Chronic Fatigue and Diet: Advice from a Clinical Dietitian

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Chronic fatigue syndrome (also known as myalgic encephalomyelitis) is a complex health condition that affects many body systems. As the name indicates, fatigue is the main symptom, and can range in severity from mild to severe and debilitating. While there isn’t a single ‘chronic fatigue diet’ that will make a miraculous difference, you can make good dietary choices that support your energy levels and better overall health.

Active Ability’s clinical dietitians talk about how to modify your diet to manage fatigue and help ensure you experience the best possible quality of life.

Eat a healthy, balanced diet to boost energy

If you’ve been diagnosed with chronic fatigue syndrome (CFS) or suspect you have it, eating a healthy, balanced diet will support energy production and ensure your nutritional requirements are met. In turn, this can help with symptom management.

Following the Australian Dietary Guidelines is a good place to start. This involves eating a wide range of nutritious foods from the five food groups each day.

Please note the amounts recommended below are for Australian adults. Children, teenagers, breastfeeding mums and older adults have special dietary needs. More information is available here.

A young woman with chronic fatigue asleep at her desk with an uneaten sandwich in front of her.

Eating a healthy, balanced diet can boost your energy

1. Vegetables and legumes/beans

Aim for five serves from this group, which includes:

  • dark green and leafy vegetables – such as lettuce, broccoli, cabbage, cauliflower, spinach and kale
  • root and bulb vegetables – such as potato, sweet potato, carrots, beetroot, onions, shallots, garlic, and turnip
  • legumes and beans – such as red kidney, lima beans and cannellini beans, chickpeas, lentils, split peas and tofu
  • other vegetables – such as tomato, celery, zucchini, squash, avocado, capsicum, mushrooms, cucumber, pumpkin, green peas, green beans and many more.

2. Fruit

Aim for two serves from this category, which includes:

  • citrus fruits – such as oranges and mandarins
  • pome fruits – such as apples and pears
  • stone fruits – such as peaches, apricots, cherries, nectarines and plums
  • tropical fruits – such as bananas, mangoes, pineapple and paw paw
  • berries
  • other fruits – such as grapes and passionfruit.

3. Grain-based foods

Aim for four to six serves per day from this group, which includes:

  • breads – choose wholemeal or wholegrain varieties whenever possible
  • breakfast cereals – preferably high fibre wholegrain or wholewheat options
  • grains – such as rice, barley, corn, polenta, rye, and quinoa
  • other grain products – including pasta, noodles, rice cakes, couscous, and popcorn.

Where possible, choose lower GI grain foods because they release energy more slowly.

4. Protein rich foods

Depending on age, adults need one to three daily serves form this group, which includes lean meats, poultry, eggs, fish and seafood, nuts and seeds, and legumes/beans.

5. Milk, yoghurt, cheese and alternatives

Most people need at least two to three serves per day from this group.

Deal with any nutrient deficiencies

While following a healthy diet for chronic fatigue should help, you may need additional dietary support, especially if you have been eating a limited range of foods. Studies indicate that people with CFS can be deficient in certain vitamins, minerals, and essential fatty acids. An important part of chronic fatigue diet therapy therefore involves correcting nutrient deficiencies that may be contributing to your symptoms.

A clinical dietitian can determine whether you have any deficiencies and tailor a chronic fatigue diet plan for you.

A range of healthy fruits, vegetables, fish, nuts and seeds arrayed on a table

An anti-inflammatory diet for chronic fatigue includes foods like leafy greens, tomatoes, fruit, oily fish and nuts

Go anti-inflammatory to beat fatigue

Inflammation seems to play a role in chronic fatigue syndrome. While an anti-inflammatory diet hasn’t yet been proven as the best chronic fatigue diet, it makes sense to limit foods that can enhance inflammation and eat more of those with anti-inflammatory properties. An anti-inflammatory diet is also healthy overall.

Anti-inflammatoy foods include leafy green vegetables, fruits, olive oil, tomatoes, fatty fish (such as tuna, salmon, sardines and mackerel) and nuts.

Foods to avoid with chronic fatigue syndrome

In addition to the foods to include in a chronic fatigue diet, there are also foods you should try to avoid as much as possible. These include:

Refined sugar

A sugar fix might boost your energy temporarily, but the dip that follows can further increase feelings of fatigue. Steer clear of sugary treats like cakes, sweet biscuits, lollies, doughnuts, chocolate, soft drinks, energy drinks and packaged fruit juices.

Be mindful, too, that some foods posing as healthy snacks (like some protein bars) are actually very high in sugar. Your dietitian can train you (and your support people) to read food labels to help you make good dietary choices for fatigue.

If you’re hungry or need an energy lift, go for a naturally sweet food such as fruit. Combining it with something that’s high in protein will help to relieve your hunger and stabilise your energy levels. For example, try some berries with natural yoghurt or a fruit smoothie made with low-fat milk.

Heavily processed foods

While some foods need to be processed so we can eat them (like oats and milk), it’s best to limit your intake of highly processed foods. These are typically low in nutrients and high in unhelpful things like refined sugar and saturated fat. They also tend to be high in kilojoules.

Foods to avoid include chips, pizza, meat pies, pastries, and processed meats.

Alcohol

Alcohol is also high in kilojoules, nutrient poor and can lead to weight gain. It is also associated with numerous health risks (including high blood pressure, heart disease and some cancers), with the risk increasing the more you drink. Learn more about Australian guidelines to reduce health risks from drinking alcohol here.

Furthermore, alcohol depresses the central nervous system, which can make you even more sleepy. Alcohol use can also interrupt normal sleep patterns, leading to further fatigue. Limiting how much you drink, or avoiding alcohol altogether, therefore makes sense as part of a diet to manage chronic fatigue.

Hydration inspiration

As well as watching what you eat, your chronic fatigue diet should consider what you drink. Dehydration is known to aggravate fatigue, so try to drink plenty of water throughout the day. Caffeine-free herbal teas and freshly made fruit and vegetable juices are also good options.

Caffeinated drinks like coffee, tea and some energy drinks can give you a burst of energy. However, too much caffeine can disrupt your sleep, leading to increased fatigue. Some caffeine may be fine but take note of how it affects you and avoid caffeinated drinks in the afternoons.

 

Should I take supplements?

A 2017 review of 17 studies into dietary and nutritional interventions for CFS found fatigue improvements from four substances. They were:

  • nicotinamide adenine dinucleotide hydride (a substance your body makes from a B vitamin which is also available in supplement form)
  • probiotics
  • high-cocoa chocolate (which is rich in polyphenols)
  • a combination of NADH and coenzyme Q10.

For most people, however, getting your nutrients from real, whole food is best wherever possible. Your NDIS dietitian can talk to you about whether supplements could be beneficial for you.

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Plan and prepare meals when you can

A great way to eat well and avoid reaching for unhealthy snacks is to plan your meals and prepare food in advance. When you have more energy, use some of that time to plan out what you’ll eat for the next few days. You can also prepare some ingredients or cook healthy meals to store in your fridge or freezer.

A woman seated in a wheelchair prepares a healthy bowl of salad as part of her chronic fatigue diet plan

For most people with chronic fatigue, a diet based on real whole foods is best

That way, you’ll have a stock of healthy snacks and meals ready to go on days when your energy levels aren’t so good. Your support people may also be able to help with activities like grocery shopping and meal prep.

Chronic fatigue and inability to lose weight

Some people with CFS may gain weight, or find it more difficult to lose excess weight, due to increased appetite and reduced physical activity levels. If this is the case for you, try to limit your intake of fatty and sugary snacks and drinks. Aim to eat according to the Australian guidelines described above. You might also need to watch your portion sizes.

Be mindful that weight loss may also take a bit longer if you have CFS. Your dietitian can help with a tailored weight loss plan.

Other helpful tips for a chronic fatigue diet

Here’s a few more helpful dietary tips for managing chronic fatigue.

Keep a food and symptom diary – tracking what you eat and how you feel is a great way to discover any relationship between your diet and your energy levels. People who have CFS often also have symptoms of irritable bowel syndrome, so this is a great way to see if any foods trigger gut symptoms.

Make changes slowly – it can be tempting to plan radical changes to your diet if it will help you feel better. Rather than changing several things at once – or eliminating whole food groups altogether – try making small, sustainable changes. Your dietitian can talk about whether eliminating certain foods from your diet may be helpful for you.

Be patient – don’t expect dietary changes to impact your CFS symptoms overnight. These things take time, so be patient with yourself and persevere. As a rule, allow about a month to see whether a dietary change has affected your fatigue levels.

Eat smaller meals more often – people with CFS frequently don’t feel hungry or are too tired to bother with eating. If you’re losing weight or struggling with regular meals, try to eat smaller meals more often, or have snacks in between your meals.

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How a clinical dietitian can help with diet and chronic fatigue

As we’ve noted, there’s no single chronic fatigue diet. However, eating well is an important part of your management plan. Clinical dietitians, like the NDIS dietitians at Active Ability, are trained to assess your unique dietary needs and create a dietary plan to meet them.

Our experienced team focus on helping people with mental health conditions, neurological disorders and intellectual disability to achieve optimal health, independence and quality of life. In addition to meeting your nutritional needs, our diet plans for chronic fatigue will consider your cultural requirements and personal preferences.

We take an evidence-based, holistic and multidisciplinary approach, working alongside NDIS registered physiotherapists and exercise physiologists to provide you or your loved one with the best possible care.

With no waiting lists, you can get quickly get started with an assessment and plan for managing chronic fatigue. We can see you at the location that’s most convenient for you, such as your home, school, or workplace.

To find out more, contact us on (02) 8678 7874, email hello@activeability.com.au or use our contact form.