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Transcript
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 a 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. r ta rs he What are the symptoms? d Raisins 6-8 a day gar and su salt fat, s ed drate dd ohy arb sa yc les ch po rtio ns d an uit f fr les yo ab ir et t e va eg ta n Choose foods lower in fat, salt and sugars Choos e wh oleg rain or h Pota igh toes er , br fib ead re , ri ve ce ,p rsi as on ta s a y day ever bles eta veg 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 , pu 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.