Nutrition interventions for the treatment of myalgic encephalomyelitis/chronic fatigue syndrome: a scoping review

Objectives
The prevalence and impact of chronic diseases are rising globally, with projections from the WHO indicating that, if current trends persist, chronic diseases will account for approximately 86% of annual deaths by 2050. Concurrently, conditions with complex etiologies and varied clinical manifestations, such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), are also increasing in incidence. ME/CFS presents challenges due to the limitations in diagnostic accuracy and effective pharmacological treatments, suggesting a need for multidisciplinary approaches, including complementary therapies like nutritional interventions. Thus, this study aims to synthesize recent literature on the outcomes of nutrition-based interventions for ME/CFS management.
Materials and Methods
A scoping review was chosen as the most suitable approach. Preliminary research indicated a systematic review conducted by Griffith University (Australia) in 2017, which assessed dietary and nutritional therapies for ME/CFS, covering studies from 1994 to 2016. Consequently, this review extends the search to Medline, Scopus, and Web of Science databases from 2017 to mid-2024 to further examine emerging trends.
Results
The 2017 review included 17 studies, with seven reporting improvements in fatigue with various nutritional supplements, including nicotinamide adenine dinucleotide hydride (NADH), probiotics, high cocoa polyphenol rich chocolate, and a combination of NADH and coenzyme Q10. Subsequent years saw more focused reviews: a 2018 probiotic review found insufficient evidence for their effectiveness in ME/CFS, and a 2019 review on nutrient deficiencies (e.g., vitamin C, vitamin B complex, sodium, magnesium, zinc, folic acid, L-carnitine, L- tryptophan, essential fatty acids, and coenzyme Q10) highlighted these as potentially influential in ME/CFS symptomatology. A 2021 review on mitochondria-targeting nutraceuticals revealed insufficient evidence of the effectiveness in ME/CFS patients. Recent individual studies have investigated coenzyme Q10, prebiotic effects of cocoa, and herbal extracts (e.g., Cervus elaphus Linnaeus, Angelica gigas Nakai, Astragalus Bunge, and botanical products with Cistanche and Ginkgo).
Conclusions
While nutritional interventions in ME/CFS have a documented research history, reviews indicate gaps in evidence-based guidance. Therefore, well-designed studies are needed to ensure robust, evidence-based nutrition research, enabling practical applications in ME/CFS management.
The study was carried out in the framework of Project No. lzp-2024/1-0343.