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CFS - General diet

A basic way to view the importance of diet in regards to our chronic health problems is in terms of the levels of essential nutrients (vitamins, minerals, protein, healthy fats) our diet provides. While this issue is certainly important the influence of diet goes well beyond this. Various aspects of diet influence virtually every contributing factor in chronic illness. Diet can be seen as one therapeutic tool to modulate the mechanisms behind disease. For example diet is a key regulator of inflammation, antioxidant/oxidative balance and even influences the expression of many of our genes. You probably already have a reasonable diet by normal standards and compared to most people, but diet can always be improved upon. Unlike most treatments dietary optimisation is cheap and what goes into your mouth is something you have complete control of, as opposed to your exposure to environmental chemicals and stressors, so it is something you should take complete advantage of.

Mechanisms of illness modulated by diet.

  • i. Inflammation
  • ii. Oxidative Stress
  • iii. Intestinal micro-organism balance
  • iv. Detoxification chemistry
  • v. Hormone balance
  • vi. Intake of toxic chemicals
  • vii. Immune function
  • viii. Circadian rhythm
  • ix. Food intolerances
  • x. Genetic expression
  • xi. Acid/base balance

Fatty acid balance.

The balance of omega-3 and omega-6 fatty acids in particular are major inflammation mediators. These fats are the basic precursors of eicosanoids, a major class of inflammation signalling chemicals and also influence expression of inflammation modulating genes. Over consumption of omega-6 fats leads to the excess production of pro-inflammatory eicosanoids whereas omega-3 fatty acids produce anti-inflammatory eicosanoids. The ratio of N6/N3 fatty acids has gradually gone up and up over the past few generations due to changing dietary habits.

One of the key factors leading to this change is the types of oils we eat in packaged foods and in cooking. Packaged foods typically contain oils which are high in omega-6 fats. Foods containing oils high in omega-6 fats listed in the following table should be avoided and these oils should never be used in cooking. Extra virgin olive oil is the healthiest oil for cooking. It is not only low in omega-6 fatty acids its predominant fat, oleic acid, and phytonutrients such as oleocanthal and squalene, are specifically anti-inflammatory in nature. Avocado is another example of a healthy fat to include in your diet.

Total omega-6 content/100 grams oil

  • 9.21 - Olive
  • 20.3 - Canola
  • 32.0 - Peanut
  • 33.4 - Rice bran
  • 41.3 - Sesame
  • 51.0 - Soybean
  • 51.6 - Cottonseed
  • 53.5 - Corn
  • 54.8 - Wheat germ
  • 65.7 - Sunflower
  • 69.6 - Grapeseed
  • 74.6 - Safflower

Emphasize lean cuts of meat as fatty animal products contain arachidonic acid, a pro-inflammatory omega-6 fatty acid.

Also avoid trans fats which are forms of fatty acids which have been industrially modified and are found in such sources as margarine and shortenings. These fats have numerous negative properties, including being pro-inflammatory.

Sugar.

Eating refined sugar produces a surge of insulin and stress hormones (cortisol and adrenalin). This both puts a great stress on our hormonal system and promotes inflammation. High sugar foods cause a degree of immunosuppression for 2–4 hours after consumption. Sugar causes overgrowth of intestinal yeast and bacteria. Sugar is also nutritionally devoid and displaces other nutrient rich foods. Sugar has little satiety value and high energy content, so promotes weight gain. Sugar also promotes a blood sugar rollercoaster, leading to blood sugar excesses and deficits (hypoglycemia) as well as sugar cravings and addiction. This is just a few of the many deleterious effects of refined sugar consumption. Avoid refined sugars (including table sugar, soft drinks, fruit juices, cordial, honey, jam, lollies, molasses, maple syrup, corn syrup, brown sugar, candy, etc.) and foods which contain refined sugars (most breakfast cereals, muesli bars, ice cream, chocolate, biscuits, cookies, cakes, etc.).

Artificial sweeteners are a whole other story. Aspartame (aka NutraSweet or Equal) is almost certainly the worst and should be strictly avoided. Sucralose (Splenda) also has suspected problems.

Dark coloured anti-inflammatory plants foods.

The dark pigments in plant foods contain an array of phytochemicals which have a long list of therapeutic effects. One very noteworthy outcome is reducing inflammation, both by direct anti-inflammatory action and by genetic modulation of genes relating to inflammation.

Special note on inflammation.

When we think of inflammation we tend to think of redness/swelling associated with acute injuries/infections and issues like dermatitis and colitis. However chronic inflammation is probably associated in one degree or another with just about every chronic illness. Diabetes, obesity, heart disease, alzheimer’s disease, major depression, ME/CFS and autism are just a few example of illnesses which involve inflammation. Diet is one of the key regulators of inflammation and our modern diet is highly pro-inflammatory.

The following is a list of some of the key anti-inflammatory foods as listed in Dr. Leo Galland’s (www.mdheal.org/) excellent book ‘The Fat Resistance Diet’. Include an emphasis on these foods in your diet on a daily basis. As discussed in Dr. Galland’s book, lowering inflammation through diet also increases sensitivity to a hormone called leptin, a key hormone involved in energy metabolism and appetite, making weight loss immensely easier.

BEVERAGES (UNSWEETENED)

  • Green tea
  • Vegetable juice

NUTS AND SEEDS (FRESH,UNSLTED, NOT ROASTED)

  • Almonds
  • Flaxseeds
  • Sesame seeds
  • Walnuts

VEGETABLES

  • Arugula
  • Broccoli
  • Cabbage
  • Carrots
  • Leeks
  • Onions
  • Romaine lettuce
  • Scallions
  • Shiitake mushrooms
  • Spinach

HERBS AND SPICES

  • Basil
  • Black pepper
  • Cardamom
  • Chives
  • Cilantro
  • Cinnamon
  • Cloves
  • Garlic
  • Ginger
  • Parsley
  • Turmeric

Antioxidant rich fruits.

Natures most perfect fruits are berries. Berries are the foods most rich in antioxidants and possess anti-inflammatory properties. They are also the fruits lowest in total sugar content and best tolerated by those with fructose malabsorption. Fructose malabsorption, a condition in which a persons absorption of fructose is impaired, is present in around 45% of those with ME/CFS. Berries are generally well tolerated by people with this condition. Have a daily serving of antioxidant rich fruits. Buying frozen berries is generally the easiest way to achieve this. Avoid fruit juices and dried fruits as they provide excess levels of fructose and exacerbate intestinal bacterial/yeast balance, among other issues.

Total antioxidant capacity per serving size (serve = 1 cup)

  • 13427 - Wild blueberry
  • 9019 - Blueberry (cultivated)
  • 8983 - Cranberry (whole)
  • 7701 - Blackberry
  • 6058 - Raspberry
  • 5938 - Strawberry

Crucifera vegetables.

The crucifera vegetables are among the most healthful foods we can eat. There are numerous health benefits from their consumption, the most note-worthy in this contenxt being they are rich in sulfur-containing compounds which directly upregulate our innate detoxification chemistry. The Linus Pauling Institute have a review article on Cruciferous Vegetables on their website. Broccoli and Brussels sprouts are the crucifera most rich in these beneficial compounds and a serving of one of these two vegetables should be eaten daily.Increased protein / reduced carbohydrates.

As a general rule, with some exceptions, people with CFS tend to do better with more protein and less carbohydrates in their diet.

People with CFS are prone to amino acid deficiencies and eating more protein helps increase amino acid levels. Detoxification, toxicity and antioxidant balance plays a crucial role in CFS and amino acids from dietary protein feed our detoxification chemistry. For example our 'master' antioxidant, glutathione, is thought to be universally low in those with CFS and is made from cysteine, glutamine and glycine. Several amino acids are needed as key biochemicals involved in phase 2 detoxification (e.g. glycine is needed for glycination). Dr. Sarah Myhill has observed that people with CFS tend to feel worse on low protein diets and believe this is at least partly because meat, especially beef, is rich in carnitine. High protein and reduced carbohydrate intake tends to promote more even blood glucose and insulin levels, less associated inflammation and increase levels of human growth hormone.

People tend to feel more fatigued after high carbohydrate meals. Higher carbohydrate intake also tends to increase levels of various intestinal bacteria and yeast, an issue known to be a key factor in CFS. Sucrose, wheat, potatoes and lactose are associated with the promotion of bacterial overgrowth in the small bowel. Reducing grains (bread, cereals, pasta, rice, etc.) and starchy vegetables (potatoes, sweet potatoes, yams) are two key steps in reducing carbohydrate intake.

Dr. Sidney Baker, integrative medicine expert of 40 years and author of ‘The Circadian Prescription’, makes a strong case for including generous amounts of protein (e.g. 30 grams) at our breakfast and lunch meals. While western countries typically have a low protein, high carbohydrate meal each morning, Dr. Baker cites evidence suggesting our bodies physiology functions more optimally when this is reversed.

Put protein in your morning meal, snacks and lunch. Emphasize fish, eggs … nuts … soy, poultry, beans, and meat… Move most of your carbohydrates from breakfast, lunch, and morning snacks to the evening. Dr. Sidney Baker

Dr. Baker reports benefits in the following areas as being typical.

  • Energy
  • Mental acuity
  • Sleep
  • Emotional balance
  • Weight regulation

… there is a marked difference between the biochemical sequences of daytime and what goes on in our chemistry at night. It is as different as night is from day. Food that supplies the different phases should be of the right sort, which turns out to be opposite to the habit of many folks: cereal and fruit, or, worse, sweet roll and coffee in the morning, and meat for dinner. I became interested in the subject when I read the studies of Charles Ehret, Ph.D., author of ‘Overcoming Jet Lag’ and noted researcher in the field of circadian (daynight cycle) physiology. I really became hooked when I saw dramatic changes in attention and vitality as well as a host of other functions in people of all ages who took my suggestion of experimenting with the “jet lag diet” delineated by Dr. Ehret… Naturally, if your child has good appetite for chicken, turkey, beef, pork, lamb, fish, beans or eggs, then you will not need recourse to rice protein. Load him or her up with these high protein foods at breakfast and lunch, and save most of the carbohydrates for any time after 4 p.m. Dr. Sidney Baker

Achieving a high protein intake in your morning and mid-day meals can be achieved either through dietary re-arrangement or through supplementation of protein powders. Just be wary that eggs, dairy and soy are all in the top six most reactive foods. Rice protein powder supplements are available. Choose one of these two options and commit to doing it daily for a minimum period of two months. Some patients require stomach acid replacement supplements (betaine-hydrochloride) and/or digestive enzymes with high protein meals.

Whole grains.

Whenever consuming grain products (cereals, breads, pastas, rice, etc.) always choose whole grains. Refined (white) grain products are nutrient depleted and promote blood sugar/insulin imbalances. Consuming refined carbohydrates is also pro-inflammatory. Look over the following table comparing the nutrient content of whole grain rice to white rice. Notice how vitamin E goes from 0.72 to 0.05. That is a 93% drop! The findings are much the same with other grains.

Whole grains are also lower in glycemic index and glycemic load, which is a measure of how much a food raises a persons blood sugar levels. Lower GI/GL is associated with more stable blood sugar, lower appetite and lower levels of inflammation. Refined grains also stimulate the activity of numerous genes related to stress, inflammation and insulin resistance. In summary there is a huge difference between whole grains and refined grain products.

Water.

Fereydoon Batmanghelidj, M.D., author of ‘Your Body’s Many Cries for Water’ recommends around 33 ml for every kg of body weight. Dr. Frank Shallenberger, author of 'Bursting With Energy', recommends a similar level of water as part of a comprehensive program to increase cellular energy production.

Celtic sea salt.

People with CFS often crave salt and due to abnormal hormonal balance tend to excrete salt in higher than normal levels. Increased salt intake is often recommended to increase blood pressure in CFS which is usually below normal. Celtic sea salt, produced in France, is highly unrefined and has a markedly different mineral balance to regular salt.

Dr. David Brownstein, author of the book ‘Salt: Your Way to Health‘ an expert on the therapeutic use of unrefined salt, has reported improvement in the following areas with the use of celtic sea salt and recommends avoiding common salts, which among other things often contain aluminium (anti-caking agent 554 is Sodium aluminosilicate).

Dr. Brownstein recommends approximately 1.5 tsp/day of salt along with a high intake of water. Celtic sea salt is also the salt recommended by Fereydoon Batmanghelidj, M.D., author of ‘Your Body’s Many Cries for Water’.

For an interesting article on salt see ‘Shattering the Myths About One of Nature’s Most Necessary Nutrients’ by David Brownstein, MD. Dr. Brownstein also has a brief video online about celtic sea salt, ‘The Health Benefits of Celtic Sea Salt Brand’.

Chemicals/toxins in foods.

CFS specialist Dr. Sarah Myhill writes:

Charred meats contain various pro-inflammatory compounds.

It's generally best to avoid peanuts as they both contain a variety of alfatoxins (mold derived toxins) and are a very commonly reactive food.

Studies by Dr. John McLaren Howard and Dr. Sarah Myhill using a lab test called 'Translocator [TL] protein studies' often reveal certain toxins bound to mitochondrial membranes, inhibiting their function. One of the chemicals found not infrequently are nitrosamines, found in smoked food and cigarette smoke. Smoked foods are also known to increase risk of stomach cancer.

Alcohol impairs mitochondrial function, taxes our detoxification chemistry, lowers levels of certain nutients, causes rebound hypoglycemia and is a commonly reactive food, due to high yeast content and preservatives.

MSG and free glutamates.

MSG (monosodium glutamate) is best avoided. MSG, and other free glutamates in excess, stimulate receptors in the nervous system called NMDA receptors leading to exacerbation of pain (inc. fibromyalgia), insomnia and anxiety.

Fermented and hydrolysed protein containing foods (eg. soy sauce, steak sauce, worcestershire sauce, vegemite, stock, etc.) also contain high levels of free glutamate.

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