Download Chronic Fatigue Syndrome - British Dietetic Association

Food Fact Sheet
Chronic Fatigue Syndrome
Can what I eat help CFS/ME?
The body needs a balanced healthy diet to keep it at
its best. Use the Eatwell plate as a guide to ensure
your diet contains a variety of foods from each of the
following groups:
Eatwell Guide
Check the label on
packaged foods
Use the Eatwell Guide to help you get a balance of healthier and more sustainable food.
It shows how much of what you eat overall should come from each food group.
Each serving contains
Energy
1046kJ
250kcal
Fat
5g
LOW
Saturates Sugars
1.3g
LOW
Salt
34g 0.9g
HIGH
of an adult’s reference intake
Typical values (as sold) per 100g: 697kJ/ 167kcal
nd
Potatoes
Fr
ui
of
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v
Eat at
leas
t5
Whole
grain l
cerea
Cous
Cous
Bagels
Frozen
peas
Rice
Lentils
Tuna
• difficulty sleeping or un-refreshing sleep
• muscle and/or joint pain
• headaches, poor concentration or poor memory
Plain
nuts
Beans
lower
salt
and
s ugar
Chick
peas
Spagh
etti
L o w f at
s o f t ch e es e
n
Leaince
m
Semi
skimmed
Crisps
Eat less often and
in small amounts
Limit fruit juice
and/or smoothies
to a total of
150ml a day.
Whole
wheat
pasta
Porridge
Sauce
w
Chopped
t omatoe s
Symptoms can include some or all of the following:
• constant mental and physical tiredness
(exhaustion)
ot
Water, lower fat
milk, sugar-free
drinks including
tea and coffee
all count.
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ta
rs
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What are the symptoms?
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Raisins
6-8
a day
gar
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salt
fat,
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rtio
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ab
ir et
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Choose foods lower
in fat, salt and sugars
Choos
e wh
oleg
rain
or h
Pota
igh
toes
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, ri
ve
ce
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y day
ever
bles
eta
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MED
12.5% 7% 6.5% 38% 15%
ith
Chronic fatigue syndrome (CFS)
is also called ME, which stands
for myalgic encephalomyelitis
(or encephalopathy). CFS/ME is
a serious condition that affects
both adults and children and
can cause long-term illness and
disability.
Soya
drink
milk
Be
ans
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lses
Ea
,
t
Veg
O il
Plain
Low fat
y o g hu r t
es
ativ
ltern
nd
nd a
fish, e
airy a
fat a
ggs, mea
t and other proteins D
wer tions
se lo
so more
red urced beans a
nd pu
and fish p
proc er week lses, 2 portions of sustainably
,
esse
d meat one of which is oily. Eat less
Choo ugar op
s
lower
Per day
2000kcal
Lower fat
spread
Oil & spreads
Choose unsaturated oils
and use in small amounts
2500kcal = ALL FOOD + ALL DRINKS
Source: Public Health England in association with the Welsh government, Food Standards Scotland and the Foods Standards Agency in Northern Ireland
© Crown copyright 2016
• feeling sick (nausea) wind/bloating, stomach pain
and diarrhoea and constipation (similar to irritable
bowel syndrome (IBS) symptoms)
• Starchy food, such as bread, cereals, potato, rice,
particularly slow release types of starchy food
with a low GI (glycaemic index) such as oats,
pasta and wholegrains. Include a portion at every
meal.
• intolerance or sensitivity to alcohol, caffeine,
some foods or medications.
• Fruit and vegetables – aim to eat five or more
portions a day. Fruit makes an ideal snack.
• always getting a sore throat or ‘flu-like’ symptoms
Diagnosis for CFS/ME is only made after other
possible diagnoses have been ruled-out and symptoms
have continued for four months in adults or three
months in children.
• Meat, fish and alternatives, also eggs, nuts,
beans, pulses and vegetarian/soya alternatives.
Include these at two meals.
• Milk and dairy products, including cheese and
yoghurts. Also calcium enriched milk alternatives
such as soya based products.
Many people with CFS/ME find eating little and often
is helpful, aiming for every three to four hours. For
example, three meals daily with the addition of three
snacks in between may help to improve energy levels.
It might also be worth trying to add porridge or
wholegrain cereals, pasta or bread (also called low
glycaemic index (GI) foods) which slowly release
energy and help keep your energy levels stable.
Avoiding high sugar food and drinks which are high GI
foods will also help to keep energy levels stable.
www.bda.uk.com/foodfacts
Care needs to be taken that your diet remains healthy,
Common dietary issues
People with CFS/ME
may put on too much
weight because they
can do less exercise
due to muscle pain
or other symptoms.
They may also eat
too much because
of food cravings,
comfort eating,
medication, feeling
the need to boost
energy levels or
having less energy
to prepare foods.
Following a healthy balanced diet and keeping higher
calorie, fat and sugar foods such as biscuits, chocolate,
cake, crisps and sugary drinks to a minimum can help
to combat weight gain.
Weight loss can occur if your appetite is poor and you
feel sick, or if tiredness makes it difficult to buy and
prepare food. Eating regularly, having small, quick
and easy to prepare meals and nourishing snacks
and drinks will help with this. If you are feeling sick
try snacking on dry, starchy foods such as toast/plain
biscuits, eat little and often and sip drinks throughout
the day.
IBS-type symptoms such as wind/bloating, abdominal
pain and diarrhoea and constipation are commonly
experienced in CFS/ME. If IBS-type symptoms are a
problem, following advice for managing IBS symptoms
can help.
If you need further help, ask your doctor to refer you
to a dietitian. They may suggest you trial a diet which
reduces short-chain fermentable carbohydrates (also
known as a low FODMAP diet).
Myths about CFS/ME and food
There is a lot of different advice and information on the
internet which can make it confusing to know what is
right or wrong.
Restricted diets
The low sugar and yeast diets (anti-candida diet) or
the stone-age/paleo and blood-type diets claim to
promote recovery and improve CFS/ME symptoms.
There is no evidence to support the claim that the
anti-candida diet, or other restrictive diets helps CFS/
ME. Restrictive diets are not recommended unless
there is evidence of specific food allergy or intolerance
and then it should be under the care of a dietitian or
healthcare professional.
nutritionally adequate and that there is no unwanted
weight loss/gain.
Food allergy and intolerances
Many people with CFS/ME report an improvement
in symptoms after changing what they eat. However
food related problems are more likely to be related to
IBS type symptoms or food intolerance (not affecting
your immune system) than a food allergy. There are
many commercially available tests claiming that they
can diagnose food intolerance and allergy but there is
no convincing evidence to support any of these tests.
The only reliable way to identify problem foods is by
following an elimination or exclusion diet under the
supervision of a healthcare professional. Your doctor
can refer you to a dietitian if you would like further
advice on food allergy or intolerance to ensure the diet
remains balanced.
Supplements
Many nutritional supplements are available, including
vitamins, minerals, essential fatty acids (omega-3s)
and co-enzymes claiming to help tiredness.
Some are very expensive and contain huge doses
of the active ingredient, some of which, for instance
vitamins A and B6, can be harmful. There is not enough
consistent evidence to support the use of vitamin and
mineral supplements to manage CFS/ME symptoms.
If you are concerned about your nutritional intake or
following a restricted diet, a multivitamin and mineral
supplement that provides no more than 100% of the
recommended daily amount (RDA - see the ingredients
label) may be recommended. If you are housebound or
don’t go outside much, your doctor should check your
vitamin D levels and may recommend a supplement of
5-10ug to prevent osteoporosis.
Summary
For CFS/ME a healthy balanced diet is recommended,
including regular meals and snacks to help maintain
energy levels. It might also be worth trying to add low
GI foods which slowly release energy and help keep
your energy levels stable. There is no evidence to
support the use of restrictive diets in treating CFS/ME.
Before trying any new diet or supplement, speak to
your doctor or ask to be referred to a dietitian.
Further information: Food facts sheets on other
topics include Healthy Eating, Glycaemic Index (GI),
Supplements, Food Allergy and Intolerance, Food
Allergy and Intolerance Testing and IBS can be
downloaded from www.bda.uk.com/foodfacts
This Food Factsheet is a public service of The British Dietetic Association (BDA) intended for information only.
It is not a substitute for proper medical diagnosis or dietary advice given by a dietitian. If you need to see a
dietitian, visit your GP for a referral or: www.freelancedietitians.org for a private dietitian.
To check your dietitian is registered check www.hcpc-uk.org
This Food Fact Sheet and others are available to download free of charge at www.bda.uk.com/foodfacts
Written by Sue Luscombe, Dietitian. Updated by Caroline Foster, Dietitian.
The information sources used to develop this fact sheet are available at www.bda.uk.com/foodfacts
© BDA February 2015. Review date February 2018. Updated March 2016.