Dietary management and strategies

Also see the section on care for people with severe or very severe ME/CFS.

1.12.19 Emphasise to people with ME/CFS the importance of adequate fluid intake and a well-balanced diet according to the NHS eat well guide.

1.12.20 Work with the person and their family or carers (as appropriate) to find ways of minimising complications caused by:

• gastrointestinal symptoms (such as nausea)
• changes to appetite
• swallowing difficulties
• sore throat
• or difficulties with buying, preparing and eating food.

1.12.21 Encourage people with ME/CFS who have nausea to:

• Keep up adequate fluid intake and advise them to try to eat regularly, taking small amounts often.
• Explain that not eating or drinking may increase their nausea.

1.12.22 Refer people with ME/CFS for a dietetic assessment by a dietitian with a special interest in ME/CFS if they are:

• losing weight and at risk of malnutrition
• gaining weight
• following a restrictive diet.

1.12.23 Be aware that people with ME/CFS may be at risk of vitamin D deficiency, especially those who are housebound or bedbound.

• For advice on vitamin D supplementation, see the NICE guideline on vitamin D.

1.12.24 Explain to people with ME/CFS that there is not enough evidence to support routinely taking vitamin and mineral supplements as a cure for ME/CFS or for managing symptoms.

• If they choose to take a vitamin or supplement, explain the potential side effects of taking doses of vitamins and minerals above the recommended daily amount.

1.12.25 Refer children and young people with ME/CFS who are losing weight or have faltering growth or dietary restrictions to a paediatric dietitian with a special interest in ME/CFS.

1.12.26 For advice on food allergies in children, see the NICE guideline on food allergy in under 19s.