Mediterranean diet and its low-antigenic and anti-inflammatory properties on fibromyalgia: a systematic review

Area of Science:

• Nutrition Science
• Rheumatology
• Gastroenterology

Background:

• Fibromyalgia (FM) is a complex condition characterized by chronic widespread pain, fatigue, and cognitive dysfunction.
• The Mediterranean diet is recognized for its antioxidant, anti-inflammatory, and low-antigen properties.
• Existing research has not comprehensively reviewed the Mediterranean diet's potential to alleviate FM symptoms through these specific properties.

Purpose of the Study:

• To systematically review the literature on the Mediterranean diet's low-antigen and anti-inflammatory properties in relation to fibromyalgia symptom modulation.
• To assess the potential of the Mediterranean diet to alleviate key symptoms of fibromyalgia.

Main Methods:

• A systematic review was conducted following the 2020 PRISMA checklist.
• Searches were performed on PubMed and Google Scholar for articles published between 2019 and 2024.
• Keywords included 'Fibromyalgia,' 'Mediterranean Diet,' 'Low-Antigen Diet,' 'Anti-inflammatory Diet,' 'Omega3,' and 'Vitamin D.'

Main Results:

• Ten studies (5 interventional, 5 observational) met the inclusion criteria.
• Evidence indicates that adherence to the Mediterranean diet is linked to significant improvements in FM symptoms.
• These improvements include reductions in chronic widespread pain, autonomic dysfunction, fatigue, sleep disturbances, and cognitive impairments ('fibro fog').

Conclusions:

• A significant relationship exists between the gut microbiome and the manifestation of fibromyalgia symptoms.
• Early intervention with the Mediterranean diet in patients with initial FM symptoms may offer a low to moderate effect on symptom severity.
• This dietary approach may be particularly beneficial before the initiation of pharmacological treatments.