Significant fatigue and pain can affect eating and weight
Symptoms that affect eating and weight may include:
- loss of appetite
- nausea (an urge to vomit)
- taste changes
- abdominal pain
- other irritable bowel like symptoms.
Can diet help with chronic fatigue syndrome (ME/CFS) and similar fatigue conditions?
There is a lot of information online about diet, not all of it is evidence based. There is no scientific evidence to support the use of restrictive diets in ME/CFS and other fatigue conditions, diets which can use time, energy and money, as well as leaving you vulnerable to nutritional deficiencies.
It is important to maintain a healthy, balanced diet with adequate fluid intake. This will help energy and symptom management. The NHS Eatwell Guide is a useful guide to getting the right balance of foods in your diet. You do not need to achieve this balance with every meal, but try to get the balance right over a day or even a week.
Each day, aim to include the following:
- 2-3 portions of protein e.g., meat, fish, eggs, beans, pulses.
- 3-4 portions of starchy foods e.g., bread, rice, potatoes, pasta.
- 5 portions of fruit and vegetables. These can be fresh, dried, frozen or tinned varieties.
- 2-3 portions of dairy and alternatives e.g., milk, cheese, yoghurt. If choosing dairy alternatives, ensure you select versions that are fortified with calcium.
A portion is measured as the amount of food that fits into the palm of your hand.
You or your parent may find it helpful to plan your meals in advance, and to batch-cook and freeze meals in individual portions for days when you are lower in energy.
Snacks
Try to choose healthier options such as fruit or a cracker with cheese or a small bowl of cereal or vegetable sticks with hummus or a handful of nuts. Limit high sugar, high fat snacks such as crisps, cakes or biscuits to only one a day.
Drinks
It is important to keep well hydrated. Drink water, diluted fruit juice or semi skimmed milk instead of fizzy drinks which have added sugar. Aim for 2 litres, or six to eight glasses, a day. Weak squash can be an alternative to water if you prefer. Alternating water and weak squash can also be helpful.
If you are feeling tired, try not to have drinks that contain caffeine, e.g., some energy drinks and fizzy drinks, as a means of waking you up as they may have the opposite effect and prevent you from sleeping later. Some people with significant fatigue find that they are more sensitive to caffeine, so you may find it helpful to reduce tea and coffee, or switch to decaffeinated. Avoid caffeinated drinks in the late afternoon and evening.
Weight loss
This can occur if you are restricting your diet, have a reduced appetite (for example due to taste changes or nausea), or are having difficulty swallowing and chewing. If you become malnourished, you will be more vulnerable to:
- increased risk of illness and infection
- slower wound healing
- low mood
- reduced energy levels
- reduced muscle strength
- reduced quality of life.
It may help to eat little and often, choose softer foods that are easier to eat, and have nourishing snacks and drinks between meals.
Weight gain
On the other hand, you may find that you gain weight because you are less physically active or have an increased appetite. If this is the case, try to reduce sweet or fatty snacks and drinks, and consider your portion sizes. Think about ways to make healthier foods, such as fruit and vegetables, more easily accessible/attractive to you.
Gastrointestinal symptoms
Many people with ME/CFS and other fatigue conditions report irritable bowel syndrome (IBS) symptoms, including constipation, diarrhoea and/or bloating. To help ease these, try reducing caffeine, fizzy drinks and rich/fatty/ spicy foods.
If IBS symptoms persist, talk to your GP. You may benefit from referral to a dietitian.
Your GP may also discuss pharmaceutical options to relieve symptoms and advise on psychological therapies if your symptoms are triggered by stress or anxiety.
Nausea
If you are experiencing nausea, try some of these dietary tips:
- Try to eat small regular meals and snacks throughout the day. Nausea may become worse when the stomach is empty, so eating little and often helps minimise it.
- Eat slowly, chew your foods well and help your digestion by relaxing after meals (Avoid lying completely flat after eating).
- Avoid highly spiced or rich fatty foods if they make your nausea worse.
- Cold foods or foods at room temperature usually smell less than hot foods and may be better tolerated.
- Frozen foods may also be better tolerated by some and lollies, ice pops and sorbets can provide additional fluid.
- Drink plenty of fluids. Some people find sipping fizzy drinks such as ginger ale, Lucozade or soda water helpful. Herbal teas containing ginger or peppermint may also help.
- It is better not to drink larger amounts of fluid during or before a meal/snack (leave 30 minutes before and after eating). It is fine to sip some fluid when eating. This will reduce the total amount of content in your stomach at one time.
- Sucking on boiled sweets, fruit sweets, crystallized ginger and mints may help.
- Specific foods to try that may help:
- Dry foods: toast, crackers or biscuits.
- Salty foods: crisps, peanuts, savoury biscuits.
- Ginger foods: ginger biscuits, ginger cake, ginger ale.
- Milky drinks: milk, milkshake, nutritional supplement drinks like Complan or Build up (available from the supermarket, pharmacy or on prescription).
- Bland foods: potatoes, rice, pasta, crackers, toast.
• Avoid caffeine, alcohol and cigarettes as these can act as stimulants and upset your stomach even more.
Are there supplements I can take?
If you are able to follow a healthy balanced diet, additional vitamin and mineral supplements should not be required. However, if you have been advised to take these by your medical team, continue to do so until you are advised to stop them.
Vitamin D is an important vitamin for the development of strong bones and muscles, the best source is from the sun. If you spend a lot of time indoors taking a supplement of Vitamin D may be helpful. A Vitamin D supplement is particularly encouraged for everyone during the winter months (October-March) but may be required all year round to ensure you have sufficient levels in your body.
It is important not to take too much of any vitamin or mineral. Speak with your GP, a pharmacist or medical team for further advice.
Why not try out some new recipes?
This might simply be making a smoothie or helping a family member prepare or cook the family meal. Starting to take an interest in what you are eating can help to ensure you are eating the right balance of foods to maintain your health now and in the future.
For further information you may find these websites helpful:
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Page last updated: 02 May 2024
Review due: 01 October 2025