation of calcium and phosphate metabolism and bone mineralization. Still, the role of vitamin D as an immunomodulator is yet to be acknowledged by healthcare practitioners as a cause, precipitating factor, and contributor to a variety of diseases. Vitamin D is shown to be an actor in multiple sclerosis, rheumatoid arthritis, insulin-dependent diabetes mellitus, and irritable bowel syndrome. Fibromyalgia syndrome (FMS) is a chronic disorder associated with a severe pain that can affect a patient's musculoskeletal system, daily routine, and mood. The clinical presentation encapsulates other disorders such as lethargy and sleep problems, brain fog and other cognitive issues, and physical and psychiatric symptoms. Methods: We have used PubMed and ResearchGate in the reviewing process of our paper. We tried to address as many topics as we judged to be adequate and relevant for the practicing clinicians. Results: Management of fibromyalgia syndrome is both nonpharmacologic and pharmacologic, which are provided in a stepwise fashion. Yet, the management of FMS remains a challenge, heeding a multidisciplinary approach. Among the dietary interventions, we chose vitamin D and its effects on FMS. Literature shows that supplementation improves pain caused by fibromyalgia syndrome, yet specific recommendations are still to be created. Conclusions: We call on all the relevant governmental bodies, public health experts and health policy makers, healthcare practitioners, and the civil society to use novel data related to fibromyalgia syndrome, and in a broader perspective, the integral role of vitamin D.
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Affiliation(s)
| | - Gunay Sahin Dalgic
- Department of Rheumatology, 63994Faculty of Medicine, Baskent University, Ankara, Turkey
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Characterizing fibromyalgia flares: a prospective observational study. Reumatologia 2022; 60:242-246. [PMID: 36186831 PMCID: PMC9494786 DOI: 10.5114/reum.2022.118677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 06/06/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Although most patients with fibromyalgia describe periods of exacerbation of their symptomatology, there are very few studies describing its characteristics. Material and methods We recruited a total of 124 patients from our outpatient clinics who agreed to a follow-up of at least 6 months. All of them were asked to note and describe whether they had had any worsening of their symptoms during that time. Results Sixty-nine patients (75%) reported at least one flare, with a mean of 2 flares per patient. The mean duration of flares was 11 weeks. The most frequent triggers were: continuous stress (56%), intense stress (39%), physical overexertion (37%) and climatic changes (36%). The most common actions taken by patients were rest and medication. Conclusions Two-thirds of fibromyalgia patients experienced flares within 6 months. The symptoms and measures taken are similar to those patients usually take when they notice a worsening of symptoms.
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Dietary Intake Is Unlikely to Explain Symptom Severity and Syndrome-Specific Microbiome Alterations in a Cohort of Women with Fibromyalgia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063254. [PMID: 35328942 PMCID: PMC8950034 DOI: 10.3390/ijerph19063254] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/06/2022] [Accepted: 03/08/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Significant alterations were recently identified in the composition and putative function of the gut microbiome in women with fibromyalgia. As diet can influence the composition of the gut microbiome, differences in nutritional intake could, in theory, account for some of these specific fibromyalgia microbiome alterations. The current study aims to compare the diet of women with fibromyalgia to that of controls in order to explore possible associations between the intake of certain nutrients, symptom severity and gut microbiome composition. METHODS The study population was comprised of 56 women with fibromyalgia and 68 controls. Dietary intake was assessed using the NIH Automated Self-Administered 24 h recall, following dietitian's instructions and the completion of a three-day dietary recall. The gut microbiome was assessed by 16S ribosomal RNA gene sequencing of stool samples. RESULTS Most demographic and anthropometric characteristics were comparable between groups. The average energy and macronutrient intake (total and relative) and overall diet quality score were not different between patients and controls, nor were the main vitamins, minerals, fatty acids, alcohol, caffeine, sugar or fiber intakes. The daily intake of micronutrients and normalized macronutrients in women with fibromyalgia was largely not correlated with disease-specific measures, including pain intensity, fatigue, cognitive symptoms and quality of sleep, or with the relative quantity of almost any of the gut microbiome bacterial taxa differentially abundant in fibromyalgia. CONCLUSION These data demonstrate that dietary intakes, as evaluated by self-reported questionnaires, probably cannot explain the syndrome-specific differences in gut microbiome or the clinical phenotype of fibromyalgia.
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Use of Dietary Supplements and Perceived Knowledge among Adults Living with Fibromyalgia in Norway: A Cross-Sectional Study. Nutrients 2021; 14:nu14010005. [PMID: 35010882 PMCID: PMC8746737 DOI: 10.3390/nu14010005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 01/13/2023] Open
Abstract
Fibromyalgia syndrome (FMS) is a complex medical condition characterized by widespread musculoskeletal pain. To date, no gold standard treatment has been developed, and persons with FMS often seek alternative methods to control their symptoms, such as dietary supplements (DS). This study aimed to describe the use of DS in persons living with FMS and examine the associations between the use of DS and its potential predictors. We recruited a convenience sample of 504 participants (≥18 years) living with FMS. The main outcome variables included estimated expenditure on DS in the last 12 months in Norwegian kroner (NOK) and the differences between the groups of users and non-users of DS. Of the 504 participants, 430 reported having used DS, and the mean amount of money spent in the previous year was determined to be NOK 2300. The most common DS reported were vitamin D, magnesium, and omega-3 fatty acids. The predictors of being a DS user were high education, high self-reported knowledge of DS but low overall knowledge of health claims. Users of DS marketed for muscles/joints appear to spend more money on DS. The increasing availability of DS and aggressive advertising in the media through health claims stipulate the need for interventions that lead to informed decisions about DS.
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The Impact of a Peer Social Support Network from the Perspective of Women with Fibromyalgia: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312801. [PMID: 34886527 PMCID: PMC8657284 DOI: 10.3390/ijerph182312801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/25/2021] [Accepted: 12/01/2021] [Indexed: 12/22/2022]
Abstract
Background: Fibromyalgia is a chronic and complex disease whose management by patients requires a high level of commitment. Patient empowerment therefore represents an important milestone in chronic disease treatment and control. We explored the impact of a peer social support network from the perspective of women with fibromyalgia. Methods: A generic qualitative design was proposed for the study, for which women who had been diagnosed with fibromyalgia were purposefully selected. Six semi-structured interviews were conducted, and the collected data were thematically analysed. Results: Three key themes emerged regarding the peer social support network: (1) empowerment (facilitating acceptance of the diagnosis and acting as a source of information); (2) effects on well-being and quality of life (attenuated the stigma, improved physical well-being, provided emotional support and was a socialization medium); and (3), valuable aspects (transmitted feelings of being understood and listened to and increased personal feelings of satisfaction). Conclusions: A peer social support network for women with fibromyalgia exerts positive effects on their physical, mental, and social well-being and empowers them to better manage their disease. Healthcare for women with fibromyalgia should include strategies that connect them through peer social support networks.
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Haddad HW, Mallepalli NR, Scheinuk JE, Bhargava P, Cornett EM, Urits I, Kaye AD. The Role of Nutrient Supplementation in the Management of Chronic Pain in Fibromyalgia: A Narrative Review. Pain Ther 2021; 10:827-848. [PMID: 33909266 PMCID: PMC8586285 DOI: 10.1007/s40122-021-00266-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/09/2021] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION The multifaceted clinical presentation of fibromyalgia (FM) supports the modern understanding of the disorder as a more global condition than one simply affecting pain sensation. The main pharmacologic therapies used clinically include anti-epileptics and anti-depressants. Conservative treatment options include exercise, myofascial release, psychotherapy, and nutrient supplementation. METHODS Narrative review. RESULTS Nutrient supplementation is a broadly investigated treatment modality as numerous deficiencies have been linked to FM. Additionally, a proposed link between gut microbiome patterns and chronic pain syndromes has led to studies investigating probiotics as a possible treatment. Despite positive results, much of the current evidence regarding this topic is of poor quality, with variable study designs, limited sample sizes, and lack of control groups. CONCLUSIONS The etiology of FM is complex, and has shown to be multi-factorial with genetics and environmental exposures lending influence into its development. Preliminary results are promising, however, much of the existing evidence regarding diet supplementation is of poor quality. Further, more robust studies are needed to fully elucidate the potential of this alternative therapeutic option.
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Affiliation(s)
| | - Nikita Reddy Mallepalli
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
| | - John Emerson Scheinuk
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
| | - Pranav Bhargava
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
| | - Elyse M. Cornett
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
| | - Ivan Urits
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
- Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA USA
| | - Alan David Kaye
- Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
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Calandre EP, Hidalgo-Tallon J, Molina-Barea R, Rico-Villademoros F, Molina-Hidalgo C, Garcia-Leiva JM, Carrillo-Izquierdo MD, Slim M. The Probiotic VSL#3 ® Does Not Seem to Be Efficacious for the Treatment of Gastrointestinal Symptomatology of Patients with Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Pharmaceuticals (Basel) 2021; 14:ph14101063. [PMID: 34681287 PMCID: PMC8537098 DOI: 10.3390/ph14101063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/13/2021] [Accepted: 10/15/2021] [Indexed: 11/16/2022] Open
Abstract
Gastrointestinal symptomatology is frequent among patients with fibromyalgia, which increases disease burden and lacks specific treatment, either pharmacological or non-pharmacological. We aimed to evaluate the efficacy and tolerability of a multi-strain probiotic, VSL#3®, for the treatment of fibromyalgia-associated gastrointestinal manifestations. This randomized, placebo-controlled trial included 12 weeks of probiotic or placebo treatment followed by 12 weeks of follow up. The primary outcome variable was the mean change from the baseline to the endpoint in the composite severity score of the three main gastrointestinal symptoms reported by patients with fibromyalgia (abdominal pain, abdominal bloating and meteorism). Secondary outcome variables were the severity of additional gastrointestinal symptoms, fibromyalgia severity, depression, sleep disturbance, health-related quality of life and patients' overall impression of improvement. No differences were found between VSL#3® (n = 54) and the placebo (n = 56) in the primary outcome (estimated treatment difference: 1.1; 95% confidence interval [CI]: -2.1, 4.2; p = 0.501), or in any of the secondary outcomes. However, responders to VSL#3 were more likely to maintain any improvement during the follow-up period compared to responders in the placebo arm. Overall, VSL#3 tolerability was good. Our data could not demonstrate any beneficial effects of VSL#3® either on the composite score of severity of abdominal pain, bloating and meteorism or in any of the secondary outcome variables. More research is needed to elucidate specific factors that may predict a favourable response to treatment in patients with fibromyalgia.
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Affiliation(s)
- Elena P. Calandre
- Instituto de Neurociencias, Universidad de Granada, 18100 Granada, Spain; (J.H.-T.); (F.R.-V.); (J.M.G.-L.)
- Correspondence: ; Tel.: +34-958-246-291
| | - Javier Hidalgo-Tallon
- Instituto de Neurociencias, Universidad de Granada, 18100 Granada, Spain; (J.H.-T.); (F.R.-V.); (J.M.G.-L.)
| | | | - Fernando Rico-Villademoros
- Instituto de Neurociencias, Universidad de Granada, 18100 Granada, Spain; (J.H.-T.); (F.R.-V.); (J.M.G.-L.)
| | | | - Juan M. Garcia-Leiva
- Instituto de Neurociencias, Universidad de Granada, 18100 Granada, Spain; (J.H.-T.); (F.R.-V.); (J.M.G.-L.)
| | | | - Mahmoud Slim
- Division of Neurology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada;
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Boulis M, Boulis M, Clauw D. Magnesium and Fibromyalgia: A Literature Review. J Prim Care Community Health 2021; 12:21501327211038433. [PMID: 34392734 PMCID: PMC8371721 DOI: 10.1177/21501327211038433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Fibromyalgia, a widespread chronic pain disorder, imposes a multitude of
hardships on patients and their communities. Supplements, specifically magnesium
supplements, have been widely used by fibromyalgia patients in an attempt to
control their symptoms. The aim of this work is to investigate if the widespread
use of magnesium in fibromyalgia is supported by evidence in the literature.
This review provides a layout of the studies examining the correlation between
body magnesium levels and fibromyalgia. Furthermore, it elaborates on the trials
testing the effectiveness of magnesium in treating different clinical parameters
of fibromyalgia.
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Affiliation(s)
| | | | - Daniel Clauw
- University of Michigan Medical School, Ann Arbor, MI, USA
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Abstract
Fibromyalgia (FM) is a condition of chronic widespread pain (CWP) that can occur throughout the life cycle and is likely underrecognized in older patients. FM is associated with considerable suffering and reduction in quality of life and may occur as a unique condition, but in older patients is most likely to be associated with another medical illness. Understood mechanistically to be a sensitization of the nervous system, recently identified as nociplastic pain, FM is accepted as a valid medical illness that requires a positive diagnosis and directed treatments. The cornerstone of treatments for FM are nonpharmacologic interventions, with the understanding that medications provide only modest benefit for most patients, and with particular concern about adverse effects in older patients. If FM is not recognized, treatments may be misdirected to the other medical condition, with failure to address FM symptoms, leading to overall poor outcome. In contrast, new complaints in older patients should not immediately be attributed to FM, and physicians should be vigilant to ensure that onset of a new illness is not ignored. As FM is most often a lifelong condition, patients should be encouraged to identify their own personal strategies that can attenuate symptoms, especially when symptoms flare. Continued life participation should be the outcome goal.
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Affiliation(s)
- Amir Minerbi
- Institute for Pain Medicine, Rambam Health Campus, Haifa, Israel.,Ruth and Bruce Rapaport Faculty of Medicine, Technion, Haifa, Israel
| | - Mary-Ann Fitzcharles
- Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada. .,Division of Rheumatology, McGill University Health Centre, Montreal, QC, Canada.
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Pagliai G, Colombini B, Dinu M, Whittaker A, Masoni A, Danza G, Amedei A, Ballerini G, Benedettelli S, Sofi F. Effectiveness of a Khorasan Wheat-Based Replacement on Pain Symptoms and Quality of Life in Patients with Fibromyalgia. PAIN MEDICINE 2020; 21:2366-2372. [PMID: 32488245 DOI: 10.1093/pm/pnaa134] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To investigate the effects of a replacement diet with Khorasan wheat products in patients with fibromyalgia, in comparison with a similar replacement diet with control products made from organic semi-whole-grain modern wheat. DESIGN Randomized, double-blinded crossover trial. SETTING Outpatient clinic. SUBJECTS Twenty subjects (19 female and one male, mean age = 48.9 ± 12.3 years) with fibromyalgia. METHODS Participants were randomly assigned to consume either Khorasan or control wheat products (pasta, bread, crackers, biscuits) for eight weeks and then crossed. Validated self-administered questionnaires were collected from each subject at the beginning and end of each intervention period. RESULTS A general linear model for repeated measurement, adjusted for potential confounders, showed that the overall score reported from each questionnaire improved after both intervention and control periods, but the effect was more evident after the intervention with Khorasan. In particular, a statistically significant difference in Widespread Pain Index (WPI) + Severity Scale (SS) and Functional Outcome of Sleep Questionnaire (FOSQ) was observed, which decreased significantly by 21.5% and 11.7% respectively, only after the Khorasan period, while no statistically significant variations were reported after the control period. Similarly, FM Impact Questionnaire scores decreased significantly only after the Khorasan period, with a reduction that was significantly different between the intervention and control periods (-22.5% vs -0.3%, P = 0.037). The improvement was even greater in people with higher symptom severity. CONCLUSIONS A dietary intervention with Khorasan wheat products seems to benefit patients with fibromyalgia, especially those with greater symptom severity.
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Affiliation(s)
- Giuditta Pagliai
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Unit of Clinical Nutrition, Careggi University Hospital, Florence, Italy
| | - Barbara Colombini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Unit of Clinical Nutrition, Careggi University Hospital, Florence, Italy
| | - Anne Whittaker
- Department of Agrifood Production and Environmental Sciences, University of Florence, Florence, Italy
| | - Alberto Masoni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giovanna Danza
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giovanna Ballerini
- Multidisciplinary Center for Pain Therapy, Reference Center for Fibromyalgia, Piero Palagi Hospital, USL Toscana Centro, Florence, Italy
| | - Stefano Benedettelli
- Department of Agrifood Production and Environmental Sciences, University of Florence, Florence, Italy
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Unit of Clinical Nutrition, Careggi University Hospital, Florence, Italy.,Don Carlo Gnocchi Foundation Italy, Onlus IRCCS, Florence, Italy
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Lowry E, Marley J, McVeigh JG, McSorley E, Allsopp P, Kerr D. Dietary Interventions in the Management of Fibromyalgia: A Systematic Review and Best-Evidence Synthesis. Nutrients 2020; 12:E2664. [PMID: 32878326 PMCID: PMC7551150 DOI: 10.3390/nu12092664] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/25/2020] [Accepted: 08/28/2020] [Indexed: 12/14/2022] Open
Abstract
Fibromyalgia syndrome (FMS) is characterised by chronic widespread pain alongside fatigue, poor sleep quality and numerous comorbidities. It is estimated to have a worldwide prevalence of 1.78%, with a predominance in females. Treatment interventions for fibromyalgia have limited success, leading to many patients seeking alternative forms of treatment, including modifications to their diet and lifestyle. The effectiveness of dietary changes in fibromyalgia has not been widely researched or evaluated. This systematic review identified twenty-two studies, including 18 randomised control trials (RCTs) and four cohort studies which were eligible for inclusion. In total these studies investigated 17 different nutritional interventions. Significant improvements in reported pain were observed for those following a vegan diet, as well as with the low fermentable oligo di-mono-saccharides and polyols (FODMAP) diets. Supplementation with Chlorella green algae, coenzyme Q10, acetyl-l-carnitine or a combination of vitamin C and E significantly improved measures of pain. Interpretation of these studies was limited due to the frequent poor quality of the study design, the wide heterogeneity between studies, the small sample size and a high degree of bias. Therefore, there is insufficient evidence to recommend any one particular nutritional intervention for the management of fibromyalgia and further research is needed.
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Affiliation(s)
- Ethan Lowry
- School of Health Sciences, Ulster University, Shore Road, Newtownabbey BT37 0QB, UK; (E.L.); (J.M.)
| | - Joanne Marley
- School of Health Sciences, Ulster University, Shore Road, Newtownabbey BT37 0QB, UK; (E.L.); (J.M.)
| | - Joseph G. McVeigh
- School of Clinical Therapies, University College Cork, Douglas Street, Cork T12 YN60, Ireland;
| | - Emeir McSorley
- School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine BT52 1SA, UK; (E.M.); (P.A.)
| | - Philip Allsopp
- School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine BT52 1SA, UK; (E.M.); (P.A.)
| | - Daniel Kerr
- School of Health Sciences, Ulster University, Shore Road, Newtownabbey BT37 0QB, UK; (E.L.); (J.M.)
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Nutritional Interventions in the Management of Fibromyalgia Syndrome. Nutrients 2020; 12:nu12092525. [PMID: 32825400 PMCID: PMC7551285 DOI: 10.3390/nu12092525] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/13/2020] [Accepted: 08/19/2020] [Indexed: 02/08/2023] Open
Abstract
Fibromyalgia (FM) is a multifactorial syndrome of unknown etiology, characterized by widespread chronic pain and various somatic and psychological manifestations. The management of FM requires a multidisciplinary approach combining both pharmacological and nonpharmacological strategies. Among nonpharmacological strategies, growing evidence suggests a potential beneficial role for nutrition. This review summarizes the possible relationship between FM and nutrition, exploring the available evidence on the effect of dietary supplements and dietary interventions in these patients. Analysis of the literature has shown that the role of dietary supplements remains controversial, although clinical trials with vitamin D, magnesium, iron and probiotics' supplementation show promising results. With regard to dietary interventions, the administration of olive oil, the replacement diet with ancient grains, low-calorie diets, the low FODMAPs diet, the gluten-free diet, the monosodium glutamate and aspartame-free diet, vegetarian diets as well as the Mediterranean diet all appear to be effective in reducing the FM symptoms. These results may suggest that weight loss, together with the psychosomatic component of the disease, should be taken into account. Therefore, although dietary aspects appear to be a promising complementary approach to the treatment of FM, further research is needed to provide the most effective strategies for the management of FM.
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Martins YA, Cardinali CAEF, Ravanelli MI, Brunaldi K. Is hypovitaminosis D associated with fibromyalgia? A systematic review. Nutr Rev 2020; 78:115-133. [PMID: 31397485 DOI: 10.1093/nutrit/nuz033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
CONTEXT Recent findings have suggested a high prevalence of vitamin D deficiency or insufficiency in fibromyalgia (FM) patients despite the lack of clinical and pathophysiological evidence. OBJECTIVE A systematic review was conducted to examine the association between vitamin D status and FM, including the effect of vitamin D supplementation. DATA SOURCE PubMed, LILACS, Scopus, SciELO, Cochrane, and EMBASE were searched, from January 2000 to July 2018, using the descriptors "Fibromyalgia" and "Vitamin D." STUDY SELECTION Trials including FM patients in whom vitamin D levels were assessed were eligible for inclusion. DATA EXTRACTION Data comprised age, gender, country, aims, bias, diagnosis criteria, cutoff point, and status of vitamin D, together with FM symptoms and vitamin D supplementation protocol. RESULTS A total of 26 articles were selected. Most of the studies were found to present unreliable control groups and small samples. Experimental data on vitamin D supplementation indicated improvement in certain FM symptoms. CONCLUSION Prevalence of hypovitaminosis D in the FM population and the cause-effect relationship were inconclusive. Nevertheless, vitamin D supplementation may be considered as a co-adjuvant in FM therapy.
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Affiliation(s)
- Yandara A Martins
- Y.A. Martins, C.A.E.F. Cardinali, M.I. Ravanelli, and K. Brunaldi are with the Department of Physiological Sciences, State University of Maringa, Maringa, Parana, Brazil
| | - Camila A E F Cardinali
- Y.A. Martins, C.A.E.F. Cardinali, M.I. Ravanelli, and K. Brunaldi are with the Department of Physiological Sciences, State University of Maringa, Maringa, Parana, Brazil
| | - Maria Ida Ravanelli
- Y.A. Martins, C.A.E.F. Cardinali, M.I. Ravanelli, and K. Brunaldi are with the Department of Physiological Sciences, State University of Maringa, Maringa, Parana, Brazil
| | - Kellen Brunaldi
- Y.A. Martins, C.A.E.F. Cardinali, M.I. Ravanelli, and K. Brunaldi are with the Department of Physiological Sciences, State University of Maringa, Maringa, Parana, Brazil
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18
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Mediterranean Diet, Body Composition, and Activity Associated With Bone Health in Women With Fibromyalgia Syndrome. Nurs Res 2019; 68:358-364. [PMID: 30939528 DOI: 10.1097/nnr.0000000000000361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND There is very little scientific literature on the potential relationships between modifiable factors, including body composition, dietary pattern and physical activity (PA), and bone status in patients with fibromyalgia-a musculoskeletal condition characterized by chronic, widespread pain that is often accompanied by a broad spectrum of symptoms. OBJECTIVES The aim of the study was to investigate the impact of body composition parameters, adherence to the Mediterranean diet (Med Diet), and PA on bone health in a population of premenopausal and postmenopausal women with fibromyalgia syndrome (FMS). METHODS Ninety-five women diagnosed with FMS were included in this cross-sectional study. Body composition, including fat mass, percentage of fat mass, and lean mass (LM), were calculated using a body composition analyzer. Adherence to the Med Diet was measured through a validated 14-item questionnaire. The International Physical Activity Questionnaire was used to assess PA. Bone mass at the calcaneus was estimated through quantitative ultrasound. RESULTS Linear regression analysis revealed that LM had a significant association with broadband ultrasound attenuation (β = 0.211, 95% CI [0.046, 1.259], p = .035) and stiffness index parameters (β = 0.201, 95% CI [0.019, 1.654], p = .045) after adjusting for age and menopausal status. The Med Diet was also significantly associated with broadband ultrasound attenuation (β = 1.693, 95% CI [0.508, 2.879], p = .006). DISCUSSION LM and the Med Diet were consistently associated with calcaneal quantitative ultrasound parameters, supporting the hypothesis that LM and adherence to the Med Diet play determinant roles in bone health in FMS women. Training programs to maximize LM and strategies for promoting good adherence to the Med Diet should be considered in order to prevent the development of osteoporosis in FMS women. Because nurses are involved in implementing preventive programs, their roles in promoting this adherence to the Med Diet and maximizing LM in patients with FMS should help reduce the impact of osteoporosis.
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Anti-inflammatory and antioxidant feeding and supplementation may serve as adjuvants in women with fibromyalgia. JOURNAL OF NUTRITION & INTERMEDIARY METABOLISM 2019. [DOI: 10.1016/j.jnim.2018.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Teoh SL, Ngorsuraches S, Lai NM, Bangpan M, Chaiyakunapruk N. Factors affecting consumers' decisions on the use of nutraceuticals: a systematic review. Int J Food Sci Nutr 2019; 70:491-512. [PMID: 30634867 DOI: 10.1080/09637486.2018.1538326] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
There is a high and increasing global prevalence of nutraceuticals use. This study aims to systematically review and critically appraise all available evidence to identify the factors affecting consumers' decisions in taking nutraceuticals. Questionnaire, interview or focus group studies which directly reported factors affecting consumers' decisions in using nutraceuticals were included. A thematic synthesis method was employed to synthesis the findings from the included studies. Out of the 76 studies included, the key factors identified as the most important factors motivating consumers to take nutraceuticals were the perceived health benefits and safety of nutraceuticals, as well as the advice from healthcare professionals, friends and family. The identified barriers to take nutraceuticals were a lack of belief in the health benefit of nutraceuticals, the high cost of nutraceuticals and consumers' lack of knowledge about nutraceuticals. As a chief course of recommendation for the use of nutraceuticals, healthcare professionals should strive to utilise reliable information from clinical evidence to help consumers in making an informed decision in using nutraceuticals. Future studies should explore the possible ways to improve channelling clinical evidence information of nutraceuticals to the public.
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Affiliation(s)
- Siew Li Teoh
- a School of Pharmacy , Monash University Malaysia , Selangor , Malaysia
| | - Surachat Ngorsuraches
- b Department of Health Outcomes Research and Policy, Harrison School of Pharmacy , Auburn University , Auburn , AL , USA
| | - Nai Ming Lai
- c School of Medicine , Taylor's University Malaysia , Selangor , Malaysia.,d Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia Platform in the 21st Century (GA21) Platform , Monash University Malaysia , Bandar Sunway , Selangor , Malaysia
| | - Mukdarut Bangpan
- e Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), Social Science Research Unit, Department of Social Science, UCL Institute of Education , University College London , London , UK
| | - Nathorn Chaiyakunapruk
- a School of Pharmacy , Monash University Malaysia , Selangor , Malaysia.,d Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia Platform in the 21st Century (GA21) Platform , Monash University Malaysia , Bandar Sunway , Selangor , Malaysia.,f Center of Pharmaceutical Outcomes Research (CPOR), Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences , Naresuan University , Phitsanulok , Thailand.,g School of Pharmacy , University of Wisconsin , Madison , WI , USA
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Silva AR, Bernardo A, Costa J, Cardoso A, Santos P, de Mesquita MF, Vaz Patto J, Moreira P, Silva ML, Padrão P. Dietary interventions in fibromyalgia: a systematic review. Ann Med 2019; 51:2-14. [PMID: 30735059 PMCID: PMC7888848 DOI: 10.1080/07853890.2018.1564360] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Fibromyalgia (FM) is a chronic non-degenerative disease, whose nutritional therapy seems controversial. This systematic review aimed to synthesize the knowledge about the effect of dietary interventions on patient-reported outcomes (PRO) and inflammation in patients with FM. Six electronic databases - PubMed, BioMed Central, Cochrane library, EMBASE, LILACS and ISI - were searched for clinical trials, in which a dietary intervention in patients with FM diagnosed was conducted. Quality of evidence assessment was measured in accordance with GRADE methodology. Seven clinical trials - 3 randomized controlled trials, 1 unrandomized clinical trial and 3 uncontrolled clinical trials were identified. Dietary approaches included gluten-free diet (n = 1), raw vegetarian diet (n = 2), low Fermentable oligo-, di- and monossacharides, alcohols and polyols (FODMAPs) diet (n = 1), hypocaloric diet (n = 2) and monosodium glutamate- and aspartame-free diet interventions (n = 1). The major PRO were pain and functional repercussion, with 5 out of 7 studies reporting an improvement. The progress in secondary outcomes was reported for fatigue (2/5 studies), sleep quality (2/3 studies), depression and anxiety (3/6 studies), quality of life (4/5 studies), gastrointestinal symptoms (1/2 studies) and inflammatory biomarkers (1/1 study). However, according to Cochrane Risk of Bias, these studies had poor statistical quality. Well-designed studies should be performed to investigate the dietary interventions effect on FM. Key messages Fibromyalgia (FM) is a chronic non-degenerative disease, whose nutritional therapy seems controversial but promising. Pain and functional repercussion in FM patients seem to improve with a hypocaloric diet, a raw vegetarian diet or a low FODMAPs diet, as much as quality of life, quality of sleep, anxiety and depression and inflammatory biomarkers. Existing studies in this subject are scarce and low quality, which does not allow conclusions to be drawn.
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Affiliation(s)
- Ana Rita Silva
- a Faculdade de Ciências da Nutrição e Alimentação , Universidade do Porto , Porto , Portugal.,b Centro de Investigação Interdisciplinar Egas Moniz (CiiEM) , Instituto Universitário Egas Moniz , Almada , Portugal
| | - Alexandra Bernardo
- b Centro de Investigação Interdisciplinar Egas Moniz (CiiEM) , Instituto Universitário Egas Moniz , Almada , Portugal
| | - João Costa
- c Centro Hospitalar Tâmega e Sousa, E.P.E. , Avenida do Hospital Padre Américo , Penafiel , Portugal
| | - Alexandra Cardoso
- b Centro de Investigação Interdisciplinar Egas Moniz (CiiEM) , Instituto Universitário Egas Moniz , Almada , Portugal.,d Instituto Português de Reumatologia (IPR) , Lisboa , Portugal
| | - Paula Santos
- e Masters in Clinical Nutrition , Instituto Universitário Egas Moniz , Almada , Portugal
| | - Maria Fernanda de Mesquita
- b Centro de Investigação Interdisciplinar Egas Moniz (CiiEM) , Instituto Universitário Egas Moniz , Almada , Portugal
| | - José Vaz Patto
- d Instituto Português de Reumatologia (IPR) , Lisboa , Portugal
| | - Pedro Moreira
- a Faculdade de Ciências da Nutrição e Alimentação , Universidade do Porto , Porto , Portugal.,f EPIUnit , Instituto de Saúde Pública, Universidade do Porto , Porto , Portugal.,g Centro de Investigação em Atividade Física, Saúde e Lazer , Universidade do Porto , Porto , Portugal
| | - Maria Leonor Silva
- b Centro de Investigação Interdisciplinar Egas Moniz (CiiEM) , Instituto Universitário Egas Moniz , Almada , Portugal
| | - Patrícia Padrão
- a Faculdade de Ciências da Nutrição e Alimentação , Universidade do Porto , Porto , Portugal.,f EPIUnit , Instituto de Saúde Pública, Universidade do Porto , Porto , Portugal
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22
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Mohammad M, Chowdhury MAB, Islam MN, Ahmed A, Zahan FN, Akter MF, Mila SN, Tani TA, Akter T, Islam T, Uddin MJ. Health awareness, lifestyle and dietary behavior of university students in the northeast part of Bangladesh. Int J Adolesc Med Health 2018; 33:/j/ijamh.ahead-of-print/ijamh-2018-0105/ijamh-2018-0105.xml. [PMID: 30864409 DOI: 10.1515/ijamh-2018-0105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 08/19/2018] [Indexed: 11/15/2022]
Abstract
INTRODUCTION University students generally face a variety of challenges. During this period of life, they practice some unhealthy eating patterns and lifestyles. Therefore, we aimed to assess the health awareness status of university students from the northeast part of Bangladesh and to evaluate its associated factors. METHODS We conducted a cross-sectional study using a stratified random sampling among public and private university students from the northeast region of Bangladesh and interviewed 1143 students. We used a self-reported questionnaire, including questions related to awareness status, lifestyle practice, dietary habit and socio-demographic factors. To assess students' health awareness status and its association with their lifestyle practices and socio-demographic factors, we used logistic regression models. RESULTS The majority (61%) of the students were not aware of better health status and their dietary habits were not adequate. Smokers [odds ratio (OR): 0.66; 95% confidence interval (CI): 0.44, 0.99] were less likely to be aware of better health status. The participants who thought that they were leading a healthy lifestyle were less likely (OR: 0.71; CI: 0.56, 0.92) to be aware. Moreover, frequency of participating in sports and the psychological factors related to eating behaviors were significantly (p < 0.05) associated with health awareness status. CONCLUSION Our study findings may help to create a foundation for possible interventional programs on health awareness and nutritional education to improve the health awareness status and dietary behavior of university students. To prevent students from poor eating habits while feeling happy, effective programs (e.g. seminars, projects and media campaigns) should be held, which may include enhancing healthy and recommended amounts of food consumption.
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Affiliation(s)
- Mahmuda Mohammad
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | | | - Md Nazrul Islam
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Arifa Ahmed
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Farha Nusrat Zahan
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Mst Farzana Akter
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Shamima Naznin Mila
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Tania Akhter Tani
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Tanjila Akter
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Tanjila Islam
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
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Aguilar-Aguilar E, Marcos-Pasero H, de la Iglesia R, Espinosa-Salinas I, Ramírez de Molina A, Reglero G, Loria-Kohen V. Characteristics and determinants of dietary intake and physical activity in a group of patients with multiple chemical sensitivity. ACTA ACUST UNITED AC 2018; 65:564-570. [PMID: 30309810 DOI: 10.1016/j.endinu.2018.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 07/25/2018] [Accepted: 07/27/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVE Multiple chemical sensitivity (MCS) is a complex, acquired, chronic syndrome of multifactorial etiology with multiple symptoms. The aim of the study was to assess the nutritional habits, dietary characteristics and physical activity, as well as their determinants, of a population diagnosed with MCS, which may allow for a more precise approach to nutritional improvement. PATIENTS AND METHOD A descriptive, cross-sectional study in patients diagnosed with MCS. Information was collected using adapted questionnaires. Data included presence of comorbidities, nutritional (use of supplements, types of diet) and food purchasing habits. Dietary intake, food intolerances, and physical activity were also recorded. RESULTS The study included of 52 patients (48 female) aged 50.9±10.3 years. Diagnosis of MCS was commonly associated to chronic fatigue syndrome (70.1%), fibromyalgia (65.4%), or electrosensitivity (51.9%). The most common comorbidities were irritable bowel, gastroesophageal reflux, and depression/anxiety-depressive disorder. Exclusion diets were followed by 57.7%, 52.1% commonly used supplements (6.4±5.2 per person), and 16.0% took more than 10 daily. A high proportion of volunteers did not take the recommended amounts of dairy products (84.3%), fruit (82.3%), and cereals (64.7%), the foods to which intolerance was greatest. As regards physical activity, active subjects only represented 12.5%. CONCLUSIONS The data collected support the need to improve food pattern and to perform physical activity according to individual characteristics. Nutritional education and diet personalization could prevent incomplete, monotonous, and unbalanced diets which impair quality of life and physiological status.
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Affiliation(s)
| | | | | | | | | | - Guillermo Reglero
- IMDEA-Food, CEI UAM + CSIC, Madrid, España; Departamento de Producción y Caracterización de Nuevos Alimentos, Instituto de Investigación en Ciencias de la Alimentación (CIAL) CEI UAM + CSIC, Madrid, España
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Bora S, Rindfleisch JA. The Elimination Diet. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00086-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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López-Rodríguez MM, Granero Molina J, Fernández Medina IM, Fernández Sola C, Ruiz Muelle A. Patterns of food avoidance and eating behavior in women with fibromyalgia. ACTA ACUST UNITED AC 2017; 64:480-490. [PMID: 29050704 DOI: 10.1016/j.endinu.2017.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/30/2017] [Accepted: 07/04/2017] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Fibromyalgia is a form of non-articular rheumatic disorder of unknown origin. It is characterized by widespread, chronic musculoskeletal pain. Patients with fibromyalgia suffer more frequently eating disorders, obesity, metabolic syndrome, and other gastrointestinal symptoms. Studies have pointed out to nutrition as a relevant factor in these patients. Some of them think that diet has an influence on fibromyalgia symptoms, and tend to adopt certain dietary patterns. This, combined with access to non-scientific information about diets and supplements, makes analysis of dietary behavior, avoidance, and restrictions particularly important. The aim of this study was to describe dietary habits and eating avoidance behaviors in patients with fibromyalgia, and to compare these data to those of a healthy sample of similar sociodemographic characteristics. METHODS A descriptive case-control study was conducted in healthy subjects (n = 60) age and sex-matched to the fibromyalgia group (n = 60), whose eating habits and restrictions were analyzed using a food frequency questionnaire, a sociodemographic questionnaire, and a food restriction scale. RESULTS The group with fibromyalgia had significantly higher values in body mass index, weight fluctuation, use of herbal products, and development of diets, and significantly lower mean consumption of cereals, fruits, sugars, alcohol, and soft drinks. CONCLUSIONS These results describe a sample of patients with fibromyalgia who follow a varied diet similar to that of healthy subjects, but more frequently avoid certain foods.
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Affiliation(s)
- María Mar López-Rodríguez
- Departamento de Enfermería, Fisioterapia y Medicina, Universidad de Almería, La Cañada, Almería, España.
| | - José Granero Molina
- Departamento de Enfermería, Fisioterapia y Medicina, Universidad de Almería, La Cañada, Almería, España
| | | | - Cayetano Fernández Sola
- Departamento de Enfermería, Fisioterapia y Medicina, Universidad de Almería, La Cañada, Almería, España
| | - Alicia Ruiz Muelle
- Departamento de Enfermería, Fisioterapia y Medicina, Universidad de Almería, La Cañada, Almería, España
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The Effects of a Gluten-free Diet Versus a Hypocaloric Diet Among Patients With Fibromyalgia Experiencing Gluten Sensitivity-like Symptoms: A Pilot, Open-Label Randomized Clinical Trial. J Clin Gastroenterol 2017; 51:500-507. [PMID: 27548732 DOI: 10.1097/mcg.0000000000000651] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Patients with fibromyalgia frequently present with symptoms similar to those experienced by patients with gluten-related disorders, raising the possibility that a subgroup of these patients could be experiencing underlying gluten sensitivity. This study aimed to evaluate the effects of a gluten-free diet (GFD) compared with a hypocaloric diet (HCD) among patients with fibromyalgia. METHODS Adult patients diagnosed with fibromyalgia were randomly allocated to receive a GFD or a HCD over a 24-week period. The primary outcome measure was the change in the number of gluten sensitivity symptoms. The following secondary outcomes were evaluated: body mass index, Revised Fibromyalgia Impact Questionnaire, Pittsburgh Sleep Quality Index, Brief Pain Inventory, Beck Depression Inventory-II, State-Trait Anxiety Inventory, Short-Form Health Survey, Patient Global Impression Scale of Severity, Patient Global Impression Scale of Improvement, and adverse events. RESULTS Seventy-five subjects were randomly allocated to receive either a GFD (n=35) or an HCD (n=40). The least squares mean change in the total number of gluten sensitivity symptoms from baseline did not differ significantly between the GFD and HCD groups (-2.44±0.40 for the GFD; -2.10±0.37 for the HCD; P=0.343). Similarly, the 2 dietary interventions did not differ in any of the remaining measured secondary outcomes. Both dietary interventions were well tolerated. CONCLUSIONS Both dietary interventions were associated with similar beneficial outcomes in reducing gluten sensitivity symptoms and other secondary outcomes. However, despite its specificity, GFD was not superior to HCD in reducing the number of gluten sensitivity symptoms or secondary outcomes.
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Ruiz-Cabello P, Soriano-Maldonado A, Delgado-Fernandez M, Alvarez-Gallardo IC, Segura-Jimenez V, Estevez-Lopez F, Camiletti-Moirón D, Aparicio VA. Association of Dietary Habits with Psychosocial Outcomes in Women with Fibromyalgia: The al-Ándalus Project. J Acad Nutr Diet 2016; 117:422-432.e1. [PMID: 27890478 DOI: 10.1016/j.jand.2016.09.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 09/21/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Fibromyalgia (FM) is a complex multidimensional disorder with pain as its main symptom. Fibromyalgia imposes a psychosocial burden on individuals that negatively impacts quality of life. The relationship of dietary habits with these psychosocial aspects is still unclear. OBJECTIVE The purpose of this cross-sectional study was to assess dietary habits in a representative sample of women with FM and to explore their association with mental health, depression, and optimism in this population. DESIGN A cross-sectional study was conducted between November 2011 and January 2013. PARTICIPANTS The study sample comprised 486 women (ages 35 to 65 years) with FM from Andalucía (southern Spain). MAIN OUTCOME MEASURES Mental health, depression, and optimism were evaluated by means of the mental component scale of the 36-item Short-Form Health Survey, the Beck Depression Inventory (BDI-II), and the Life Orientation Test Revised, respectively. A short form of a validated food frequency questionnaire was used to assess dietary habits. STATISTICAL ANALYSES PERFORMED Analysis of covariance was used to assess associations between dietary habits and mental health, depression, and optimism. The presence of severe depression (BDI-II ≥29) as a function of dietary habits was examined with logistic regression. RESULTS A daily or almost-daily consumption of fruit and vegetables and a moderate consumption of fish (2 to 5 servings per week) were associated with higher scores in mental health (P<0.001, P<0.05, and P<0.001, respectively) and lower levels of depression (P<0.001, P<0.01, and P<0.01, respectively). A daily or almost-daily consumption of vegetables and a moderate consumption of dairy products and fish were associated with higher levels of optimism (P<0.05, P<0.05, and P<0.001, respectively). A daily or almost-daily consumption of cured meats and sweetened beverages were associated with higher levels of depression and lower levels of optimism, respectively (both P<0.05). CONCLUSION The results this study suggest that a daily or almost-daily intake of fruit and vegetables and a moderate intake of fish may be associated with more favorable psychosocial outcomes in women with FM. Conversely, excessive intake of cured meats and sweetened beverages was related to worse scores in optimism and depression outcomes. Future research analyzing dietary patterns as well as intervention studies evaluating the effects of healthy dietary patterns on psychosocial and physical outcomes in individuals with FM are warranted.
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A low fermentable oligo-di-mono saccharides and polyols(FODMAP) diet reduced pain and improve ddaily life in fibromyalgia patients. Scand J Pain 2016; 13:166-172. [DOI: 10.1016/j.sjpain.2016.07.004] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 07/20/2016] [Accepted: 07/21/2016] [Indexed: 12/19/2022]
Abstract
Abstract
Background and aims
Fibromyalgia (FM) is a chronic, rheumatic disease characterized by widespread myofascial pain, of unknown aetiology, having a major impact on quality of life (QOL). Available pharmacotherapy for FM is marginally effective. FM is associated with co-morbidities of gastrointestinal (GI) disorders and Irritable Bowel Syndrome (IBS). There is growing evidence that diets low in FODMAPs, “fermentable oligo-, di- or mono-saccharides and polyols” [Low FODMAP Diet (LFD)], are effective in treating IBS. The aim of this pilot study was to examine the effects of LFDs on symptoms of FM, especially with regard to pain, QOL and GI disorders.
Methods
A longitudinal study using LFD intervention was performed on 38, 51±10 year-old, female patients diagnosed with FM for an average of 10 years, based on ACR (American College of Rheumatology) 2010 criteria. The study was conducted from January through May, 2015, using a four-week, repeated-assessment model, as follows: Moment 0 – introduction of the protocol to participants; Moment 1 – first assessment and delivery of individual LFD dietary plans; Moment 2 – second assessment and reintroduction of FODMAPs; Moment 3 – last assessment and final nutritional counselling. Assessment tools used were the following: RFIQ (Revised Fibromyalgia Impact Questionnaire), FSQ (Fibromyalgia Survey Questionnaire), IBS-SSS (Severity Score System), EQ-5D (Euro-QOL quality of life instrument), and VAS (Visual Analogue Scale). Daily consumption of FODMAPs was quantified based on published food content analyses. Statistical analyses included ANOVA, non-parametric Friedman, t-student and Chi-square tests, using SPSS 22 software.
Results
The mean scores of the 38 participants at the beginning of the study were: FSQ (severity of FM, 0–31) – 22±4.4; RFIQ (0–100) – 65±17; IBS-SSS (0–500) – 275± 101; and EQ-5D (0–100) – 48± 19. Mean adherence to dietary regimens was 86%, confirmed by significant difference in FODMAP intakes (25 g/day vs. 2.5 g/day; p < 0.01). Comparisons between the three moments of assessment showed significant (p < 0.01) declines in scores in VAS, FSQ, and RFIQ scores, in all domains measured. An important improvement was observed with a reduction in the severity of GI symptoms, with 50% reduction in IBS scores to 138±117, following LFD therapy. A significant correlation (r = 0.36; p < 0.05) was found between improvements in FM impact (declined scores) and gastrointestinal scores. There was also a significant correlation (r = 0.65; p < 0.01) between “satisfaction with improvement” after introduction of LFDs and “diet adherence”, with satisfaction of the diet achieving 77% among participants. A significant difference was observed between patients who improved as compared to those that did not improve (Chi-square χ2 = 6.16; p < .05), showing that the probability of improvement, depends on the severity of the RFIQ score.
Conclusions
Implementation of diet therapy involving FODMAP restrictions, in this cohort of FM patients, resulted in a significant reduction in GI disorders and FM symptoms, including pain scores. These results need to be extended in future larger studies on dietary therapy for treatment of FM.
Implications
According to current scientific knowledge, these are the first relevant results found in an intervention with LFD therapy in FM and must be reproduced looking for a future dietetic approach in FM.
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Theoharides TC, Tsilioni I, Arbetman L, Panagiotidou S, Stewart JM, Gleason RM, Russell IJ. Fibromyalgia syndrome in need of effective treatments. J Pharmacol Exp Ther 2015; 355:255-63. [PMID: 26306765 DOI: 10.1124/jpet.115.227298] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 08/24/2015] [Indexed: 12/18/2022] Open
Abstract
Fibromyalgia syndrome (FMS) is a chronic, idiopathic condition of widespread musculoskeletal pain, affecting primarily women. It is clinically characterized by chronic, nonarticular pain and a heightened response to pressure along with sleep disturbances, fatigue, bowel and bladder abnormalities, and cognitive dysfunction. The diagnostic criteria have changed repeatedly, and there is neither a definitive pathogenesis nor reliable diagnostic or prognostic biomarkers. Clinical and laboratory studies have provided evidence of altered central pain pathways. Recent evidence suggests the involvement of neuroinflammation with stress peptides triggering the release of neurosenzitizing mediators. The management of FMS requires a multidimensional approach including patient education, behavioral therapy, exercise, and pain management. Here we review recent data on the pathogenesis and propose new directions for research and treatment.
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Affiliation(s)
- Theoharis C Theoharides
- Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, Boston, Massachusetts (T.C.T., I.T., L.A., S.P., J.M.S.); Department of Internal Medicine, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts (T.C.T.); Department of Psychiatry, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts (T.C.T.); Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, Massachusetts (T.C.T.); National Fibromyalgia and Chronic Pain Association, Logan, Utah (R.M.G.); Fibromyalgia Research and Consulting, Arthritis and Osteoporosis Center of South Texas, San Antonio, Texas (I.J.R.)
| | - Irene Tsilioni
- Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, Boston, Massachusetts (T.C.T., I.T., L.A., S.P., J.M.S.); Department of Internal Medicine, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts (T.C.T.); Department of Psychiatry, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts (T.C.T.); Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, Massachusetts (T.C.T.); National Fibromyalgia and Chronic Pain Association, Logan, Utah (R.M.G.); Fibromyalgia Research and Consulting, Arthritis and Osteoporosis Center of South Texas, San Antonio, Texas (I.J.R.)
| | - Lauren Arbetman
- Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, Boston, Massachusetts (T.C.T., I.T., L.A., S.P., J.M.S.); Department of Internal Medicine, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts (T.C.T.); Department of Psychiatry, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts (T.C.T.); Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, Massachusetts (T.C.T.); National Fibromyalgia and Chronic Pain Association, Logan, Utah (R.M.G.); Fibromyalgia Research and Consulting, Arthritis and Osteoporosis Center of South Texas, San Antonio, Texas (I.J.R.)
| | - Smaro Panagiotidou
- Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, Boston, Massachusetts (T.C.T., I.T., L.A., S.P., J.M.S.); Department of Internal Medicine, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts (T.C.T.); Department of Psychiatry, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts (T.C.T.); Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, Massachusetts (T.C.T.); National Fibromyalgia and Chronic Pain Association, Logan, Utah (R.M.G.); Fibromyalgia Research and Consulting, Arthritis and Osteoporosis Center of South Texas, San Antonio, Texas (I.J.R.)
| | - Julia M Stewart
- Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, Boston, Massachusetts (T.C.T., I.T., L.A., S.P., J.M.S.); Department of Internal Medicine, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts (T.C.T.); Department of Psychiatry, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts (T.C.T.); Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, Massachusetts (T.C.T.); National Fibromyalgia and Chronic Pain Association, Logan, Utah (R.M.G.); Fibromyalgia Research and Consulting, Arthritis and Osteoporosis Center of South Texas, San Antonio, Texas (I.J.R.)
| | - Rae M Gleason
- Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, Boston, Massachusetts (T.C.T., I.T., L.A., S.P., J.M.S.); Department of Internal Medicine, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts (T.C.T.); Department of Psychiatry, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts (T.C.T.); Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, Massachusetts (T.C.T.); National Fibromyalgia and Chronic Pain Association, Logan, Utah (R.M.G.); Fibromyalgia Research and Consulting, Arthritis and Osteoporosis Center of South Texas, San Antonio, Texas (I.J.R.)
| | - Irwin J Russell
- Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, Boston, Massachusetts (T.C.T., I.T., L.A., S.P., J.M.S.); Department of Internal Medicine, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts (T.C.T.); Department of Psychiatry, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts (T.C.T.); Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, Massachusetts (T.C.T.); National Fibromyalgia and Chronic Pain Association, Logan, Utah (R.M.G.); Fibromyalgia Research and Consulting, Arthritis and Osteoporosis Center of South Texas, San Antonio, Texas (I.J.R.)
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Slim M, Molina-Barea R, Garcia-Leiva JM, Rodríguez-Lopez CM, Morillas-Arques P, Rico-Villademoros F, Calandre EP. The effects of gluten-free diet versus hypocaloric diet among patients with fibromyalgia experiencing gluten sensitivity symptoms: Protocol for a pilot, open-label, randomized clinical trial. Contemp Clin Trials 2015; 40:193-8. [DOI: 10.1016/j.cct.2014.11.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 11/25/2014] [Accepted: 11/28/2014] [Indexed: 12/28/2022]
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Slim M, Calandre EP, Rico-Villademoros F. An insight into the gastrointestinal component of fibromyalgia: clinical manifestations and potential underlying mechanisms. Rheumatol Int 2014; 35:433-44. [PMID: 25119830 DOI: 10.1007/s00296-014-3109-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 07/31/2014] [Indexed: 12/14/2022]
Abstract
Fibromyalgia syndrome is characterized by chronic generalized pain accompanied by a broad symptomatologic spectrum. Besides chronic fatigue, sleep disturbances, headaches and cognitive dysfunction that are extensively described in the literature, a considerable proportion of patients with fibromyalgia experience gastrointestinal symptoms that are commonly overlooked in the studies that are not specifically dedicated to evaluate these manifestations. Nevertheless, various attempts were undertaken to explore the gastrointestinal dimension of fibromyalgia. Several studies have demonstrated an elevated comorbidity of irritable bowel syndrome (IBS) among patients with fibromyalgia. Other studies have investigated the frequency of presentation of gastrointestinal symptoms in fibromyalgia in a nonspecific approach describing several gastrointestinal complaints frequently reported by these patients such as abdominal pain, dyspepsia and bowel changes, among others. Several underlying mechanisms that require further investigation could serve as potential explanatory hypotheses for the appearance of such manifestations. These include sensitivity to dietary constituents such as gluten, lactose or FODMAPs or alterations in the brain-gut axis as a result of small intestinal bacterial overgrowth or subclinical enteric infections such as giardiasis. The gastrointestinal component of fibromyalgia constitutes a relevant element of the multidisciplinary pathophysiologic mechanisms underlying fibromyalgia that need to be unveiled, as this would contribute to the adequate designation of relevant treatment alternatives corresponding to these manifestations.
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Affiliation(s)
- Mahmoud Slim
- Instituto de Neurociencias "Federico Olóriz", Universidad de Granada, Avenida de Madrid, 11., 18012, Granada, Spain
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de Araújo TA, Mota MC, Crispim CA. Obesity and sleepiness in women with fibromyalgia. Rheumatol Int 2014; 35:281-7. [PMID: 25056401 DOI: 10.1007/s00296-014-3091-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 07/07/2014] [Indexed: 11/28/2022]
Abstract
Fibromyalgia (FM) is associated with a number of comorbidities, including chronic widespread pain, fatigue and non-restorative sleep. Evidence has shown that FM is closely associated with overweight and obesity. The objective of the present study was to investigate the relationship between obesity and sleepiness in women with FM. A total of 100 adult female patients with a prior medical diagnosis of FM participated in the study. Body mass, height and waist circumference were measured, and body mass index (BMI) was calculated. The diet quality was evaluated by the Healthy Eating Index. Subjective analyses of daytime sleepiness [Epworth Sleepiness Scale (ESS)] and sleep quality (Pittsburgh Sleep Quality) were performed. An obesity rate of 41 % was found in all women (56.1 % were sleepy and 43.9 % were not, p = 0.04). Obese women showed a greater level of sleepiness when compared with non-obese (10.2 and 7.0, respectively, p = 0.004). Sleepy women showed a greater weight gain after the diagnosis of FM when compared with non-sleepy women (11.7 and 6.4 kg, respectively, p = 0.04). A positive and significant correlation between BMI and sleepiness (r = 0.35, p = 0.02) was also found. In multivariate logistic regression, moderate or severe sleepiness (ESS >12) was associated with obesity (odds ratio 3.44, 95 % CI 1.31-9.01, p = 0.04). These results demonstrate an important association between sleepiness and FM, suggesting that the occurrence of obesity may be involved with sleepiness in these patients.
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Affiliation(s)
- Tânia Aparecida de Araújo
- Post Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Av. Pará, 1720, Bloco 2U, Sala 20. Campus Umuarama, Uberlândia, MG, 38405-320, Brazil
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