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The Best Diet for Hypermobility Conditions (HSD & EDS)
- Aleisha Adams, Accredited Practicing Dietitian
- 2 days ago
- 7 min read
Hypermobility conditions, including Ehlers Danlos Syndromes (EDS) and Hypermobility Spectrum Disorders (HSD), affect connective tissues and are characterised by joints that move beyond their normal range. Digging deeper, altered connective tissue affects far more than just joints - with many of our clients with EDS and HSD also facing co-existing conditions and symptoms including mast cell activation syndrome (MCAS), pain, fatigue, digestive issues, postural orthostatic tachycardia syndrome (POTS) and dysautonomia - just to name a few! Managing these often involves a holistic approach and multidisiplinary healthcare team, including Nutrition and Dietetics. While diet cannot cure hypermobility, nutrition plays a crucial role in managing co-morbidities and symptoms.
Here we explore the best diet for hypermobility spectrum disorders and EDS and share our practical tips on how you can support your joint health and overall well-being.
Disclaimer: this information is for educational purposes only. Please speak with a dietitian or qualified health professional for personalised advice.
Micronutrients and Hypermobility: What do I need?
Nutrition is a vital component in managing hypermobility conditions. Many individuals with EDS and HSD face higher micronutrient needs due to factors such as absorption issues, chronic inflammation and poor oral intake. Suboptimal levels of specific micronutrients can exacerbate both general health concerns, and specific symptoms and conditions related to Hypermobility & Co.
These are a few key nutrients we evaluate with clients:
Vitamin C: also called ascorbic acid, is critical for collagen synthesis, wound healing and supporting connective tissue integrity. Specifically, it increases the production of both type I and X collagen which are needed for bone matrix formation and supporting articular cartilage. Vitamin C also helps the body break down histamine and contains antioxidants to suppress inflammatory processes [1]. While vitamin C-rich foods are found in foods such as citrus fruits, capsicum, broccoli and strawberries, research suggests that additional daily supplementation of 750-1000mg Vitamin C is beneficial for those with hypermobility conditions [2]. It is especially important to consider for those on diets limiting histamine and salicylates, where dietary Vitamin C intake is often reduced.
Magnesium glycinate: a highly bioavailable form (as it is bound to the amino acid glycine which transports it across the gut lining), is particularly beneficial for individuals with hypermobility. It supports muscle relaxation, reduces cramps, may support sleep quality and aids in reducing anxiety through the regulation of neurotransmitters such as GABA. Magnesium glycinate is often the preferred form of magnesium due to its bioavailability and tolerance in high doses. Food sources of magnesium include leafy greens (rocket, kale), nuts (almonds, cashews), seeds (pumpkin, chia), and whole grains (quinoa, brown rice etc.) [3].
Zinc: Zinc not only plays an important role in tissue repair and immune function, but also assists in regulating degranulation and cytokine production in mast cells. The best food sources of zinc include shellfish, red meat, chicken, and nuts and seeds [4].
Vitamin D: Vitamin D deficiency is prevalent among individuals with hypermobility and is associated with an increased risk of osteoporosis, and likely increased risk of excessive mast cell activation. In most cases, those with EDS or HSD require supplementation of D3 (and lots of sunlight!) to maintain optimal levels to support calcium absorption and bone density. [2]. Small amounts of vitamin D are found in fatty fish, egg yolks, cheese, beef liver and sun-exposed mushrooms.
We always suggest getting your blood serum levels tested with your general practitioner to highlight any suboptimal micronutrient, and correct levels through supplementation as needed. A food first approach is always preferred when trying to maintain the best diet for your hypermobility, however in some cases, supplements may be required under Dietetic or Medical guidance (e.g. especially in cases of ongoing inflammatory symptoms, motility disorders, or malabsorption).
See our post: 'Supplements for Hypermobility and EDS: what should I look out for'.
Is there a 'best diet' for hypermobility?
People with hypermobility conditions often face unique nutritional challenges, including gastrointestinal issues, nutrient absorption difficulties, and chronic inflammation. There is no ‘best’ diet for hypermobility, as everyone has individual needs and different symptom presentations. However, there are several dietary considerations that can help alleviate symptoms and support connective tissue health.
Some of these key elements include:
Protein-rich foods: Protein is vital for maintaining and repairing the body’s tissues, including muscles, tendons, and ligaments. For individuals with hypermobility, consuming adequate protein helps support joint stability, muscle strength, and recovery from physical strain. Additionally, protein helps regulate blood sugars throughout the day, supporting energy levels and reducing the risk of dysregulation, which can often impact POTS and MCAS symptoms.
Tips:
Although there is not a ‘set’ amount of protein that has been researched for hypermobility, we typically aim for a higher amount of 1.5-1.9g protein per kg of body weight. For example, if you weigh 60kg, you would be aiming for 90-114g protein per day.
Spread your protein throughout the day, aiming to include a good source of protein at every food opportunity.
Best sources of protein include: meat, chicken, fish, eggs, tofu, legumes and dairy (if tolerated)
Using a protein powder (e.g. Whey, plant-based or collagen) can be an easy way to meet your protein targets if you struggle with food intake due to nausea or low appetite.
Anti-inflammatory foods: chronic inflammation is common in hypermobility conditions, which may be due to,
MCAS
repeated injuries and micro-injuries
nutrient deficiencies
under-eating
gut dysbiosis
chronic stress
infections
autoimmunity
Anti-inflammatory foods incorporate a wide range of nutrients which can lower markers of inflammation (e.g. CRP is one of the most common general inflammatory markers commonly tested), alleviate joint pain and have even been shown to reduce symptoms of depression [1]. These foods include:
Omega 3s - the most useful forms for our body (DHA & EPA) are found in oily fish such as salmon, sardines, mackerel, trout and some algae, and less bioactive forms (ALA) are found in many foods including extra-virgin olive oil, flaxseeds, walnuts and hemp seeds. The fatty acids in EPA and DHA have also shown promising outcomes for reducing skin inflammation and protecting the skin from UV damage [2].
Beans and legumes - contain prebiotic fibres which support the production of short-chain fatty acids (SCFAs) in the gut. SCFAs indirectly reduce inflammation in the gut, while also supporting gut motility, blood flow and blood sugars.
Dark red and purple fruits and vegetables - for example, berries, pomegranate, cranberries, beetroot, red cabbage, purple carrots. These foods are rich in potent antioxidants, such as polyphenols, flavanols and lycopene, which work to combat free radicals and oxidative stress in the body.
Herbs and spices - particularly turmeric, ginger, garlic and rosemary. Herbs and spices contain powerful anti-inflammatory compounds and antioxidants which work by suppressing pro-inflammatory molecules and protecting tissues from oxidative damage.
3. Electrolytes and hydration: Cardiovascular changes due to hypermobile blood vessels and altered autonomic nervous system function can result in people with HSD & EDS having very high sodium requirements, and potentially altered fluid requirements compared to the general population. If you have a dysautonomia and symptoms indicating the need for sodium supplementation, not having enough sodium can worsen fatigue, brain fog, mood and cardiovascular symptoms. Additionally, fluid is essential for helping to flush out toxins and keep the joints lubricated. We won’t go into too much detail here, but check out our other blog posts on our favourite electrolytes for POTS and POTS and hydration.
Additional considerations for Hypermobility nutrition
Nutrition in hypermobility conditions can be quite complex, as many individuals with HSD or EDS also have co-existing conditions such as MCAS, POTS, gastrointestinal motility issues and are neurodivergent. This presents with additional considerations around food sensitivities, digestion, sensory preferences and executive function. This is where it is always best to consult with a dietitian for personalised advice and guidance. If you have co-existing conditions, here are some other dietary factors to consider:
Histamine
Many of our clients with hypermobility conditions experience food sensitivities, often exacerbated by MCAS and histamine sensitivities. If this is the case, some of our clients need to reduce:
Histamine-containing foods
Histamine liberators - foods that trigger the release of histamine from mast cells
Diamine-oxidase inhibitors - foods that block the release of DAO, an enzyme that breaks down histamine
These foods may directly trigger symptoms such as headaches, skin rashes/flushing, nausea, dizziness, digestive distress, inflammation and widespread pain. However, reducing histamine is not a black and white approach. Every person with MCAS or histamine sensitivities reacts to different foods and triggers. For example, while one person may aggressively react to tomatoes, another may have no symptoms but react to dairy.
It's important to note that there are many non-restrictive dietary factors which can exacerbate histamine sensitivity in HSD & EDS, including fecal loading, gut microbiome health, poor hydration, food storage and more. There are also supplements (such as DAO enzyme) and medications (such as H2 antihistamines and mast cell stabilisers) that can work to manage your 'histamine bucket' and MCAS reactions - so don't stress if you have symptoms of histamine intolerance but have no capacity for dietary restriction!
Gastrointestinal Issues
Very rarely do we see clients with hypermobility who do not have any gastrointestinal symptoms such as constipation, diarrhoea, gastroparesis, reflux and vascular compressions. This can really complicate digestive ability and certain modifications may be necessary such as high/low fibre diet, soft/easy to chew foods or liquid nutrition.
Neurodivergence and executive function
Neurodivergence and hypermobility commonly co-exist. For people who identify as neurodivergent, there may be a few additional areas that we consider, including:
Executive function - meal planning/shopping and decision making can be more fatiguing and overwhelming, so finding systems that work for each individual is key
Sensory preferences - including flavours, smells and textures of foods, sounds that appliances make, and the desire for sameness (or variety and sensory seeking!)
Interoception - altered hunger, fullness, thirst and bowel cues
Motor skills - impacts resulting in the meal preparation process being more physically and mentally exhausting for some
While the message ‘fresh is best’ is often projected in the nutrition space, it carries significant unacknowledged privilege and ableism. The best diet for hypermobility for some may be one that is more processed and pre-packaged to accommodate for low spoons, or to meet executive functioning capacity.
To wrap up...
The general consensus is that an anti-inflammatory diet rich in wholefoods such as fruits, vegetables, wholegrains, protein & herbs and spices is the best diet for hypermobility conditions. However, finding the right eating pattern for individuals tends to involve a bit of trial and error, and adaptation to meet individual needs and capacity.
Working alongside a health professional to help you map your gastrointestinal symptoms, identify your triggers and assess the appropriateness of dietary restrictions is essential to prevent nutrient deficiencies and further complications. If you're curious to learn more, download our free anti-inflammatory food guide and shopping list for more ideas!
~ Aleisha
Aleisha Adams is an experienced Dietitian, currently accepting clients on a case-by-case basis. Alongside Hypermobility & Co dietetics, she has a special interest in relationship with food counselling, meal planning for complex dietary needs and microbiome health. To enquire about bookings with Aleisha, email us at admin@savvydietetics.com.au.
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