The Chronic Fatigue Syndrome Diet

Eating for Symptom Management

Woman sitting on bed, holding fruit salad, mid section
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A healthy diet can be an important part of managing chronic fatigue syndrome (CFS or ME/CFS). While it's not a "cure," and there is no magic diet that works for everyone, eating right can help you feel better and have more energy.

As important as eating right is not eating wrong—certain foods and drinks could be worsening your symptoms. It will take some trial and error to find what works best for you, and that starts with learning what you can about how food may be impacting you.

ME/CFS & Diet: The Research

We don't have a lot of research on diet and nutrition for this disease, and none of it is conclusive. Until we know more, you'll have to test the information for yourself and see what helps.

A review of studies on diet and nutritional supplements published in 2017 underscores some problems with research that has been done. The authors said:

  • the amount of studies is inadequate
  • they didn't include enough people
  • weren't long enough
  • didn't use enough measures to evaluate changes

However, they did find at least some evidence that certain foods/nutrients improved fatigue. They included:

The study on chocolate was published in The Nutrition Journal. It involved just ten subjects and lasted eight weeks. The results suggested improvement in depression, anxiety, and general function in addition to fatigue.

The polyphenols in chocolate are a type of antioxidant, which may be especially important in ME/CFS. Antioxidants are believed to reverse damage to molecules that may cause illness. One theory about the underlying mechanisms of this disease includes oxidative stress, which is treated with antioxidants.

A study published in The Journal of Human Nutrition and Dietetics looked at a low sugar, low yeast diet verses healthy eating. Researchers found no significant differences between them and concluded that guiding people to eat healthy is more pragmatic than a complicated dietary regimen.

A 2012 study on dietary habits concluded that dietary changes should be based on proven allergies or intolerances rather than suggesting a single diet for everyone.

To see whether you have food allergies or intolerances that could be contributing to your symptoms, talk to your doctor about testing. You may also want to try an elimination diet.

A "Balanced Diet"

With few answers coming from research, the best advice may be to simply eat a healthy, balanced diet. What, exactly, does that mean, though? There's a lot of contradictory information out there.

According to nutritionists, a balanced diet is mainly one that includes a wide variety of foods and drinks from all the food groups, while practicing moderation when it comes to saturated or trans fat, cholesterol, refined sugar, salt, and alcohol.

The five food groups are:

  1. grains
  2. fruits
  3. vegetables
  4. protein (poultry, fish, lean meats or dried beans)
  5. dairy (low-fat milk, cheese or yogurt)

    Some ME/CFS doctors recommend against caffeine and other stimulants, believing that the energy they provide puts too many demands on your system and will leave you more tired and sick in the long run. This hypothesis, however, has not been proven.

    If you're having trouble making positive changes to your diet, you may benefit from seeing a nutritionist.

    Raising Available Serotonin

    Serotonin is a neurotransmitter that's involved in several processes in your brain, including pain perception, sleep regulation and feelings of well being. Abnormal serotonin levels are linked to ME/CFS, as are several overlapping conditions, including irritable bowel syndrome, some sleep disorders, and depression.

    Medical science doesn't yet know for sure whether we can raise serotonin levels in the brain through the diet. For more information on serotonin dysfunction, plus foods and supplements that may increase it, see:

    Inflammation

    ME/CFS is believed to involve chronic inflammation. Many comorbid conditions cause inflammation as well.

    So far, an anti-inflammatory diet hasn't been studied for this disease. However, doctors recommend it for many people with inflammatory conditions.

    You can learn more here:

    Some Caveats

    Here are some things to keep in mind while experimenting with your diet to see if it improves your health.

    While improving your eating habits might help you lose weight, keep in mind that your first goal needs to be feeling better. Once you feel better, you'll be more able to face the specific challenges that keep you from dropping extra pounds.

    DO NOT TRY EXTREME OR "FAD" DIETS. Make dietary changes one at a time so you can gauge their effect on your health. Sudden or extreme changes—even beneficial ones—could temporarily make your symptoms worse.

    A lot of websites advertise "cures" or treatments in the form of diets and supplements. Some of these are reputable, while others are not, so it's important to research the claims they make. Some diets may not provide proper nutrition, which could damage your health. Others may require you to spend a lot of money on proprietary products that might not work and may be hazardous.

    Getting Started with Good Nutrition

    If you're feeling overwhelmed and don't know how to get started, here are more resources that can help you:

    • Learn more about general nutrition from Verywell.com's Nutrition page.
    • Get nutritional information for several brands of foods and for restaurant meals at CalorieKing.com.

    Don't forget that your doctor is an important resource when it comes to nutrition. Talk to him/her about any changes you make and what results they have. You might also want to see a nutritionist who can help you plan meals and change your eating habits for the better.

    Sources:

    Campagnolo N, Johnston S, Collatz A, Staines D, Marshall-Gradisnik S. Dietary and nutrition interventions for the therapeutic treatment of chronic fatigue syndrome/myalgic encephalomyelitis: a systematic review. Journal of human nutrition and dietetics. 2017 Jan 22. doi: 10.1111/jhn.12435.

    Hobday RA, Thomas S, O'Donovan A, Murphy M, Pinching AJ. Dietary intervention in chronic fatigue syndrome. Journal of human nutrition and dietetics. 2008 Apr;21(2):141-9. doi: 10.1111/j.1365-277X.2008.00857.x.

    Sathyapalan T, Beckett S, Rigby AS, Mellor DD, Atkin SL. High cocoa polyphenol rich chocolate may reduce the burden of the symptoms in chronic fatigue syndrome. Nutrition journal. 2010 Nov 22;9:55. doi: 10.1186/1475-2891-9-55.

    Trabal J, Leyes P, Fernandez-Sola J, Forga M, Fernandez-Huerta J. Patterns of food avoidance in chronic fatigue syndrome: is there a case for dietary recommendations? Nutricion hospitalaria. 2012 Mar-Apr;27(2):659-62. doi: 10.1590/S0212-16112012000200046.

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