Chronic Fatigue Syndrome Training & Nutrition
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Chronic Fatigue Syndrome - Training + Nutrition
Chronic Fatigue Syndrome is characterised by extreme fatigue, post-exertion malaise, myalgia (pain), sleep disturbances and cognitive dysfunction (3).
There is no conclusive support for any one pathogen (3), though it may stem from multiple facets including upper respiratory infections, bronchitis or sinusitis, gastroenteritis or an acute flu-like illness (3). Events that stress the central nervous system, regulatory system, immune system, and physical trauma such as a motor vehicle accident or fall may also be of cause. CFS can begin presenting symptoms within days or weeks of the initiating event (3).
The symptoms of Chronic Fatigue Syndrome are largely debilitating and are based on neurological, immunological and endocrinological dysfunction (3). Prolonged fatigue is one of the more known symptoms however other symptoms are largely non-specific. With no cure or approved treatment, symptoms can be managed to provide relief.
CFS can persist for as little as 6 months, a number of years, or remain for life. Like any condition, it’s important to work towards relief through treatments, nutrition and exercise. Always discuss with your health professional, doctor, occupational therapist or physiotherapist to create a suitable training and nutrition program and monitor progress (2).
Training
Exercise can improve symptoms of fatigue, sleep, disability and mood. This can be achieved for those who are diagnosed with Chronic Fatigue Syndrome given they avoid strenuous exercise that can trigger a ‘push-crash’ cycle with increased symptoms (2). Post-exertion malaise (aka the worsening of symptoms) is one characteristic that separates CFS from other conditions (1), with the onset of severe symptoms within 6 to 48 hours following exercise, lasting 2 days to 2 weeks (1).
Stabilising your physical activity level
A well known contributor to the prolonging of CFS is reduced activity and increased rest.. basically the less your body does the less it wants to do and your body adapts to this. This can often lead to unpredictable energy patterns and erratic sleeping behaviours if left unaddressed.
The best way to stabilise your energy is to regularly include low intensity activity but consistently increase the time spent on these activities and allowing your body to adapt to this level of energy exertion.
Physical graded exercise has been said to be more effective than relaxation and stretching exercises (1). “Such exercise could lead to physical reconditioning and could increase their ability to perform physical activities” (1) wrote Kenny de Meirleir (MD, PhD) and Patrick Englebienne (PhD) in their book Chronic Fatigue Syndrome - A Biological Approach. Non-strenuous, gentle exercise such as walking can improve blood flow and prevent muscles from slacking and joints getting stiff (2).
Can exercise make me feel worse?
It’s important to assess your energy level and ability prior to exercise and discuss with your health professional what is best for you. Understanding your limits, avoiding overexertion and using common sense will allow you to overcome any deconditioning that you may experience.
What’s the right level of exercise for me?
Exercise isn’t as important as treating your pain or fatigue and may not be a means to losing weight or getting in shape, however the longer you have the condition the more important exercise becomes (2). If you’re not already familiar with exercising with CFS you may need to start slow with frequent rests and simple movement. This could mean moving to the next room, brushing your pet, grocery shopping or household chores - if you’ve been active throughout the day you’ve probably done enough movement for the day. Building stamina and creating realistic goals will allow you to incorporate small manageable amounts of exercise into your daily routine.
What should a graded training program include?
Realistic goals that are achievable over both short and long term
Plan an initial activity that is realistic - one that you enjoy or one that is necessary in your life, such as walking an extra distance to the bus stop for work or taking the dog out for longer than usual. This should be an additional activity to your normal, everyday activity. The purpose is to challenge your body slightly so that it strengthens.
Start with activity that you know you will be able to include every day
Once this can be consistently achieved begin to increase intensity slowly. The increases you consider are very small: e.g. a 5-minute walk becomes 6 minutes. An increase from 5 to 10 minutes would not be advisable as this is an enormous 100% increase; our bodies tend only to be happy with increases of around 20%.
Remember that the process is slow and can take weeks or even months
Which activity should I choose?
Well.. what would you like to do? The best option here is activity that you can do regularly, and that you at least mildly enjoy. Many people like to choose walking because it’s something that we need to do on a daily basis anyway. If you’re interested in sport the lowest intensity options would be cycling or swimming.
Some days the movement will come easier than others, but it’s important not to overdo it on these days and stick to your time limit target to avoid falling into a boom-bust pattern. Do what you have planned to do, not what you feel you can do. You should take a short rest after exercise. Long enough to allow your muscles and central nervous system to relax, but not so long that you fall asleep.
Other forms of exercise
Housework
Gardening
Playing with children/ grandchildren
Yoga, Pilates, Tai Chi
Nutrition
Improving nutrition is a good way to help alleviate symptoms and help yourself stay on track (2). Keeping a food and symptom diary may help to identify any effects caused by diet. This can be done as an elimination diet as guided by your health professional - always make sure to check-in with your doctor before beginning any diet. Bloating, sensitivity, gassiness or other Chronic Fatigue Syndrome symptoms (such as fatigue) can be tell-tale reactions of finding which food is bad for you.
Keep it simple with vegetables, non-processed meats, rice, oats, barley, alternative grains, fruit (minimising citrus), water and herbal teas. Limit foods such as chocolate, milk, processed foods, sugar, food colouring, soda’s and sugar substitutes (2). Remove or greatly reduce your intake of coffee or caffeinated drinks.
Make sure to eat enough food to keep up energy levels - anything below 1200 calories will not give you the nutrients your body needs. Once you’ve identified what is working to relieve your CFS symptoms you can create an eating schedule if it will help calm nerves (2).
Your likes, dislikes, capabilities and disabilities, time constraints and daily routine (2) are factors in your relief of Chronic Fatigue Syndrome.
Looking for more tips on nutrition?
While we make every effort to make sure the information in this website is accurate and informative, the information does not take the place of professional or medical advice.
References
De Meirleir, K; Englebienne, P., Chronic Fatigue Syndrome - A Biological Approach, 2002, CRC Press
Dougherty, K.; Lisman, S.,Chronic Fatigue Syndrome for Dummies, 2011, Wiley
Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols, 2003, The Hamworth Medical Press