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Role of dietary modification in alleviating CFS symptoms: a systematic review

Kati

Patient in training
Messages
5,497
Role of dietary modification in alleviating chronic fatigue syndrome symptoms: a systematic review

http://onlinelibrary.wiley.com/doi/10.1111/1753-6405.12670/abstract

Abstract

Objective: To review the evidence for the role of dietary modifications in alleviating chronic fatigue syndrome symptoms.

Methods: A systematic literature review was guided by PRISMA and conducted using Scopus, CINAHL Plus, Web of Science and PsycINFO scientific databases (1994–2016) to identify relevant studies. Twenty-two studies met the inclusion criteria, the quality of each paper was assessed and data extracted into a standardised tabular format.

Results: Positive outcomes were highlighted in some included studies for polyphenol intakes in animal studies, D-ribose supplementation in humans and aspects of symptom alleviation for one of three polynutrient supplement studies. Omega three fatty acid blood levels and supplementation with an omega three fatty acid supplement also displayed positive outcomes in relation to chronic fatigue syndrome symptom alleviation.

Conclusions: Limited dietary modifications were found useful in alleviating chronic fatigue syndrome symptoms, with overall evidence narrow and inconsistent across studies.

Implications for public health: Due to the individual and community impairment chronic fatigue syndrome causes the population, it is vital that awareness and further focused research on this topic is undertaken to clarify and consolidate recommendations and ensure accurate, useful distribution of information at a population level.
 

msf

Senior Member
Messages
3,650
My diet, which has been very successful in reducing my symptoms is FODMAP-based, low in insoluble fibre, low in resistant starch, low in sugar, caffeine-free, and I also try to limit my intake of things that have been associated (according to the Paleo stuff, but it seems to bear out for me) with a leaky gut, such as peppers and tomatoes (although I eat a lot of potatoes since the solanine, which apparently causes leaky gut, is mostly in the skin).

This probably sounds very restrictive, and it is, but it has enabled me to go from moderately severe to just moderate, and the gut treatment (antibiotics) I have had have then put me in the position to start thinking about working again.
 
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msf

Senior Member
Messages
3,650
I should just note that my ME was triggered by Yersinia, so gut interventions may be more effective for people like me than for those with other kinds of infections/triggers. That´s no reason not to try dietary ones though.
 

Gondwanaland

Senior Member
Messages
5,092
Whatever diet we follow we must be careful to NOT follow a thiamine depleting diet:
FURTHER EXPERIMENTS ON THIAMINE DEFICIENCY IN MAN
Each subject was allowed unlimited
amounts of foods that are low in the vitamin
B-complex. These consisted of ordinary
white bread, soda crackers, butter,
cheddar cheese, macaroni, spaghetti, polished
rice, farina, heavy cream, sugar,
honey, molasses, tapioca, salad oil, egg
white, ice cream, puffed rice, coffee, tea,
salt, pepper, vinegar, hard candies, and
gelatin. Small amounts of orange juice,
grapefruit juice, onions, and lettuce were
given each day and twice a week very small
portions of meat, fish, or poultry were permitted.
 

Attachments

  • B1 1943 FURTHER EXPERIMENTS ON THIAMINE DEFICIENCY IN MAN.pdf
    188.7 KB · Views: 5

Kati

Patient in training
Messages
5,497
Everybody seems to have an opinion about whether diets and dietary supplements make a difference in ME or not. According to thIs abstract, there is not much scientific evidence out there. It means that people's experiences are N=1 experiments and improvement may be attributable to personal beliefs that the diet will change anything (placebo effect), to the fluctuatons of the disease, or to the diet itself.

The people who swear they got better from dietary changes are still here and still sick.

The problem with people litterally advertising they got better with xyz supplement or diet is that it provides one more reason for governments and socialized health care systems to fund less research, less costly clinical trials, and more education about diets as treatment.

The current evidence for special diets, supplements is simply not there at the moment.
 
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msf

Senior Member
Messages
3,650
Everybody seems to have an opinion about whether diets and dietary supplements make a difference in ME or not. According to thIs abstract, there is not much scientific evidence out there. It means that people's experiences are N=1 experiments and improvement may be attributable to personal beliefs that the diet will change anything (placebo effect), to the fluctuatons of the disease, or to the diet itself.

The people who swear they got better from dietary changes are still here and still sick.

The problem with people litterally advertising they got better with xyz supplement or diet is that it provides one more reason for governments and socialized health care systems to fund less research, less costly clinical trials, and more education about diets as treatment.

The current evidence for special diets, supplements is simply not there at the moment.

I don´t agree in the case of the FODMAP diet, since this has been shown to help those with IBS, and as we know, IBS is a co-morbid condition in ME patients.
 

Solstice

Senior Member
Messages
641
I don´t agree in the case of the FODMAP diet, since this has been shown to help those with IBS, and as we know, IBS is a co-morbid condition in ME patients.

The physician treating me does lactose and fructose tests and a test for food sensitivities. After that I got a detailed dietplan from his inhouse dietician(Tobback). These in no way cured me, but it has made things more bearable for me. If I eat certain food from outside the diet my stomach tends to swell up, my sleep get's worse, pain get's worse also and I start to itch(especially with herbs and spices). This is the same regardless if I'm knowingly taking it in or unknowingly.

For me it's very very far from a cure. But it definitely does make things better to restrict my eating to what's on the list.
 

msf

Senior Member
Messages
3,650
I have the same physcian, although I didn´t get a diet plan (probably because I didn´t have any food sensitivities) and had to work things out for myself. I think every ME physician should recommend trying the FODMAP diet, I mean if it only helps 10% (likely to be higher given the number of ME patients with IBS) as much as it helped me, why wouldn´t you? This isn´t a criticism of ME physicians, I think doctors in general pay little heed to dietary considerations.
 

Learner1

Senior Member
Messages
6,305
Location
Pacific Northwest
The current evidence for special diets, supplements is simply not there at the moment.
Well, not in that paper...

We are all genetically different, with different gut microbiomes, levels of toxicity, immune and endocrine system status, and nutrient status.

It is ludicrous to think we all need the same supplement, no matter how sick we are.

What we need are studies on personalised medicine - testing people for nutrient status and microbiome status and providing them with customized supplementation and microbiome support.

I know I need massive doses of B12. Lab tests and the fact it gets me out of a stupor have proven this to be so. If you give me some standardized RDA/DV dose of cyanocobalamin, it wouldn't faze me... and I don't happen to need DHA or EPA, so giving me 2g of fish oil a day wouldn't help either. And I'm celiac and allergic to casein, so that gluten free/dairy free diet helps me greatly while you may have no need for it.

The human body is complex and our dietary needs are complex. Random double blind placebo studies are not an effective way to tell if a single dietary invention works across a population of unique individuals.

Garbage in, garbage out... Let's advocate for thoughtful dietary studies that show benefits of personalized interventions.
 

pamojja

Senior Member
Messages
2,384
Location
Austria
Let's advocate for thoughtful dietary studies that show benefits of personalized interventions.

Though not against ME/CFS but individualized, for example this:

Abstract 309: Twelve Year Followup for Managing Coronary Artery Diease Using a Nutrigenomics Based Diet and Supplement Program With Quarterly Assessment of Biomarkers
  1. Steven R Gundry
+ Author Affiliations
  1. The Cntr for Restorative Medicine, Intl Heart & Lung Institute, Palm Springs, CA
Abstract

Introduction: Coronary Artery Disease (CAD) is thought to be progressive; standard protocols call for a low fat/low cholesterol diet, exercise, and lipid lowering agents in an effort to slow the onset of recurrent MI’s, stents, CABG’s, stroke, or death. This results in an approximate 30-40% new event rate in 5 yrs.

Methods: Based upon our experience using a Nutrigenomic-based, Lectin-limited diet to prevent/reverse Metabolic Syndrome and CAD, we have enrolled and followed 978 pts (aged 42-89 yrs) with known CAD, defined as previous MI, stent, CABG, or positive stress test/angiogram, positive Corus score greater than 30, into a diet and supplement based, physician coached program, which emphasizes large amts of leafy green vegetables, olive oil, radical reduction of grain, legumes, nightshades, and fruits; and 4 oz amts of animal proteins, emphasizing shellfish, wild fish, and grass fed meats, while avoiding commercial poultry (Matrix Protocol). All Apo E 4 genotypes ate large amts of shellfish and avoided animal fats and cheeses. All pts were instructed to take 2-4,000 mg of high DHA fish oil, 200mg of Grape Seed Extract, and 50 mg of Pycnogenol per day. Supplements were individualized based on results of Advanced Cardiovascular Risk Markers, which were sent to three core labs, (Berkeley Heart Labs, and Singulex, Alameda, CA, Health Diagnostics Labs, Richmond,VA) q 3 months and followed to measure compliance and to change supplement/eating regimens.

Results: Pts have been followed for 1.5 to 12 years (mean 9 yrs). While enrolled, 13/978 pts (1.3%) have received a new stent, two that were predicted by a rising Lp-PLA2, two required CABG, based on a rising Corus score, despite HDL’s of 110-120 mg/dl. There have been no MI’s, unstable angina. One pt underwent carotid endarterectomy ; one pt suffered a CVA and died, while in atrial fibrillation, A second pt expired from a ruptured cerebral berry aneurysm. Total CV events over 12 years is 16/978 (1.6%).

Conclusions: We conclude that simple Nutrigenomic-based dietary interventions, emphasizing lectin avoidance, with compliance and supplement choices based upon q 3 month assessment of biomarkers, represents a quantum leap forward in preventing/modifying Cardiovascular events in known CAD patients.

Key Words:
  • Author Disclosures: S.R. Gundry: Consultant/Advisory Board; Modest; SINGULEX
  • © 2015 by American Heart Association, Inc.

With standard protocols (low fat/low cholesterol diet, exercise, and lipid lowering agents) 1 in 3 patients experience a new adverse event within 5 years.

With Nutrigenomic-based dietary interventions (reduction of grains, real food, individualized supplementation) about 1 in 60 patients only experience a new adverse event within 9 years.
 

Gondwanaland

Senior Member
Messages
5,092
For those looking to reducing auto-antibodies... It will not cure CFS but can relieve a lot of symptoms.
Drug Des Devel Ther. 2016; 10: 2939–2946.
Published online 2016 Sep 14. doi: 10.2147/DDDT.S106440
PMCID: PMC5028075
Effects of low-carbohydrate diet therapy in overweight subjects with autoimmune thyroiditis: possible synergism with ChREBP
Teresa Esposito,1,2 Jean Marc Lobaccaro,3 Maria Grazia Esposito,4 Vincenzo Monda,1 Antonietta Messina,1 Giuseppe Paolisso,5 Bruno Varriale,2 Marcellino Monda,1 and Giovanni Messina1,6
Author information ► Copyright and License information ►

Abstract
The thyroid is one of the metabolism regulating glands. Its function is to determine the amount of calories that the body has to burn to maintain normal weight. Thyroiditides are inflammatory processes that mainly result in autoimmune diseases. We have conducted the present study in order to have a clear picture of both autoimmune status and the control of body weight. We have evaluated the amount of either thyroid hormones, or antithyroid, or anti-microsomal, or anti-peroxidase antibodies (Abs) in patients with high amounts of Abs. In a diet devoid of carbohydrates (bread, pasta, fruit, and rice), free from goitrogenic food, and based on body mass index, the distribution of body mass and intracellular and extracellular water conducted for 3 weeks gives the following results: patients treated as above showed a significant reduction of antithyroid (−40%, P<0.013), anti-microsomal (−57%, P<0.003), and anti-peroxidase (−44%, P<0,029) Abs. Untreated patients had a significant increase in antithyroid (+9%, P<0.017) and anti-microsomal (+30%, P<0.028) Abs. Even the level of anti-peroxidase Abs increased without reaching statistical significance (+16%, P>0064). With regard to the body parameters measured in patients who followed this diet, reduction in body weight (−5%, P<0.000) and body mass index (−4%, P<0.000) were observed. Since 83% of patients with high levels of autoantibodies are breath test positive to lactase with a lactase deficit higher than 50%, this fact led us to hypothesize a correlation with carbohydrate-responsive element-binding protein and therefore a possible role of carbohydrate metabolism in the development and maintenance of autoimmune thyroiditis associated with body weight increase and slower basic metabolism.
 
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Messages
33
http://gundrymd.com/food-pyramid/

I'm interested in hearing from anyone else trying the diet Dr. Gundry outlines in his latest book "The Plant Paradox."

The diet overlaps with Dr. Terry Wahls' "Wahl's Warrior Diet," and Dr. Sara Myhill who pushes a ketogenic diet as of late. And probably Dr. Mercola's Fat for Fuel diet. Sort of Ketogenic and Paleo, but with the emphasis not on adding anything to the diet, but removing lectins.

The book has clear Yes and No food lists, and some simple recommended products that are not Gundry's own.

It's available in public libraries, so you don't need to buy it. Many reviews on Amazon, some of which are critical of poor citation and references to support the doctor's claims, yet many anecdotal raves.

Gundry has a powerful marketing machine for his supplements, but one can try the diet without buying any of his supplements.

Not pushing anything here, just looking for feedback about this diet...

Edit: Sorry, I see this subforum is for Studies only; so I started a new thread in the "Gut" forum:
http://forums.phoenixrising.me/index.php?threads/dr-gundry-plant-paradox-diet.55872/
 
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Messages
9
My diet, which has been very successful in reducing my symptoms is FODMAP-based, low in insoluble fibre, low in resistant starch, low in sugar, caffeine-free, and I also try to limit my intake of things that have been associated (according to the Paleo stuff, but it seems to bear out for me) with a leaky gut, such as peppers and tomatoes (although I eat a lot of potatoes since the solanine, which apparently causes leaky gut, is mostly in the skin).

This probably sounds very restrictive, and it is, but it has enabled me to go from moderately severe to just moderate, and the gut treatment (antibiotics) I have had have then put me in the position to start thinking about working again.