From the Journal of Human Nutrition and Dietetics (open access), 22 January 2017
Review – Systematic Review – Meta-Analysis
Dietary and nutrition interventions for the therapeutic treatment of chronic fatigue syndrome/myalgic encephalomyelitis: a systematic review
N. Campagnolo, S. Johnston, A. Collatz, D. Staines, S. Marshall-Gradisnik
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.
From BMC Pediatrics (open access), 1 February 2017.
Important factors to consider when treating children with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): Perspectives of health professionals from specialist services
Roxanne M. Parslow(1,*), Alison Shaw(2), Kirstie L. Haywood (3), Esther Crawley(4)
1) Centre for Child and Adolescent Health, School of Social & Community Medicine, University of Bristol, Barley House, Oakfield Grove, Bristol, BS8 2BN, UK.
2) Centre for Primary Care Research, School of Social & Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PS, UK.
3) Royal College of Nursing Research Institute, School of Health and Social Studies, University of Warwick, Coventry, CV4 7AL, UK.
4) Centre for Child and Adolescent Health, School of Social & Community Medicine, University of Bristol, Barley House, Oakfield Grove, Bristol, BS8 2BN, UK.
* Corresponding author. Email: roxanne.parslow@bristol.ac.uk
Abstract
BACKGROUND
Paediatric Chronic Fatigue Syndrome (CFS)/Myalgic Encephalomyelitis (ME) is relatively common and disabling. Improving treatment requires the development of Patient Reported Outcome Measures (PROMs) that enable clinicians and researchers to collect patient-centred evidence on outcomes. Health professionals are well placed to provide clinical
insight into the condition, its treatment and possible outcomes.
This study aimed to understand the perspectives of specialist paediatric CFS/ME health professionals and identify outcomes that are clinically important.
METHODS
Focus groups and interviews were held with 15 health professionals involved in the care of children with CFS/ME from the four largest specialist paediatric CFS/ME services in the NHS in England. A range of clinical disciplines were included and experience in paediatric CFS/ME ranged from 2 months to 25 years. Ten participants (67%) were female.
Focus groups and interviews were recorded, transcribed verbatim and data were analysed using thematic analysis.
RESULTS
All health professionals identified the impact of CFS/ME across multiple aspects of health. Health professionals described four areas used to assess the severity of the illness and outcome in children: 1) symptoms; 2) physical function; 3) participation (school, activities and social life); and 4) emotional wellbeing. They also described the complexity of the condition, contextual factors and considerations for treatment to
help children to cope with the condition.
CONCLUSIONS
Clinically important outcomes in paediatric CFS/ME involve a range of aspects of health. Health professionals consider increases in physical function yet maintaining school functioning and participation more widely as important outcomes from treatment. The results are similar to those described by children in a recent study and will be combined to develop a new child-specific PROM that has strong clinical utility and patient relevance.
Dietary and nutrition interventions:Conclusions – in plain English – with some personal bias.
This is a very large area to study given the amount of different types of supplement available and the different ways of using each supplement, either individually or in combination. Add to this the many different ways of defining ME/CFS and whether to include people suffering commonly diagnosed “additional” conditions such as fibromyalgia and irritable bowel syndrome, along with different outcome measures and ways to measure each, research done in this area so far, although it includes many studies, has only scratched the surface. Most studies are short, small and intensely specific in a large and multifactorial field. So far there has been no overwhelming evidence to support any one particular supplementary or dietary intervention as being helpful. This is in large part because so much more, larger, longer and broader study needs to be done.
Another 2 pointless research publications.
Meta analysis of limited research is err pointless! “Studies were limited by the number of studies investigating the interventions, small sample sizes, study duration, variety of instruments used” We knew that before they started. Obviously got nothing better to do on a small budget.
BMC Pediatrics publication was also pointless. The summary is just waffling nonsense, stating the obvious.
We deserve better than this stuff.
I totally agree with you Derek, and I also think very strongly that this is a treatment/management area that is woefully under researched in the UK regarding 100% of all diseases. The study above has managed to pull out Probiotics, Cocoa, NADH and Co Enzyme Q10. That make a difference. These are all available in NUTRITION. Which is something I have been personally researching for a few years now and I have improved noticeably since I have been doing it.
When you look at average “Nutrition” on the supermarket shelves these days and compare it to 30 years ago, the problem is obvious. From Jamie Oliver to the programme on channel four about 4 years ago, I feel so STRONGLY about this. Drs who list these things such as NADH as if they are Phramaceuticals. They are NOT. They are found in NUTRITION. And let me tell you all, that as I browse the supermarket shelves online, and try and OMIT GMO, Palm Oil, Pesticides. As I remeber when I first came don with M.E. when I was fortunate enough to still be doing a lot of travel – travelling to parts of the world where they have DIFFERENT Nutrition. As I buy those things now online and BENEFIT from them. From the Anti Inflammatory Properties of foods from Coconut OIl to Turmeric – this is NOT pie in the sky – a Turmeric Bomb Drink that I make and then freeze in ice cube trays for when I need it like you need an NSAID – it works the same. It’s like bombing a large Diclofenac YET it works BETTER. Moreover, it is NOT disputed. There are studies – legitimate ones, huge ones that have already been completed on Turmeric and Coconut Oil – just 2 that I am using as examples.
I am not surprised AT ALL, that Cocoa has cropped up and I know WHY – if you look into it, there is ANOTHER ANTI INFLAMMATORY PAIN KILLING AMINO ACID. You should try it made into what I call ENERGY BOMBS mixed with coconut oil to make Truffles with mixed nuts and coconut flour. Sounds a bit Vegan? I am NOT a Vegan. I am not a Clean Eating Faddy diet shit talker. BUT, Nutrition works. And it’s time the M.E. Association REALLY started to kick arse about this. If people really want to help others, kill pain and make life a bit better. DELICIOUSLY, then it is high time the ME Assoc really started to look at this.
Big Pharma will not profit though, so in the “MEAN” time, we will all die waiting.
But who PROFITS from all of this?
Isobel
I am not sure why you are agreeing with me as I, in no way, give any support to anything you the go on to say. If you want to rant on about this, imho, mumbo jumbo then there are plenty of forums for this stuff.
I want well-funded research into the biological causes of ME/CFS, not ‘surveys’, ‘reviews’, ‘focus groups’, nor psychobabble stuff, which is the bulk of what we get.
Interesting angle on nutrition supplementation see
http://www.ox.ac.uk/news/2016-07-29-ketone-drink-gives-competitive-cyclists-boost-altering-their-metabolism
Perhaps needs to look at in an ME/CFS context