In this informative webinar, with expert nutritionist Dr Nina Bailey, you will learn about how we can optimise our diet to help manage many of the symptoms associated with CFS/ME, namely lack of energy, extreme fatigue and ‘brain fog’:
Foods the brain and body needs to function optimally: what we should be eating
Foods that starve the brain and body of nutrients and energy: what foods we really need to avoid
Supplements: the best nutrients for providing energy and treating symptoms associated with CFS/ME, backed up by science
By making some relatively simple dietary changes that may, in some cases, include the use of dietary supplements, it is possible to see significant improvement in symptoms.
2. Myalgic Encephalomyelitis (ME)is a condition
that causes fatigue severe enough to interfere
with a person’s normal life
ME is also known as chronic fatigue syndrome (CFS)
According to the NHS, it’s estimated that approximately
250,000 people in the UK have ME/CFS
5. And yet:
Food directly influences brain function, mood and energy
Living with CFS can have a significant impact on our appetite and
eating habits
Some people lose interest in cooking and don't have the energy to
prepare meals, whilst others have physical or emotional symptoms
that can be linked to either over- or under-eating
Standard drugs, such as commonly prescribed SSRIs, (whilst
providing relief for some suffers) can also present with side effects
that affect appetite, leading to undesirable weight gain or weight
loss
GPs do not generally give advice on nutrition!
6. Viral infections
ME/CFS is thought to arise from a persistent viral infection
o Epstein Barr virus (glandular fever)
o Enteroviruses
o Non-specific viral infection (URI)
o SARS
o Influenza
o Borrelia (Lyme disease)
o Xenotropic murine leukaemia virus-related virus (XMRV)
‘sub-clinical infection’ - once a person is infected, viruses can
remain latent in the body for long periods of time
8. Two different methods exist by which the body fights
infections
Cellular immunity (Th1) directs specialist cells (i.e. natural
killer T cells) to attack microorganisms at sites of infection
inside the cells
Humoral immunity (Th2) results in the production
of antibodies used to neutralise foreign invaders and
substances outside the cells
9. When an immature immune cell is exposed to a virus, a
Th1 response should be initiated
Some viruses are able to deceive the immune system into
thinking that the threat is not coming from a virus
The immune system counters with too little of a Th1
response, the virus remains concealed and the infection
becomes active or chronic
10. ME/CFS patients appear to
exhibit changes in the immune
system that increase their
susceptibility to viral infections
Link to stress?
12. Acute stressors occur rapidly and
have an obvious onset and offset;
chronic stressors are ongoing and
may not have a clear endpoint
Brief, predictable stressors are
generally beneficial in terms of
enhancing cognition, emotion and
neurobiological systems such as the
immune system
Chronic, sustained stressors are
considered to be the most
deleterious, contributing to immune
and endocrine dysfunction, altered
mood, and several neurobiological
and psychological diseases
14. Mitochondria generates ATP and these molecules are the
"currency" of energy in the body
The reserves of ATP are generally very low and have to be ‘re-
cycling’ to keep the cell constantly supplied with energy
If the cell is not very efficient at re-cycling ATP, then the cell
runs out of energy very quickly and this causes symptoms of
weakness and poor stamina because the cell must wait until
more ATP can be produced
When there is no ATP available, then the body will start to use
another molecule called ADP instead
15. The body can create energy from ADP but the only way that
ADP can be regenerated is by making it from fresh
‘ingredients’ which is an extremely slow process
D-ribose, CoQ10, acetyl-L-carnitine, NAD, magnesium and
vitamin B12 are ‘key ingredients’ that help support
mitochondrial function and improve energy
16.
17. Managing CFS/ME symptoms
Support immune function
Support energy requirements (via mitochondrial function)
Support brain function
Reduce ‘body’ inflammation
Support gut function
18. DHA
EPA
ALA
delta -6 desaturase
Viruses stop us making long
chain omega-3 fatty acids
EPA and DHA are important
regulators of:
Brain function
Cardiovascular function
Immune function
Inflammatory regulation
Plants
Fish and
seafood
19. DHA
EPA
ALA
delta -6 desaturase
Other factors that can reduce
EPA and DHA levels:
Stress (cortisol)
Alcohol
Saturated fat
Low vitamin and mineral
intake
Caffeine
Plants
Fish and
seafood
23. Bosma-den Boer et al. 2012
Initiation Resolution Termination
Inflammatory
‘messengers’
derived from
omega-6 fats
Initiation requires an inflammatory ‘trigger’
24. Bosma-den Boer et al. 2012
Initiation Resolution Termination
Pro-inflammatory signals
from omega-6 reduce
Inflammatory switch must occur for resolution to begin
Anti-inflammatory products
produced from omega-3 are
required for resolution of the
inflammatory process
STOP!
25. Bosma-den Boer et al. 2012
Initiation Resolution Termination
Pro-inflammatory signals
from omega-6 reduce
Inflammatory switch must occur for resolution to begin
Anti-inflammatory products
produced from omega-3 are
required for resolution of the
inflammatory process
STOP!
CORTISOL
26. Bosma-den Boer et al. 2012
Initiation Resolution Termination
If the inflammatory response doesn’t reach the termination
phase we have issues with ‘silent’ inflammation
CORTISOL
STOP!
42. “Whereas the role of diet in the prevention of other noncommunicable
diseases, such as cardiovascular disease (CVD), has been widely
investigated for the last 50 years, the relationship between diet and
depression is so far a novel and interesting field that has only emerged in
the last five to ten years”
43. “Long term exposure to unhealthy dietary habits
independently predisposes to depression over the life
course”
“Chronic inflammation may underlie the relationship
between diet and depression”
44.
45. Understanding diet quality - what is an inflammatory diet?
Pro-inflammatory foods
Lower-quality foods include highly processed snack foods, sugar-
sweetened beverages, refined (white) grains, refined sugar, fried foods,
foods high in saturated and trans fats, and high-glycaemic foods such as
potatoes, white bread and pasta
Anti-inflammatory foods
High-quality foods include unrefined, minimally processed foods such as
vegetables and fruit, wholegrain products, healthy fats and healthy
sources of protein
46.
47. Packaged and processed foods have become the norm in most industrialised
countries and increasingly throughout the world
Since the 1950s there has been a 70% decline in the purchase of flour – directly
attributed to the availability of ready prepared foods
There are now approximately 320,000 different packaged food and drink
products in the marketplace
In an average supermarket, there are approximately 25,000 + different products
on the shelves - yet fresh food makes up a very small percentage
At the end of 2004, total sales of the top products in the main processed food
categories (such as ‘bagged’ snacks and canned drinks) accounted for over £62
billion in the UK alone
Changing Diets, Changing Minds: how food affects mental well being and behaviour
48.
49.
50. The agricultural and industrial revolutions, followed by the globalisation
of world food trade, mean that most people in rich countries (and
growing proportions in poor countries) eat:
Small amounts of a few types of vegetables and fruit
Very few wholegrain products - our carbohydrates are mostly refined
(such as sugar and products made from white flour) - and from a very
narrow range of cereals (90% of the calories from cereals eaten in the
UK are from wheat)
Very little oily fish, but large quantities of intensively produced meat,
meat products and dairy products
55. The combination of nutrients most commonly associated with good
mental health and wellbeing:
Polyunsaturated fatty acids (particularly the omega-3 types found in oily
fish)
Quality (organic, grass fed) animal protein
Minerals, such as zinc (in wholegrain foods, legumes, meat and milk),
magnesium (in green leafy vegetables, nuts and wholegrain) and iron (in
red meat, green leafy vegetables, eggs and some fruit)
Vitamins, such as folate (in green leafy vegetables and fortified cereals),
a range of B vitamins (wholegrain products, yeast and dairy products),
and antioxidant vitamins such as C and E (in a wide range of fruit and
vegetables)
56. Eat protein-rich foods to boost alertness
Try to include a protein source in your diet several times a day, especially
when you need to clear your mind, boost your energy, lift mood, promote
relaxation and help deal with stress
Protein is broken down into amino acids
Amino acids provide the building blocks for the production of
neurotransmitters
Combine protein with complex carbohydrates (protein slows down the
absorption of sugars found in carbohydrates)
Vegetables (and fruit) provide vital ‘cofactors’ required to modify proteins
and amino acids into neurotransmitters
59. Choose your carbohydrates wisely!
The brain needs fuel, but at a constant rate
Glycaemic index
GI is a measure of the effect that carbohydrates have on blood sugar
levels
Carbohydrates that break down quickly during digestion, releasing
glucose rapidly into the bloodstream, will have a high GI
Carbohydrates that break down more slowly, releasing glucose more
gradually into the bloodstream, will have a low GI
60. Sugar is inflammatory!
The more processed and refined the carbohydrate, as a rule, the
faster it breaks down in the digestive system, and the bigger the sugar
rush it delivers
That’s why refined flours, sugars and sugar syrups pose such a
problem for our systems
Sugar plays a direct role in inflammatory diseases
Poor regulation of glucose and insulin is a breeding ground for
inflammation
61. L-Tryptophan
5-HTP
Serotonin
Melatonin
Magnesium, zinc & B6
Mood
Sleep
High levels of
Inflammatory products
(cytokines) and cortisol
(stress hormone) can
disrupt the normal
production of serotonin,
affecting both mood and
sleep
62. Pro-inflammatory carbohydrates include sugar of all sorts, white rice
and refined carbohydrates made from refined or enriched flour (such as pizza
crust, bagels, most breads, crackers, most packaged cereals, biscuits, cakes,
etc.)
Anti-inflammatory carbohydrates are the unrefined whole
carbohydrates that come packaged just the way nature designed them
including all fruits, vegetables, beans, legumes and unrefined non-flour
wholegrain products
All anti-inflammatory carbohydrates are also brimming with nutrients,
including vitamins & minerals, phytonutrients and antioxidants
63.
64. Optimise your gut health!
Complex carbohydrates are also a good source of fibre
Fermented foods such as fermented vegetables are also important for
optimal mental health as they are key to optimising your gut health
(prebiotics and probiotics), other natural probiotics include
Kombucha – enzymes and bacteria
Kefir – beneficial yeast and bacteria
Your gut is literally your ’second brain’, and can significantly influence
your mind, mood and behaviour
Your gut actually produces more mood-regulating serotonin than your
brain does!
65. 60% of the brain is comprised of fat
Deficiencies in specific kinds of fats can have a negative impact on
intelligence, behaviour and mood
Omega-6 and omega-3 fats in particular are required for brain
structure and function
Deficiencies in omega-3 are associated with a number of neurological
conditions
- Developmental disorders (i.e. ADHD)
- Depression
- Bipolar disorder
- Schizophrenia
- Dementia
66. Choose good fats!
Fats
Include Avoid
Coconut oil Margarine
Olive oil Sunflower oil
Rapeseed oil Canola oil
Butter (grass fed is optimal)
Flaxseed oil
Fish oil
Vegetable oil
72. Marine products offer a unique nutritional package
Rich source of essential micronutrients acting as
cofactors for neurological processes
• Neurotransmitters
• Methylation
Rich source of protein
• Tryptophan - serotonin
• Phenylalanine - dopamine
Major source of EPA and DHA
82. Eat well, spend less!
Cutting down on unhealthy food items such as ready
meals, sweets, cakes, crisps and fizzy drinks will free
up more money for healthier items
Many unhealthy food items offer little or no nutritional
benefit and can actually exacerbate feelings of
depression
“Let food be thy medicine and medicine be thy food.”
― Hippocrates c. 460 – c. 370 BC
83. Eat well, spend less
Get organised and try meal planning so that when you go shopping,
you can write a list and buy only what you need
We can spend a lot of our precious budget on ‘impulse’ purchases
because supermarkets are very clever at making us spend more than
we want!
This also helps to avoid supermarket promotions, which are seldom
related to good foods and often only encourage spending
Shopping with a friend can be a good idea (or buy online), if you do
want to take advantage of the healthier ‘buy one get one free’ offers!
84. Eat well, spend less
The nutrient content of fruit and vegetables begins to diminish as soon as
they are picked, so ideally you should try to only pick/buy the quantities you
really need for the next few days/meals
Frozen fruit and vegetables can be much better value than buying fresh
Frozen vegetables also tend to offer more nutrients, because they are frozen
within a very short time of being harvested
‘Fresh’ vegetables, on the other hand, are sometimes transported thousands
of miles, so aren’t always fresh when you finally eat them
Local markets or greengrocers often offer better value for money and are
more likely to sell locally sourced produce
Grow your own veg or forage for ‘free’ food!
85.
86.
87.
88.
89.
90. Eat well, spend less
Whilst organic, grass-fed animal products (meat & dairy) are the healthiest
option when choosing a protein source, pulses and soy products can be
much cheaper than meat, and offer additional nutrients not found in meat
Cuts of meat such as skirt, flank and shin (and offal) are cheap and nutritious
Tinned sardines, mackerel, pilchards etc offer very good value for money and
are packed with omega-3!
Try cooking in bulk and freezing portions for when you don’t feel like cooking
Remember – it doesn’t have to be expensive to eat well in order to look after
not only your brain, but your whole body
Eating the right foods can improve memory, mood and energy levels as well
as improve sleep patterns
91. “But I don’t feel like eating”
What about
High nutrient rich soups
Raw smoothies (vegetables/fruit)
Add coconut oil (MCTs) for an energy ‘hit’
Add protein powder
Try to eat little and often
92. Top tips
Adopt an anti-inflammatory diet
Eat at least 5 portions of fruit and vegetables a day (4 veg and 1 fruit)
(raw fruit and vegetables provide the biggest nutrient hit)
Choose whole foods, not refined foods (and anti-nutrients i.e. sugar)
Choose good fats (limit omega-6 and increase omega-3)
Choose quality protein
Eat small portions regularly
Use supplements where appropriate
95. SAMe – metabolism of neurotransmitters
serotonin, melatonin and dopamine
cysteine and glutathione – vital for antioxidant
protection and detoxification processes
DNA – cell cycle, genetic replication, growth
and development
carnitine, choline and CoQ10 – energy
metabolism and mitochondrial function
myelin proteins – nerve transmission and CNS
communication
A healthy methylation cycle – necessary for the production of:
96. Highly bioavailable (‘body-ready’) micronutrient
actives
Formulated at proven dosages for enhanced
efficacy
Strong benefits supported with strong health
claims
Offers benefits for cardiovascular health, brain
function and mood balance
Synergistic benefits alongside the Igennus clinical
omega-3 range
Small, easy-to-swallow tablets optimised for split-
dosing
Split-dosing overcomes bioavailability issues
related to vitamin B12 intake and maintains
optimal blood levels of key B-vitamins
Suitable for vegetarians & vegans
Suitable for adults and children aged 7+
Nutritional information Per dose % RI*
Vitamin C (ascorbic acid) 160 mg 200
Vitamin B3 (niacin) 48 mg 300
Vitamin B5 (pantothenic acid) 36 mg 600
Vitamin B1 (thiamine ) 20 mg 1818
Vitamin B6 (pyridoxal-5-phosphate) 20 mg 1429
Vitamin B2 (riboflavin-5-phosphate 14 mg 1000
Vitamin B12 (methylcobalamin) 900 mg 36000
Folate ([6S]-5-methyltetrahydrofolate) 400 mg 200
Vitamin B7 (biotin) 300 mg 600
Super B-Complex
97. Igennus MindCare® is the first comprehensive range of targeted brain
nutrition supplements based on four identified consumer need-states.
EPA & DHA +
vitamins E & D
EPA & DHA +
vitamins E & D
EPA & DHA +
vitamins E & D
EPA & DHA +
vitamins E & D
Magnesium glycinate,
L-Theanine &
micronutrients
Acetyl-l-Carnitine,
L-Theanine, taurine,
caffeine &
micronutrients
5-HTP, Magnesium
glycinate &
micronutrients
N-Acetyl L-Cysteine,
alpha-lipoic acid,
resveratrol &
micronutrients
98. S-adenosylmethionine (SAMe)
SAMe is an important co-factor involved in the biosynthesis of several
hormones and neurotransmitters, such as dopamine and serotonin,
which affect mood
Supplementing the diet with SAMe increases levels of serotonin and
dopamine
Usual dose is 100-200mg daily
Cannot be taken alongside standard antidepressants
99. Neurotransmitter precursors - tryptophan and 5-HTP
Serotonin is made in the body and brain from the amino acid 5-HTP
which is derived from tryptophan
Both can be found in the diet; tryptophan is found in many protein-rich
foods such as meat, fish, beans and eggs
Tryptophan supplements are available as 500mg to 1000mg
The highest immediate form of 5-HTP is the African Griffonia bean
(100mg-200mg dose)
Not advised to take alongside SSRIs
Editor's Notes
CFS – chronic fatigue
ME – fatigue and inflammation of the spine cord and brain
↓ NK activity
↓ Th1, ↑Th2
↑ Tc
As a biomarker, the AA to EPA ratio gives an indication of the inflammatory status
Diet has the capacity to influence the amount of polyunsaturated fats within our cell membranes, so we also need a structural biomarker
The omega-3 index = biomarker of intake, but also as risk marker, a risk factor and target for therapy
Combining the AA to EPA ratio with the omega-3 index gives us a comprehensive overview of health status
Understanding that diet affects physical health is well understood
Understanding that diet affects physical health is well understood
Epidemiological evidence suggest a link between poor diet and depression risk
When we talk about poor diet we are talking about an inflammatory diet pattern
The introduction of intensive farming methods, food processing, refining and the use of pesticides, herbicides and fertilizers has led to cheaper, highly available foods, some of which are of poor nutritional value
Highly processed ‘convenience’ and ‘junk’ food being seen as the ‘norm’ and merely part of 21st century living?
Significant negative effect on our long-term health (physical and mental health)
What our children eat in their early years is now known to have a profound effect on their food choices as they grow into adulthood, a major factor influencing their long-term health
Antioxidant phytonutrients
Refining and processing
Results in loss of minerals, vitamins, enzymes,
fibre, antioxidants, probiotics, proteins, essential
fats and phytonutrients
It renders the food into an "empty calorie" source
with little or no nutritional value
Detrimental effects on blood sugar levels
Refining and processing
Results in loss of minerals, vitamins, enzymes,
fibre, antioxidants, probiotics, proteins, essential
fats and phytonutrients
It renders the food into an "empty calorie" source
with little or no nutritional value
Detrimental effects on blood sugar levels
Most dietary sugars are simple carbohydrates, meaning that they’re made up of one or two sugar molecules stuck together, making them easy to pull apart and digest. Complex carbohydrates, like those found in whole grains, legumes and many vegetables, are long chains of sugar molecules that must be broken apart during digestion, therefore offering a longer-lasting surge of energy. The presence of naturally occurring fiber, protein and fat in many whole foods further slows the sugar-release process.
Refining and processing
Results in loss of minerals, vitamins, enzymes,
fibre, antioxidants, probiotics, proteins, essential
fats and phytonutrients
It renders the food into an "empty calorie" source
with little or no nutritional value
Detrimental effects on blood sugar levels
Refining and processing
Results in loss of minerals, vitamins, enzymes,
fibre, antioxidants, probiotics, proteins, essential
fats and phytonutrients
It renders the food into an "empty calorie" source
with little or no nutritional value
Detrimental effects on blood sugar levels
Refining and processing
Results in loss of minerals, vitamins, enzymes,
fibre, antioxidants, probiotics, proteins, essential
fats and phytonutrients
It renders the food into an "empty calorie" source
with little or no nutritional value
Detrimental effects on blood sugar levels
Refining and processing
Results in loss of minerals, vitamins, enzymes,
fibre, antioxidants, probiotics, proteins, essential
fats and phytonutrients
It renders the food into an "empty calorie" source
with little or no nutritional value
Detrimental effects on blood sugar levels
Refining and processing
Results in loss of minerals, vitamins, enzymes,
fibre, antioxidants, probiotics, proteins, essential
fats and phytonutrients
It renders the food into an "empty calorie" source
with little or no nutritional value
Detrimental effects on blood sugar levels
Oxidative damage, inflammation, demyelination, impaired processing and metabolic deficits are all associated with both neurodegenerative disease and mood disorders?
Could a cocktail of multiple antioxidants with anti-inflammatory agents be beneficial in the prevention of neurodegenerative disease?