Anti-inflammatory diets

A number of different diets have been proposed to be anti-inflammatory diets, with the mediterranean diet being the best-researched anti-inflammatory diets.

Anti-inflammatory diets aim to reduce foods or nutrients that cause inflammation and to increase foods or nutrients that reduce levels of inflammation in the body.

Theory
Increasing evidence shows that chronic fatigue caused by many different physical illnesses is linked to chronic low-level inflammation in the body. Raised levels of inflammatory substances and inflammation in areas of the body have also been found in ME/CFS patients, including neuroinflammation. Anti-inflammatory diets aim to reduce the level of inflammation in the hope that this will reduce systems, particularly to reduce fatigue.

Some anti-inflammatory diets may cure certain illnesses in a subgroup of people, for example the DASH diet aims to reduce or cure hypertension.

Types

 * Single-nutrient: focused on increasing levels of particular nutrients, eg the fatty acids omega 3 fatty acid, EPA and DHA, Vitamin A, Vitamin D, magnesium, D-ribose, or polyunsaturated fatty acids
 * Anti-inflammatory food diets: focused on including an increased amount of certain foods believed to have anti-inflammatory effects or using supplements, eg probiotics, ginseng (Korean/panax or radix ginseng), ginger (zingiber officinale), and plant polyphenols
 * The DASH diet
 * fatigue reduction diet
 * Leaky gut diet
 * Mediterranean diet
 * Nordic diet
 * Plant-based diets
 * Whole-grain diet and Whole foods plant-based diet (WFPB)

Evidence
ME/CFS cannot be diagnosed if a person is suffering from malnutrition, vitamin or mineral deficiencies, so medical tests must rule these out before diagnosis, and it is highly unlikely that ME/CFS would be cured by a change of diet.

In ME/CFS a number of studies have shown the presence of inflammation including neuroinflammation. However, no particular diet is recommended for ME/CFS beyond a healthy, balanced diet and there is a lack of clinical trials to establish the effects and potential harms of various different anti-inflammatory diets on patients with ME/CFS.

A limited number of dietary supplements do have evidence of benefits for people with ME/CFS.

Risks and safety

 * People with ME/CFS often develop food intolerances, so any diet would need to be adapted for this
 * A lack of clinical trials and a lack of expert ME/CFS clinicians advising on anti-inflammatory diets mean that potential benefits and risks are largely unknown.
 * An internet-based study found that many people seek dietary information online, especially for ME/CFS, multiple chemical sensitivity, and rheumatoid arthritis, but those who self-reported improvements as a result of altering their diet were more likely to report improvements related to other illnesses rather than ME/CFS. Feeling more refreshed after sleep was mentioned by many, although these were for a variety of different diets and it is not clear how many ME/CFS patients experienced this. Many patients did report improvements in many irritable bowel syndrome symptoms, and IBS is common in ME/CFS.

Costs and availability
Readily available. Some diets may be expensive, eg if they suggest only organic foods or gluten-free foods are used.

Notable studies

 * 2016, A systematic review of probiotic interventions for gastrointestinal symptoms and irritable bowel syndrome in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) - (Abstract)
 * 2017, Dietary and nutrition interventions for the therapeutic treatment of chronic fatigue syndrome/myalgic encephalomyelitis: a systematic review - (Full text)
 * 2017, Role of dietary modification in alleviating chronic fatigue syndrome symptoms: a systematic review - (Full text)
 * 2018, Whole grain diet reduces systemic inflammation - (Full text)
 * 2019, Anti-Inflammatory Diets and Fatigue - (Full text)
 * 2019, Inflammatory proteins are altered in chronic fatigue syndrome–a systematic review and meta-analysis - (Full text)
 * 2020, Inflaming Public Interest: A Qualitative Study of Adult Learners’ Perceptions on Nutrition and Inflammation - (Full text)