Nutritionist Kathleen Holton, PhD, discusses eating well and reports the latest research on probiotics.

1. Optimal Nutrition for
Fibromyalgia
Dr. Katie Holton

2. Importance of
Diet
Nutrition is the single most important factor in
optimizing your health
Positive vs. negative aspects to diet:
Positive
Vitamins, Minerals, Protein, EFAs, Fiber
Negative
 Food additives, excess sugar, pesticides, herbicides, trans fats

3. Food Additives
Excitotoxins
Glutamate, aspartate and L-cysteine
Found under a myriad of names
Artificial sweeteners
Aspartame, acesulfame K, saccharin, sucralose
Artificial colors
Interactions w/excitotoxins

4. Glutamate
Glutamate – a non-essential, negatively
charged AA from diet
The most ubiquitous excitatory
neurotransmitter in mammals – very important!
• Functions all over body (gut, immune
system, pancreas, neuromuscular junction and brain)
• Precursor to the inhibitory neurotransmitter
GABA
Disordered glutaminergic neurotransmission
has been implicated in FM
Excess glutamate can lead to excitotoxicity
• Also causes oxidative stress
Bound vs free glutamate
• Meat versus soy sauce

5. Hidden Excitotoxins
Acesulfame-K (Sunett, Sweet One)
Aspartame (Equal, NutraSweet, Canderel)
Autolyzed yeast (or autolyzed yeast extract)
Barley malt extract
Bouillon
Broth
Calcium caseinate
Carrageenan
Flavoring
Gelatin
Hydrolyzed corn, wheat, or soy protein
L-cysteine
Malt extract
Malt flavoring
Modified food starch (any type )
Monopotassium glutamate
Monosodium glutamate (MSG)
Natural flavoring
Nutritional yeast
Plant protein extract
Saccharin (Sweet’N Low)
Seasoning
Smoke flavoring
Sodium benzoate
Sodium caseinate
Sodium guanylate
Sodium inosinate
Soy (only soybean oil /soy lecithin are OK to eat)
Soy protein concentrate
Soy protein isolate
Spices (this term can hide other ingredients)
Stock
Sucralose (Splenda)
Textured protein
Whey protein concentrate
Whey protein isolate
Yeast extract
I also recommend avoiding all artificial
colors, artificial flavors, artificial
sweeteners

6. Food Additives
Gelatin

7. Focus on REAL Food
Real Food – Food that is not highly
processed
Low in additives, no trans fats
High in nutrients
High in fiber

8. What Nutritional Factors are Important
for Optimal Glutamatergic Function?
 Adequate protein and low sugar
 Antioxidants - Vitamins C & E
 Vitamin D
 Omega-3 Fatty Acids
 Magnesium
 Zinc

9. Protein and Sugar
Protein deficiency causes increased susceptibility to
excitotoxicity
Has been linked to increased prevalence of epilepsy in
developing countries
Excess sugar in the diet also increases susceptibility to
excitotoxicity
Ketogenic diet is used in epilepsy to counter this effect
Artificial sweeteners are not the answer!
Hundreds of times sweeter than sugar
Cause increased cravings for sugar (& alter taste Rs)
Can also cause increased excitotoxicity themselves

10. Vitamin C
Synthesized in all green plants
Potent antioxidant
• Protects against oxidative stress
Vitamin C saturates the brain first
Important for cartilage formation & immune
function, improves endothelial function & lowers BP

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

12. Vitamin D
VS.
Synthesized from cholesterol
• Inhibited by cholesterol lowering meds
• Also inhibited by older age, northern
latitude, season, sunscreen, clothing, dark skin, obesity
Important for calcium regulation, immune function,
serotonin synthesis
Reduces inflammation & protects against excitotoxicity

13. Omega-3 Fatty Acids
Important in maintaining fluidity of cell membranes
to support cell-to-cell communication
Protects against excitotoxicity
Prevents inflammation
Alpha-linolenic acid is the basic
essential omega-3 fatty acid in the diet
• Found mainly in walnuts, flax seeds, and oils
DHA
• Found in fish and fish oils
• Farmed vs. wild fish

14. Magnesium
A very important mineral!
75% of the population does not
meet the RDA of 420 mg
May be lost from GI tract in GI
disorders
Stress can alter magnesium
levels
Deficiency causes:
Neuromuscular excitability,
high BP, dizziness,
constipation, seizures,
tachycardia

15. Food sources of Magnesium

16. Zinc
Antioxidant Function
Can block NMDA receptors, protecting against excitoxicity
Deficiency caused by diets high in phytates and low in meat
Phytates are
high in seeds,
bran, beans,
& grains
Soaking helps
lessen phytate
load

17. Prebiotics - Fiber
Benefits
• Mucosal Barrier
• Reduction in bowel pH
• Synthesis ofVitamin K
• Production of short chain FAs
• Lowering of Cholesterol
• Improved glucose tolerance
• Gut-brain axis

18. Probiotics -Yogurt
Diarrhea/Antibiotic Use
Greek yogurt
Supplies beneficial probiotics (bacteria)
High in protein
Can be consumed by those who are lactose intolerant
Activia is not needed (and contains additives)
Plain or vanilla recommended
Can add:
Granola, wheat germ
Fresh or dried fruit
Nuts, honey
Lemon/orange cod liver oil

19. Mediterranean Diet
Bulgur

20. The End