The Right Diet for CFS and Fibromyalgia: Part II

cfs diet

In Part I, we saw how a diet reliant on carbohydrate can be detrimental to many aspects of health important to CFS and fibromyalgia patients—including the gut, hormones, mitochondria, and brain health. Specifically we saw how high carbohydrate diets may drive microglia activation, damage mitochondria, and promote inflammatory cytokines.

So given this information, what should those with CFS or fibromyalgia eat?

A High Fat Diet

Once maligned by the media and public health outlets, fat is slowly becoming fashionable again. This dramatic shift is mostly due to a careful look at the literature. Several meta-analyses and interventional studies, when closely examined, indicated that high fat diets are not detrimental to health (1). In fact, the research goes so far as to suggest high fat diets are heart healthy and good for brain health too (2)!


But are all fats good for you?

No. Not all fats are created equal. The trans fats, known to cause various nasty effects to the body, are not the same as monounsaturated fats from nuts. The saturated fat found in grass-fed butter is not the same as the easily oxidized polyunsaturated fats of extra virgin olive oils. So how do we choose?

Consumption of saturated fats appears to be the healthiest choice (3). Yes, you read that correctly! Saturated fats from whole food sources are the best choice due in part to their chemical stability. Polyunsaturated and monounsaturated fats from whole foods—good choices in their natural state—are prone to oxidation through cooking or exposure. Oxidation of these fats leads to free radical production and thus the promotion of oxidative stress in the body. In fact, it is the oxidized form of fats, such as cholesterol, that is linked to coronary artery disease.

A Nutrient Dense Diet

Due to the excessive metabolic and immune system demands seen in CFS and fibromyalgia, more nutrients are required. This is commonly observed in the literature with most patients severely depleted in minerals and B vitamins—the body’s essential energy cofactors. Without adequate nutrients, metabolic processes come to a halt; producing a vicious cycle of symptoms. Constant replenishment of both micro- and macronutrients is essential to support biochemical systems in the body. While most rightly choose to replenish through supplementation, nutrients consumed from foods should form the basis of a healthy diet.

What are nutrient dense foods?

Nutrients dense foods are defined by their density of nutrients per calorie. For example, vegetables contain more micronutrients than a donut. Said another way, the donut is calorie dense but nutrient poor. The Nutrient-Rich Food Index (NRF) was established to quantify nutrient density in certain foods. It measures calcium, magnesium, potassium, vitamin A, vitamin C, vitamin E, and fiber in certain foods compared to their calorie content (4). Painfully left out are other essential micronutrients, minerals, and phytonutrients. Thankfully, common sense thwarts the need for charts and databases in this incidence. A whole foods diet, rich in colorful foods, full of variety, and well spiced, provides a hefty dose of both micronutrients and phytonutrients.

Choose Organic

Another shift in opinion is occurring surrounding organic foods. A few years ago most weighed in that there was no evidence to suggest organic foods were superior to conventional foods. Now deeper investigation is showing quite the opposite. Herbicides containing glyphosphate have been shown to suppress detoxification pathways in the liver and disrupt normal gut bacteria (3). Glyphosphate is the main component of Round-Up, utilized by farmers on wheat, corn, soy, and sugar crops around the world. Even worse news comes from researchers at Washington State University who determined that exposure to pesticides, herbicides, fungicides, plastics, and hydrocarbons may lead to epigenetic changes that potentially span as many as 3 generations (6)! In other words, there may be a real possibility that the DDT our grandparents were exposed to had genetic effects on their grandchildren.

If this news isn’t disconcerting enough, consider the nutrient content of organic foods versus conventional foods. A recent review and meta-analysis from the British Journal of Nutrition highlighted that organically grown produce contained less pesticides residue and higher antioxidant content than conventional foods (7). Organic foods may cost more but you do get more bang for your buck!

A CFS & Fibro Dietary Framework

Conventional medicine doesn’t teach that dietary changes have the ability to reverse disease. Yet myself and my colleagues in Ancestral Health and Functional Medicine experience the healing power of foods in daily practice. Many are improving from chronic debilitating conditions by establishing healthier eating habits. Yet few in the CFS/FM community prescribe a dietary framework as part of a treatment protocol. It was Hippocrates who said “let food be thy medicine and medicine be thy food,” yet this idea is so foreign to the current CFS/FM treatment paradigm. Why?

Eat for health.

Choose a low carbohydrate, nutrient-dense diet—one that relies primarily on a variety of whole, organic foods. Ensure high quality fat intake from saturated sources and unadulterated poly- and monounsaturated fats.

Has your CFS or fibromyalgia specialist recommended dietary change as part of your treatment? I want to know. Tell us your experience in the comments.


1  Chowdhury R, et al. (2014) Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Ann Intern Med. 160(6):398-406.

2  Elias PK (2005) Serum cholesterol and cognitive performance in the Framingham Heart Study. Psychosom Med. 67(1):24-30.

3  German JB & Dillard CJ. (2004) Saturated fats: what dietary intake? Am J Clin Nutr. 80(3):550-9.

4  Mobley AR, Kraemer D, Nicholls J. (2009) Putting the nutrient-rich foods index into practice. J Am Coll Nutr. 2009 Aug;28(4):427S-435S.

5  Samsel, A. & Seneff, S. (2013) Glyphosate’s Suppression of Cytochrome P450 Enzymes and Amino Acid Biosynthesis by the Gut Microbiome: Pathways to Modern Diseases. Entropy. 15(4), 1416-1463.

6  Skinner MK, et al. (2014) Pesticide Methoxychlor Promotes the Epigenetic Transgenerational Inheritance of Adult-Onset Disease through the Female Germline. PLoS ONE

7  Barański M, et al (2014) Higher antioxidant and lower cadmium concentrations and lower incidence of pesticide residues in organically grown crops: a systematic literature review and meta-analyses. Br J Nutr. 112(5):794-811.