Plain language summary
This systematic review evaluated the evidence available for dietary and nutritional interventions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). 17 studies met the inclusion criteria the authors used. Notably, studies that used multi-treatments were excluded from this review. The quality of the studies varied, but two thirds were considered to be of high quality. None of the trials reported a dietary intake method at start and end of the trial period, so dietary changes alongside the intervention may have influenced the results. A variety of scales were used to measure improvement of symptoms, making it difficult to compare studies, and study designs limited recruitment to those CFS/ME sufferers who were well enough to attend a clinic/hospital. Positive results were found for nicotinamide adenine dinucleotide hydride (NADH), with and without Co-enzyme Q10, polyphenol rich chocolate and probiotics, however, studies were either of short duration or had small samples sizes, and for most interventions there was only one study. The authors conclude that, whilst there is insufficient evidence for the general prescription of supplements or elimination diets for CFS/ME patients, such interventions may be considered on an individual basis.
Abstract
BACKGROUND Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is characterised by unexplained fatigue for at least 6 months accompanied by a diverse but consistent set of symptoms. Diet modification and nutritional supplements could be used to improve patient outcomes, such fatigue and quality of life. We reviewed and discussed the evidence for nutritional interventions that may assist in alleviating symptoms of CFS/ME. METHODS Medline, Cinahl and Scopus were systematically searched from 1994 to May 2016. All studies on nutrition intervention were included where CFS/ME patients modified their diet or supplemented their habitual diet on patient-centred outcomes (fatigue, quality of life, physical activity and/or psychological wellbeing). RESULTS Seventeen studies were included that meet the inclusion criteria. Of these, 14 different interventions were investigated on study outcomes. Many studies did not show therapeutic benefit on CFS/ME. Improvements in fatigue were observed for nicotinamide adenine dinucleotide hydride (NADH), probiotics, high cocoa polyphenol rich chocolate, and a combination of NADH and coenzyme Q10. CONCLUSIONS This review identified insufficient evidence for the use of nutritional supplements and elimination or modified diets to relieve CFS/ME symptoms. Studies were limited by the number of studies investigating the interventions, small sample sizes, study duration, variety of instruments used, and studies not reporting dietary intake method. Further research is warranted in homogeneous CFS/ME populations.
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