Dietary and nutrition interventions for the therapeutic treatment of chronic fatigue syndrome/myalgic encephalomyelitis: a systematic review

J Hum Nutr Diet. 2017 Jun;30(3):247-259. doi: 10.1111/jhn.12435. Epub 2017 Jan 22.


Background: Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is characterised by unexplained fatigue for at least 6 months accompanied by a diverse but consistent set of symptoms. Diet modification and nutritional supplements could be used to improve patient outcomes, such fatigue and quality of life. We reviewed and discussed the evidence for nutritional interventions that may assist in alleviating symptoms of CFS/ME.

Methods: Medline, Cinahl and Scopus were systematically searched from 1994 to May 2016. All studies on nutrition intervention were included where CFS/ME patients modified their diet or supplemented their habitual diet on patient-centred outcomes (fatigue, quality of life, physical activity and/or psychological wellbeing).

Results: Seventeen studies were included that meet the inclusion criteria. Of these, 14 different interventions were investigated on study outcomes. Many studies did not show therapeutic benefit on CFS/ME. Improvements in fatigue were observed for nicotinamide adenine dinucleotide hydride (NADH), probiotics, high cocoa polyphenol rich chocolate, and a combination of NADH and coenzyme Q10.

Conclusions: This review identified insufficient evidence for the use of nutritional supplements and elimination or modified diets to relieve CFS/ME symptoms. Studies were limited by the number of studies investigating the interventions, small sample sizes, study duration, variety of instruments used, and studies not reporting dietary intake method. Further research is warranted in homogeneous CFS/ME populations.

Keywords: diet therapy; public health; supplements; systematic review; vitamins.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Diet*
  • Dietary Supplements*
  • Exercise
  • Fatigue Syndrome, Chronic / diagnosis*
  • Fatigue Syndrome, Chronic / diet therapy*
  • Humans
  • NAD / administration & dosage
  • Patient Outcome Assessment
  • Polyphenols / administration & dosage
  • Probiotics / administration & dosage
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Ubiquinone / administration & dosage
  • Ubiquinone / analogs & derivatives


  • Polyphenols
  • NAD
  • Ubiquinone
  • coenzyme Q10