April 23, 2020

Diet Makes a Difference

Diet can have a significant effect on the symptoms of many chronic conditions, and RLS is no exception. While there is no specific “RLS diet,” your dietary choices can make a difference – and may even help avert a night of unwanted “night walking.”
For many people with RLS, the optimum diet boils down to avoiding four common ingredients: caffeine, alcohol, sugar and salt. Pay close attention to your diet and RLS to determine if any of these ingredients trigger RLS symptoms.
Research studies have shown caffeine to be an RLS trigger. In addition to avoiding coffee and caffeinated tea, be sure to check ingredient lists for hidden sources of caffeine in soda, chocolate, energy drinks and other convenience foods. Another common RLS trigger is alcohol, which disrupts sleep, and in turn exacerbates RLS. Watch for hidden sources of alcohol in products such as mustard, extracts, sauces (e.g., bearnaise or bordelaise) and fondue.
Anecdotally, many people report that sugar, artificial sugars (such as those found in reduced-calorie and weight loss products) or salt increases their RLS symptoms. With salt, it is thought that excess fluid retention may stimulate sensory components in the legs that trigger RLS sensations.
If your healthcare provider determines that a vitamin deficiency is contributing to your RLS, then you may be directed to supplement your diet with iron, vitamin B12 or folate.
In fact, all patients with RLS should have their iron stores checked. Iron is vital to the functioning of the brain’s dopamine system. In addition, brain iron deficiency is a known contributing factor to RLS. For someone with RLS, it’s important to maintain a serum ferritin (blood iron) level above 75–100 micrograms per liter (as measured by a serum ferritin lab test). Lower iron stores correlate to greater severity of RLS symptoms.
If your ferritin level is low, your doctor may ask you to increase your dietary intake of iron through supplements or food. You can find heme iron (animal-based) in beef, poultry, seafood and fish; and non- heme iron (plant-based) in foods such as tofu, beans, fruits, vegetables, and enriched cereal, rice and pasta. To absorb the most iron, avoid supplements or eating foods high in calcium (for example, calcium supplements, dairy products) for two hours before or after taking iron. The tannins in coffee and tea also reduce the absorption of iron. On the other hand, consuming foods high in vitamin C, such as strawberries or orange juice, may enhance your iron absorption.
Your doctor may also recommend intravenous iron therapy or oral iron supplements to treat your RLS. Iron supplements should only be taken under the care and supervision of a healthcare provider.
Another dietary element to consider is magnesium. Magnesium plays a role in regulating protein synthesis, nerve and muscle function. It is vital for the function of gamma aminobutyric acid (GABA) receptors in the brain, which initiate sleep. Low magnesium can cause a variety of health issues, including numbness, tingling, muscle twitching, cramps and muscle soreness.
The recommended daily allowance for magnesium is about 400 mg for adults. You can find magnesium in green leafy vegetables, cereals and, to a lesser extent, foods containing fiber. Foods that interfere with magnesium absorption include carbonated beverages, sugar, high-carb foods, caffeine and alcohol. However, there is little research to show that increasing magnesium via supplement intake improves RLS. Please consult with your healthcare provider before taking any supplements, as moderate amounts of some minerals can cause toxicity.
If you suffer from gastrointestinal symptoms such as gas, bloating, abdominal pain, intermittent diarrhea and constipation, or anemia, then your provider may evaluate you for two disorders that impair iron absorption: small intestinal bacterial overgrowth (SIBO) and celiac disease. The common link between these disorders is gluten. While there is little evidence suggesting that gluten causes or exacerbates RLS, limited research has shown a link between gluten ingestion and changes in bacteria in the gut, which may result in SIBO. For people who have SIBO, the small intestine does not absorb nutrients as it should.
Celiac disease is an immune disorder in which ingestion of gluten can damage the small intestine and limit the absorption of nutrients. If you have persistent low iron levels on lab tests and are taking oral iron supplementation as directed, your doctor may order a specific antibody blood test to check for celiac disease.
If you are diagnosed with SIBO or celiac disease, your doctor my recommend a gluten free diet to increase absorption of nutrients, and iron in particular.
When making dietary changes or starting supplements to improve RLS symptoms, keep in mind that obesity is associated with RLS, and maintaining a healthy weight in general can help to alleviate health issues. Ask your doctor about dietary changes you can make to improve your health – such as following the Mediterranean diet or a gluten-free diet. Be sure to avoid fad diets, which are difficult to maintain and may even cause weight gain in the long run. By taking steps to a healthier lifestyle by getting moderate exercise and eating right, you can make strides toward improving your RLS.