The evidence for ME/CFS specifically

At present, there is insufficient evidence to suggest that any specific dietary plans can be helpful with ME/CFS, beyond the suggestion that a diet should be well balanced, with sufficient hydration, in accordance with the NHS Eat Well Plan.
However, we know that some people individually have different personal experiences with regards to how their symptoms respond helpfully, or, unhelpfully to certain food groups. If you are making any strict diet changes, it is well worth considering talking to a dietician or your GP to make sure that it is being done in a safe and healthy way. For instance, several years ago dairy was thought by some to exacerbate inflammatory arthritis. As a result, large numbers of people suddenly cut dairy from their diet all together, without sourcing calcium from other foods. As a result, we saw an increase in people with inflammatory arthritis, who now also had osteoporosis.
While the evidence for diet in ME/CFS specifically may be in its infancy, there is stronger evidence for its related conditions, such as persistent pain, IBS and even mental health.
  • Supplements and Vitamins
    Unfortunately, there is no firm evidence for any specific supplements or vitamins as being helpful for people with ME/CFS currently. However, Vitamin D is a notable consideration, since some people with ME/CFS may be at greater risk of vitamin D deficiency, especially if they seldom have access to natural sunlight. The National Institute for Health and Care Excellence (NICE) recommends the following reference intakes for vitamin D:
    • 10 micrograms of vitamin D per day, throughout the year, for everyone in the general population aged 4 years and older
    • 10 micrograms of vitamin D per day for pregnant and lactating women and population groups at increased risk of vitamin D deficiency.
    The ME Association have suggested that for those whose diet is restricted, it may be worth considering taking a good quality multivitamin tablet every day. 

    The Association of UK Dietitians

  • Inflammatory and Anti-inflammatory foods
    We now know that some food groups are ‘pro-inflammatory’ (i.e., they increase inflammation in the body) and that others have an anti-inflammatory effect. This can have an impact on our pain and mental health.
    As a rule, processed, high-sugar, simple carbohydrates (such as white bread, white pasta, white rice) foods may make inflammation worse (think beige, convenience foods!).
    Conversely, whole foods like vegetables, nuts, seeds, legumes (beans and peas), wholegrains, complex carbohydrates (brown bread, brown/wild rice) and oily fish are helpful anti-inflammatory foods.
    A diet, which is richer in these more nutritious, whole, foods could be helpful in the management of persistent pain and is fast becoming a more important part of pain management programmes.
  • The Microbiome
    Out digestive system is home to trillions of helpful micro-organisms… or it should be! These organisms that inhabit our bowel and perform vital functions are often referred to as the microbiome.
    These helpful microbes are one of the first lines of defence against the unhelpful bacteria and viruses that can make us unwell. They also protect the lining of our digestive system, help us process and extract nutrients and energy from food and INCREDIBLY, 90% of the serotonin that our nervous system & brain need to regulate our moods and stay mentally well is produced by these helpful microbes, not by ourselves! The gut is now often referred to as the ‘second brain’ for this reason, as well as the fact that there are more neurones (nerve cells) in our guts that there are in our spine.
    The benefit of a healthy microbiome is becoming increasingly clear, yet we also know that our modern lifestyles (poor diet and antibiotic use in particular) are having a detrimental effect on this amazing system.
    If our diet is lacking in nutrients, fibre and wholesome foods, the bacteria in our gut don’t have the environment that they need to grow and thrive. A single course of broad-spectrum antibiotics can kill up to a third of our healthy gut bacteria and it could potentially take 2 years for this correct. This should not deter people from taking any antibiotics that the doctors feel you need and there are things we can do to help restore the balance.
    It may be helpful to think of our microbiome as being like a garden…
    • We can ‘sow’ healthy bacteria into our gut through certain foods, such as sauerkraut, kimchi, kefir and kombucha.
    • However, if the ‘soil’ in our gut isn’t given the bacteria the nutrients they need, then they will not germinate and flourish.
    • We also need to create a healthy soil (gut environment) by eating fibre, whole (plant-based) foods of a variety of colours (such as carrots, beetroot, broccoli, cauliflower, oranges) … in other words, try and ‘eat the rainbow’ every day.
    • If we develop the soil by eating the right foods and we sow bacteria through fermented foods, then the garden in our gut will blossom!
  • IBS
    IBS is a condition that we often see alongside an ME/CFS diagnosis, most likely because of their common causative factors.
    Diet is an important consideration in the management of IBS and in recent years FODMAP diets have become more common place. FODMAP diets should only be followed under the supervision of an IBS service or suitable dietician. 
    Unfortunately, our Fatigue Service does not specialise in IBS or FODMAP diets, however, we have included some links to helpful webpages and other organisations:

    IBS Network - FODMAPS

    Guts Charity IBS

  • Hydration
    Water makes up two thirds of our body. Drinking enough liquids helps ensure all bodily functions can operate as normal. This includes our blood carrying vital nutrients, our kidneys removing waste from our bodies, lubricating our joints and many other things!
    Headaches, poor concentration, sluggishness- these are just some symptoms we can experience from even a slight drop in fluids in the short term. Long term, dehydration can be associated with Urinary Tract Infections and the formation of kidney stones.
    Recommendations say we should be drinking 6-8 cups/glasses of water a day. If water is something you dislike, try adding no-sugar squash or adding a slice of fresh fruit!


  • Helpful Resources