The 1991 Persian Gulf War lasted only 43 days, but for hundreds of thousands of US veterans, their battle is still raging more than three decades later. They are suffering from what is called Gulf War Illness (GWI) – a cluster of chronic and debilitating health problems that can include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, skin problems, and memory impairment. According to a 2020 Department of Defense report, Gulf War Illness still affects 175,000 to 250,000 veterans of the nearly 700,000 troops who were deployed to the Gulf.

But now, there might be some hope, and the key might be as simple as diet. Kathleen Holton, an Associate Professor of Health Studies and Neuroscience at American University, received a US Department of Defense grant of $6.4 million for a clinical trial to confirm the efficacy of a low-glutamate diet as a treatment for Gulf War Illness. The diet has the potential to become a safe, low-cost treatment that can make huge improvements in the quality of life for countless veterans. 

Holton runs AU’s Nutritional Neuroscience Lab, which researches the impact of food and food additives (such as glutamate) on neurological and psychiatric disorders. Glutamate occurs naturally in some foods, like soy sauce, fish sauce, seaweed, mushrooms, and aged cheeses. It is also a flavor enhancer commonly added to processed foods, from fast food to frozen dinners. It functions as an important excitatory neurotransmitter in the nervous system — it is necessary for brain function and plays a role in learning and memory, but too much has been linked to neurodegenerative diseases and mental health disorders.

Holton previously conducted a small study of 40 veterans with Gulf War Illness, published in the journal Nutrients. After just one month on a diet low in glutamate, the veteran’s GWI symptoms were reduced, and they experienced less pain and fatigue. Holton's new study will recruit 160 veterans with diversity in race, gender, and body mass index, and she is hoping to start recruiting subjects in the beginning of January. If her previous results are confirmed in this larger study, she hopes to roll out this diet through the Veteran’s Affairs (VA) system by training all VA dietitians on how to administer the diet.

Stories of Hope

Holton has previously done research on other widespread chronic pain disorders like fibromyalgia, but she is drawn to working with veterans who have suffered these symptoms for many years. “They have given so much to serve our country and it feels good to be able to give back to them,” she says.

Holton has seen veterans in tears because they were so happy to finally feel a decrease in their symptoms. “Some of the most debilitating symptoms are not the widespread pain and fatigue, but rather the massive cognitive dysfunction and mood symptoms,” she says. “For example, we had one veteran who was still working, but constantly felt like he was trying to hide his cognitive symptoms so that he would not be fired. After a month on the diet, he reported that he was able to give presentations at work without misspeaking or being unable to remember what he was talking about and felt much more confident about being able to keep his job due to the drastic improvements in his cognitive function.”

Another study participant was divorced from his wife and had lost custody of his children due to his mood symptoms. After being on the diet, he not only felt dramatically better, but his massive mood swings were gone, allowing him to pursue shared custody of his children.  

“Many of the veterans talk about strained relationships due to the mood symptoms associated with GWI,” Holton explains. “The change in irritability was quite dramatic, where at baseline people reported fearing how angry they might get, and after a month on the diet, they were reporting that they no longer felt irritable all the time, with one veteran saying, ‘I no longer feel like throwing people through a window.’”  

Another veteran presented with very severe pain that would make him jump constantly, as if being shocked. He also suffered from severe PTSD, especially when he found himself in crowds. “He told us stories about how his service dog would ‘protect him’ in crowds by circling him for up to 15 minutes while he felt like he was having a panic attack,” Holton says. “After a month on the diet, his pain was drastically reduced; he no longer felt the electric shocks, and he was able to enter crowded locations with only a slight increase in his heart rate. Even his service dog could tell the difference, as he would only circle him once and then sit down!”

For More Information

For more information about Professor Holton’s work with veterans, visit American University’s Center for Neuroscience and Behavior, the Nutritional Neuroscience Lab, and the Department of Health Studies.