Diet

[Pianomom3355]

Hello again,

Does anyone have any diet suggestions for RLS sufferers? I know that I react to sugar, alcohol, caffeine, and gluten. I also
react to xylitol, erythritol, and other keto sweeteners. I have had trouble losing weight and am currently trying to cut
sugar out of my diet....any suggestions? I'd like to lose weight AND have less RLS symptoms.

Thanks!
Terri

[stjohnh]

The most commonly recommended diet that seems to help some RLS patients is a ketogenic diet. Didn't help me though. Lately there had been discussion of a low oxalate diet on this forum, and some people seem to be helped by that. There is no generally recognized diet that helps a majority of RLS patients.

[Frunobulax]

We don't know if it's connected to Restless Legs, but if you have trouble losing weight then you should definately consider keto to counter a likely metabolic syndrome (http://bb.rls.org/viewtopic.php?f=20&t=10588). Me, I lost 30 pounds over the last year while I was able to reduce my oxycodone from 30mg to 20mg daily. No guarantees though that it relieves RLS symptoms, but keto works very well for sustainable weight loss.

The theory behind this is that high insulin drives systemic inflammation, which may be connected to RLS. (We do know that inflammation changes iron metabolism, and that RLS is strongly linked to iron deficiency in the brain. But inflammation could be an independent factor for RLS in my personal opinion.) Ketogenic diet, if done right (avoiding omega-6 polyunsaturated fats) is considered anti-inflammatory.

[Pianomom3355]

I may give the keto diet another try....I just can't use the sweeteners, so that would be hard. I have a sweet tooth!

[Frunobulax]

I may give the keto diet another try....I just can't use the sweeteners, so that would be hard. I have a sweet tooth!

Stay away from sugar alcohols. Have you tried stevia, inulin and monkfruit? I also have issues with xylitol and erythrol, but I can tolerate those.
But you'll need only minimal amounts of sweeteners on keto, after a while.

Sweet tooth is an addiction. Robert Lustig and David Ludwig have good videos on that on youtube.

[debbluebird]

I continue to try and follow keto way of eating. It's not always easy for me, especially when I visit family members.
After a week or so of staying off sugar, gluten, artificial sweeteners, etc you should stop craving all of that. I take gabapentin which works against me. This way of eating reduces inflammation which in turn should help with the RLS.
Good luck.

[Pianomom3355]

Monkfruit doesn't work for me because it is usually combined with erythritol. Stevia is OK, but I don't care for the taste. Question for debbluebird:
you said that gabapentin works against you.....why is that?

[yawny]

Pianomom3355,
I just stumbled on a Monkfruit sweetener that has nothing else added to it, just pure monkfruit by Smart Monk. I react to additives, especially anything fermented, so this product has been really great. I use this one (https://amzn.to/2HxGhUr), but it looks like the company makes several versions (powder, liquid), and some do have erythritol.

You ask about diets...I’m currently experimenting with one for Histamine Sensitivity, or Histamine Intolerance (HIT), or Mast Cell Activation Syndrome (MCAS). And I have been doing Intermittent Fasting for at least a year. I skip breakfast and eat lunch around 1-2pm. I just drink water and herbal teas, ones for lowering histamine and inflammation, every morning. I’ve been slowly dropping pounds. The histamine diet is helping my sleep symptoms. I noticed over several years my symptoms being worse after eating certain foods and I think it might be histamine that’s the culprit. It’s so difficult to figure it all out. I have seen RLS listed as one of the many outcomes of histamine intolerance. The symptoms of HIT are varied but if you try the diet for awhile, you can see if it’s truly your ailment. If you’re interested, I think these websites are great place to start:

https://healinghistamine.com/

https://mastcell360.com/low-histamine-foods-list/

[badnights]

pianomom: the sweet tooth really does go away like deb says. For me, it took a couple of months, not a week, but I persevered and the cravings went away. It's actually microbes in your gut that want the sugar. My primitive understanding of it is: those microbes release chemicals that are absorbed into your bloodstream along with your broken-down food. Those chemicals travel to your brain and make you crave sugar. So if you stop eating sugar and easily digested carbohydrates (and eat lots of vegetables, and raw fermented vegetables) those microbes eventually die off and your cravings stop. The raw fermented vegetables contain living good microbes that can help re-populate your gut with good bugs.

(yawny: yikes! no fermented food! Is it just yeast you're sensitive to? You might be able to find raw kimchi or saurkraut without yeast??)

It's probably best to avoid artificial sweeteners always, and to avoid not only sugar, but food products with sugar added, and simple carbs like potatoes and rice (unless you've just exercised, and eat them alongside a good fat like avocado) and even fruit. Fruit should not be eaten to fill you up, it should be eaten in small quantities. It contains sugar, after all. (And depending on the fruit, also lots of micronutrients, so you don't want to cut it out completely.) (but if you decide to try keto again, and you want to actually get ketogenic, you will probably have to cut out fruit).

I would imagine that avoiding monk fruit will enable you to tell when your body/guts have adjusted and your craving is actually gone, but I don't know otherwise if it would be good or bad.

@ yawny: the whole histamine thing is interesting. We respond dreadfully - and universally (every one of us) - to anti-histamines that cross the blood-brain barrier. So why would histamines hurt us? I don't understand the physiology of it. I do think there's something relevant going on with our histamine system.

[yawny]

Beth,
I can’t tolerate the traditionally heavily fermented foods so all yeast (I’ll love you forever, bread), vinegars, yogurt, etc., but also I’m finding sensitivity to foods on the high histamine lists like oranges. I was taking a vitamin C with my iron supplement and my legs went bonkers. Turns out the vitamin C had a citrus/orange base. And most Vitamin C on the market are corn based which is also often fermented (corn is high histamine). If you’re a RLS sufferer, and are told to take iron, but you’re also sensitive to histamine, I imagine this protocol would make things worse, and it can with varying degrees and symptoms. Maybe this is why some of us don’t improve on iron supplementation? So now I’m consuming powdered Camu which is very high in vitamin C and recommended by histamine educators. Strangely, my favorite foods have always been what are considered high histamine. I could happily make a meal of pickles, sliced lemons with salt, or fluffy wheat bread. I’m definitely bitter about the loss.

[badnights]

Fascinating stuff! I didn;t realize that even the fermented vegetables had high histamine contents. I just read on a website that a healthy gut is full of enzymes that break down histamines before they can be absorbed into our bloodstream. Unhealthy gut = problems with too much histamine in our bodies. The content on this website seems professional enough but they are trying to sell something (https://bodyecology.com/articles/histam ... ted-foods/). I probably shouldn't post without researching it more but - here it is, with that caveat. (I'm sure yawny you've already researched this and can correct if it's off base). More from the site:

"Two enzymes are responsible for breaking down histamine. They are DAO (diamine oxidase) and HNMT (histamine-N-methyl-transferase). When these enzymes aren’t working like they should—or if we are genetically wired to have underactive enzymes—we begin to show signs of histamine intolerance.

You can help the DAO enzyme do its job by making sure your diet is rich in vitamin C and vitamin B6.

There are a few factors that influence DAO activity. In women, the menstrual cycle can actually predict how much of this detoxifying enzyme is available. (10) For example, during the luteal phase (after ovulation), a healthy woman has higher levels of DAO. This means that it is easier for her to detoxify histamine after she releases an egg and before she menstruates.

But one of the most important factors that influences DAO activity is diet. ... a healthy small intestine is full of enzymes that break down histamine. When the small intestine is inflamed or leaky, there is less DAO and more histamine."
They point out that "histamine produced by gut bacteria actually regulates the immune system and has an anti-inflammatory effect." and go on to suggest healing leaky gut as a way of removing histamine intolerance (but only if you're not one of the people with a genetic intolerance): eating more soluble fiber while on a diet low in histamine-rich foods for a few months, then re-introducing histamine-containing foods.

From another site (https://paleoleap.com/histamines/)
"The biggest nonfood source of histamines in most people’s bodies, though, is their gut flora. Some kinds of bacteria produce histamines, while others degrade them. Too many histamine-producing bacteria can fill up your “sink” faster than DAO can empty it..... DAO, the “emergency drain” in the histamine sink, is mainly produced by the mucous lining the intestinal wall. If the lining of the gut is irritated (by inflammatory foods like grains and legumes), DAO production decreases, and the symptoms of histamine overload only get worse.
To sum it all up, good gut health is just as important for histamine tolerance as it is for everything else. Unhealthy gut flora might even be able to create histamine intolerance problems in a person who would otherwise be completely healthy."

Their solution is the same: heal the gut. Here's their protocol for that:
"Gut healing on a low-histamine diet seems like a paradox, because the fermented foods that you need to heal are the same foods that are causing the problem! It is possible to restore normal gut flora without sauerkraut, though:

- > a well-chosen probiotic supplement. In this study, a supplement with two strains of bifidobacterium actually suppressed histamine release. In another study, Lactobacillus rhamnosus helped suppress histamine receptors.
If you’re not interested in micromanaging your probiotic strains, don’t worry: you have another option that might be even better. This new treatment is confusing, because it sounds almost the same: prebiotics are just one letter away from probiotics. Instead of a supplemental dose of gut flora in pill form, prebiotics deliver a tasty banquet of fiber to the flora that are already in your intestines. They’re basically a kind of carbohydrate indigestible to humans, but absolutely delicious to the bacteria.
Prebiotics require a little bit of caution: in people who have too few gut bacteria, they’re excellent, but in people who have too many, they’re just more fuel on the fire... If you feel bloated, gassy, and constipated afterwards, they’re not for you. " They also mention DAO supplements, vitamin B6, copper, and vitamin C.

Strangely, my favorite foods have always been what are considered high histamine. I could happily make a meal of pickles, sliced lemons with salt, or fluffy wheat bread. I’m definitely bitter about the loss.

Sometimes I wonder if the stuff we like becomes the stuff that's bad for us because we expose our bodies to too much of it. Maybe the threshold is really low.

[debbluebird]

I have recently lost weight. 20 pounds. I have to say, that my sleep has been improving. RLS is under control. I feel so much better.
I have always struggled to lose weight. This time I'm on a low salt diet because I was retaining fluid. I was started on a diuretic. Consequently I'm eating a lot of fresh fruit and veggies.

[Polar Bear]

debbluebird - Well done. I'm so glad you are feeling better.

[Yankiwi]

Congratulations. Fresh fruit and veggies are the best.
I eat lots of fruit but not much in the way of vegetables. I know it should be the other way around.

[debbluebird]

Since losing this weight, I have not had any RLS. It's been 2.5 weeks since my last RLS episode and I really can't believe it. It's got to be that the weight is not pulling on my back. My RLS stems from my pinched nerves in my back.
I just find this very interesting. In the past, I always thought that when I went to exercise class, I'd have some RLS. That seemed to be a pattern. Now I have been going to class M - F and doing a lot of walking, what also always seemed to he a trigger. I'm still not having any RLS.
Now granted it's only been 2.5 weeks since the loss, but I'm very interested in seeing what's going to happen.
I haven't been at this weight since 1999. Before I gained this weight, at that point, I was taking mirapex and it didn't always help my RLS.
So this time period is also the difference between a DA and an opioid .
I realize that other people's RLS may not be caused from pinched nerves.