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CFS Diets

"You are what you eat" and "Let food be your medicine" are wise sayings attributed to Hippocrates, the father of modern medicine around 450 BC.

These types of reveiw PMID 11925084 all mention the importance of DIET in CFS but what do they mean, rarely can one find details on this except for food allergies and food intolerance elimination. The usual conservative response is 'eat a healthy diet', howver that approach had a high drop out rate in this CFS trial PMID 18339054 What is needed is a more scientific approach.

The new developing science of nutritional genomics has potential in CFS as genetic polymorphisms and gene expression findings have already been made with seven distinct subtypes of CFS identified. The new science links nutrient-gene interaction with a health or disease state; nutrigenetics examines genetic variation and associated responses to nutrients, in order to generate individual dietary recommendations, nutrigenomics focuses on the effects of nutrients on regulatory functions of genes and their products; the clinical axis ties in the modifying effects of genetic polymorphisms to biomarkers of clinical effect; and specific nutrient / diets address to minimize the symptoms. PMID 18087577 PMID 18240552 PMID 18211650

In coeliacs, fatigue is a common finding, which ameliorates with the gluten-free diet PMID 16128688 .

Fasting then a vegetarian diet recommended for CFS is well tolerated and can be beneficial PMID 12232494 PMID 11757776

This study PMID 18063928 recommends a 'leaky gut diet' low in carbohydrates which sounds like the anti-fungal diet?

I am not too sure about Russian supplements made from 'beer yeasts' and what negative effect that might have on fungal/gut problems?? PMID 15154366 PMID 7476598 .

Omega-3 supplementation fish oils and flaxseed oil are well recommended PMID 12018979 PMID 15041033 PMID 15117099 as is Zinc PMID 1020483. Also some fish oil N-3 EFA's bypass the D6D, deficiency and may explain the improvements. There is also the magnesium deficiency hypothesis and calcium / magnesium balance PMID 7939386 .

Where mitochondrial dysfunction is suspected (as in CFS) a different diet is advised, the total amounts and types of dietary oils is important in reducing disease specific intermediates PMID 17825594 indicates more carbohydrate, low total fat, low saturated fat, low mono-unsaturated fat and more N-6 and N-3 polyunsaturated fats is best. Carnitine supplementation improves mitochondrial function in CFS PMID 15039515 With mitochondrial damage "the most rational approach is to understand the mechanisms underlying mitochondrial damage for specific medications and attempt to counteract their deleterious effects with nutritional therapies." PMID 18626887.

Dietary factors that modulate the cytokine profile balance need to be considered. like this . and PMID 16029148 also PMID 12699726

The role of oxidative stress in CFS is an emerging focus of research due to evidence of its association with some pathological features of this syndrome. New data collectively supports the presence of specific critical points in the muscle membranes that are affected by free radicals and in view of these considerations, the possible role of skeletal muscle oxidative imbalance in CFS is considered. PMID 18274865 The oxidative stress induced muscle membrane modifications may be related to alteration of membrane fluidity with deregulation of pump activities, sodium / potassium (Na(+)/K(+) and calcium (Ca(2+)-ATPase). PMID 12899875

If these cell membranes changes are more generally found in CFS, it has several implications for CFS Diets. Firstly cell membrane fluidity is directly controlled by essential fatty acids, and the membrane content can be altered by diet PMID 7968718. The second relevant point is that the sodium / potassium pump (in each cell) is estimated to consume about 1/3 rd of the bodies resting energy and alterations to it can have profound fatige consequences. The pump load can be influenced also by diet. Eat less salty food, so the body has less work to remove excess from cells and also increase the gradient across the cell membrane to improve its efficiency, by increasing natural souces of foods rich in potasium, such as fruit. PMID 2159972 Finally the calcium / magnesium ratio (Ca2+/Mg2+) is considered to be an important guide for signs of peripheral vasoconstriction and or spasm and possibly enhanced atherogenesis. Overall, the data point to important uses for IMg2+ in the diagnosis and treatment of disease states. PMID 7939386 With the above findings it may be just as important to reduce calcium as well as to increase magnesium in the diet. PMID 7968720 PMID 2472189 Calcium channels are also important in neurotranmitter function. Caffine consumption also effects the muscle findings, maybe usefull diagnostically, certainly not treatment? PMID 16371327

In general in CFS it pays to make general diet changes first and gradually, before doing so a baseline of the current diet should be made. This would entail weighing and measuring everything eaten or drunk in a typical day's diet. Then tabulate all foods into constituate components. This food database is handy to search or download. Total calories, carbohydrate calories, protein calories, total fat calories, and the above reference would suggest amounts of different types of fats, Supplements should be tried one at a time at lower than normal doses to begin. Hope this of help.

Regarding protein, sulphur drugs are found to help pain in Ross River post viral CFS PMID 18433328. Sulphur is mentioned also in regard to fibromyalgia PMID 11354556 and PMID 11896744 (the free text) is worth a read, particularily for vegetarian CFS patients, unless you can dip daily in the dead sea? It seems that getting sufficient sulphur might be a problem, unless diet protein levels are adequate to provide, on the formula's this paper gives for a 70 kg (155 lb) person, it calculates to 103g (3.6 oz) of protein content in the diet each day. Thats about 15% of daily energy intake for a diet of 2750 k/cal, which seems to be the metabolic requirement in illness! Protein is about 10% of bread or grain and 2.5% of potato and 10% of cooked beans, so clearly just for sulphur the diet needs to be watched. The form of any sulphur supplements also needs caution, given that SAMe is said here to increase serotonin, already high in CFS, and I am aware of patients who say this substance worsened their condition? Other supplements in the methionine / homocysteine cycle could presumably have the same effect. Maybe homocysteine is high in CFS as a consequence of the metabolism attempting to limit serotonin?

Also anthocyanins isolated from bilberries and black currants efficiently suppressed LPS-induced activation of NF-kappaB (the mediator defined in the Ross River findings). PMID 17634269 also zinc supplementation PMID 15451058 and possibly selenium PMID 15255784 The ratio of different fats in the diet is also relevant PMID 17204269 Also dietary polyphenolic antioxidants, such as trans-resveratrol (RSV) and hydroxytyrosol (HT) PMID 17586618

Several herbs are said to improve natural killer cell function and immune function suppression in CFS. PMID 9043936 Where as conservative advice is given about other herbs that may be of benefit in CFS PMID 11547487

This article on Supplements in CFS suggests start with 1/8 to 1/4 of normal dose. Even this one on Pharmacotherapy for CFS says should start drugs, supplements or herbs at a fraction of normal dose because of sensitivity in patients,Jagra

Diet general

Other supplements

ON/ONOO cycle; PMID 18057706 also full text Based on current and other findings, we propose that betaine could be a beneficial dietary supplement to attenuate age-related oxidative stress and possibly as an antiinflammatory agent. Betaine was first discovered in the juice of sugar beets (Beta vulgaris) in the 19th century and now found widely in various microorganisms, plant, and animals. Craig S. A., Am. J. Clin. Nutr., 80, 539—549 (2004)

effects of green leafy vegetables