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

Objective. The Mediterranean diet is known for its antioxidant, anti-inflammatory, and low-antigen properties. The rationale is that this diet can modulate fibromyalgia (FM) symptoms for patients, but it has not been reviewed focusing on its low-antigen and anti-inflammatory properties. The objective of this review is to understand whether these properties of the Mediterranean diet can potentially alleviate symptoms of FM. Methods. This study was conducted using the 2020 version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Two electronic databases- PubMed and Google Scholar, were searched for interventional, observational, therapeutic, and clinical trial articles published between 2019 and 2024. Key search words included: ‘Fibromyalgia’ ‘Mediterranean Diet’ ‘Low-Antigen Diet’ ‘Anti-inflammatory Diet’ ‘Omega3’ and ‘Vitamin D’. Results. Of 88 records screened in the title/abstract stage, 5 interventional, 5 observational, 0 therapeutic, and 0 clinical trial articles were included in the systematic review. The sample sizes in interventional studies varied between 13 and 84 and for observational studies varied between 84 and 442. Evidence suggests that adherence to a Mediterranean diet is associated with significant improvements in FM-related symptoms, including chronic widespread pain, autonomic dysfunction, persistent fatigue, sleep disturbances, and cognitive impairments such as ‘fibro fog’. Conclusion. The articles studied within this review show that there is a relationship between the gut and how FM symptoms can be affected. They suggest that placing patients with early symptoms of FM on a Mediterranean diet may have a low to moderate effect on manifestation, especially before medications are introduced.