Effects of lacto-vegetarian diet and stabilization core exercises on body composition and pain in women with fibromyalgia

This was a small randomized control study done in 2018 through the University of Alicante in Spain. A randomized controlled study is one in which people are allocated at random to receive one of several interventions. This means that the treatments can be compared more fairly. 

Background: fibromyalgia is a disease of unknown origin characterized by chronic muscular pain. The lack of knowledge about this disease is one of the main causes that makes it complex to make a diagnosis and an appropriate treatment.

Objective: the main objective of this study was to know the effectiveness of physiotherapy treatment combined with a lacto-vegetarian dietary-nutritional intervention, on low back pain and body composition in women with fibromyalgia.

Methods: twenty-one women were randomly divided into three groups: 

A (core stabilization exercises + lacto-vegetarian diet), 

B (placebo + lacto-vegetarian diet) and 

C (control). 

A lacto-vegetarian diet avoids animal products and eggs but does include dairy products.

The intervention lasted 4 weeks. Pain assessments (EVA scale) and body composition (bioimpedance) were performed at the beginning and at the end of the intervention.

The core is the group of muscles that surround the spine and midsection. Muscles in the midsection, glutes, hips, along the spine, and others work together to uphold the stability of the spine.

Results: group A showed significant changes in pain reduction and body composition at the end of the intervention, increasing muscle mass and decreasing fat mass. In addition, this group significantly improved outcomes compared to groups B and C. The correlations showed a relationship between muscle mass and pain reduction referred to at the end of the study in patients in group A.

Conclusions: the four-week intervention program contributed to both pain reduction and improved body composition. The program combined core stabilization exercises plus lacto-vegetarian diet in patients with fibromyalgia who had low back pain. 

Implications for those of us with fibromyalgia this gives us hope that combining these 2 strategies can provide us with reduced symptoms of pain and specifically low back pain. 

I have written to the researchers and hope to get some more specifics on the diet and exercises that were done and obviously they will be shared here when they are received. 

DIETARY NUTRITIONAL PROGRAM INFORMATION FROM THE STUDY
The recommended daily amount of micronutrients for the Spanish population, was planned by a registered dietician-nutritionist. 

Before the start of the study all participants began a prior nutritional education program so that they could follow the dietary program
during the intervention without any problem. 

• Protein consumption was around 1.2-1.4 g/kg (< 20% of total calories) of body weight; 
• Carbohydrate intake was 5-8 g/kg (50-60% of total calories) of body weight
• Lipids around 1 g/kg (20-30% of total calories) of body weight.

REHABILITATION PROGRAM WITH CORE EXERCISES

The proposed exercises consisted of keeping the spine in a neutral position while maintaining the physiological curvatures when it is subjected to internal or external forces that test its stability

The patients performed a 30-minute exercise program twice a week,

always at the same time.

The intervention lasted 4 weeks where the exercises progressively increased their difficulty based on the technical execution and intensity of the exercise. The intensity of the exercise was evaluated using the scale of perceived effort for

women with fibromyalgia.

The participants began the first sessions with basic lumbo pelvic stabilization exercises focused on the movement of anteversion and retroversion of the pelvis. 

Exercises examples were bridges where the pelvis had to be kept against the force of gravity without resting on the floor,

or “pointing dog” and “dead bug”, in which the patients

kept the spine in a neutral position against forces caused by the movement of their limbs.

The exercise protocol consisted of performing 10 basic core exercises. There were exercises more difficult variables for patients with better physical condition. 

The number of sets and repetitions depended on the previous physical condition of each patient, starting with 1 set of 5 to 10 repetitions for each exercise and following the recommendations of the exercise guidelines published by the American College of Sport Medicine.

All exercises were performed in a controlled and progressive manner, without causing muscle discomfort, pain or causing excessive fatigue. The last 5 minutes of the session were used to perform a series of simple stretches to end the session.

SOURCE: MARTÍNEZ-RODRÍGUEZ A, LEYVA-VELA B, MARTÍNEZ-GARCÍA A, NADAL-NICOLÁS Y: [Effects of lacto-vegetarian diet and stabilization core exercises on body composition and pain in women with fibromyalgia: randomized controlled trial]. Nutr Hosp 2018; 35:392-9