26 July 2011

Diet and Exhaustion - Part 2

DietDoc looks at the role that psychological conditions, medicines and unbalanced diets (caused by food allergies, slimming diets and eating disorders) may play in chronic fatigue.


DietDoc looks at the role that psychological conditions, medicines and unbalanced diets (caused by food allergies, slimming diets and eating disorders) may play in chronic fatigue.

In this second article devoted to conditions that can cause extreme exhaustion and the dietary factors that can possibly assist those people who struggle to stay awake or get up in the morning and are always feeling totally knocked out, we will consider psychological, and medication-induced exhaustion, as well as the role that  unbalanced diets may play.

Psychological factors

Most psychological conditions such as anxiety, stress, and depression, can make patients feel so tired that they are unable to function effectively in everyday life. If you suspect that your constant exhaustion is due to a psychological condition, then it is important to seek help from experts in the field, like clinical psychologists and psychiatrists.

From a dietary point of view, patients who have been exposed to stress, constantly suffer from anxiety, or are struggling with depression, need to ensure that they are eating a balanced diet which should provide them with sufficient vitamins, minerals and energy.

Unfortunately many psychiatric conditions of varying severity, can interfere with normal food intake. Someone who is deeply depressed may forget to eat or only eat "comfort food". Vitamin and mineral deficiencies induced by poor eating habits can worsen neurological function and create a vicious cycle of a mental disorder leading to poor eating habits leading to nutrient deficiencies which in turn exacerbate the mental condition.

Discuss the use of a complete vitamin and mineral supplement with your psychologist and ask to be referred to a registered dietician if you are not eating a balanced diet. The dietician will be able to guide you back to eating healthy foods and regular meals which can make all the difference to your mental health and the speed of your recovery.

Medication-induced exhaustion

Many medications can cause tiredness and sleepiness as side-effects. Medications, not intended for weight loss, that suppress the appetite can also lead to unbalanced food intakes, lack of energy and nutrient deficiencies.

So if you have started with a new treatment and suddenly feel totally exhausted, check the package insert of your medication (e.g. antihypertension medicines, ADHD medications, antidepressants, and many more) and if tiredness or lack of appetite are listed as side-effects, talk to the prescribing doctor to find out if something can be done about this situation.

Don’t reduce your dose or stop taking the medication without your doctor’s guidance. Your doctor may be able to adjust the dose or change you to another medication which does not cause pronounced tiredness or suppress your appetite.

Exhaustion induced by an unbalanced diet

Last week, I pointed out that the human brain requires a constant supply of glucose to function efficiently. To ensure that your brain and muscles always have an adequate supply of glucose so that you don’t drop off to sleep all day or feel as weak as a kitten, you need to eat a balanced diet that contains adequate quantities of all the nutrients, particularly carbohydrates.

Alas, carbohydrates are often the first foods that people with other health problems or goals, decide to avoid. This includes people who suffer from self-diagnosed food allergies and intolerances (it is always the carbs that are suspected, never the family cat or house mites or pollen!), many individuals who attempt to lose weight, athletes who want to build a six-pack, and patients with eating disorders.

a) Food allergies and intolerances

Never self-diagnose an allergy or intolerance for yourself or your children. Your runny nose or bloating and little Johnnie’s skin rash, can be caused by a multitude of other potential allergens in the environment or conditions that are not related to food at all. Consult your doctor so that you can have allergy or intolerance tests done to determine if the cause of your condition is actually related to a food, or if it is due to the myriad other allergens that surround us.

If you are one of the few patients who is allergic to certain foods (wheat or gluten or milk and dairy products, soya, nuts, etc), then of course you will need to avoid all foods that contain the allergen, but it is vital that you get assistance from a dietician to replace those foods with others that do not contain the allergen, but still ensure a balanced diet.

Just because you may be allergic to wheat or are gluten intolerant, does not mean that you should cut out all carbs. If you do, you will no longer have an adequate supply of brain and muscle fuel in your diet and will start feeling constantly tired. Your dietitian will assist you to include other carbs that don’t contain wheat or gluten (rice, sorghum, maize and quinoa) as sources of energy in your avoidance diet, so that you still have sufficient energy to lead a normal life.

b) Slimming diets

Many unbalanced slimming diets are either so low in total energy or encourage total avoidance of all carbs, that dieters are also cut off from their energy supply and tend to become exhausted. You may lose masses of weight in a short time, but you will struggle to function, and as for doing any exercise, well that will be impossible.

It is far more sensible to use a balanced slimming diet that still contains all the food groups, including carbohydrates (preferably low-GI carbs), if you want to lose weight. Your weight loss may be slower, but you will not feel exhausted or develop cravings, and you will be able to exercise. Regular exercise will combat depression, tighten your muscles to prevent post-diet sag, and stimulate your metabolism.

Conversely, if you are one of those people who is already thin and are petrified of gaining weight, you may restrict your energy intake to such an extent that you can’t function optimally. When some of my readers outline what they eat in a day, the food would not keep a mouse alive, much less allow an adult to work and still have the energy to go for a walk or play some sport at the end of the day.

So if you are always too tired to live, first check your diet and ask yourself if it honestly contains sufficient energy and/or carbohydrates to keep you going. If the answer is "No” then see a dietician to provide you with a balanced diet prescription. The latter won’t cause weight gain, but it could turn you from a dormouse into a happy, active, wide-awake person again.

c) Eating disorders

Individuals who suffer from eating disorders (including bulimia, anorexia, and orthorexia), tend to eat such minimalistic diets that they develop energy and nutrient deficiencies. If you are starved of energy or have mineral, vitamin or electrolyte imbalances due to induced vomiting or excessive purging (bulimia), then you won’t be able to function properly either mentally or physically. If your exhaustion could be due to an unbalanced diet because you have an eating disorder, please do go for professional help as soon as possible. Consult a dietician and a psychologist to help you escape from the devastating trap of eating disorders.

In this 2-part series on "Diet and Exhaustion", we have seen that there are many factors that could be causing your exhaustion and that a sensible approach and a balanced diet with the addition of supplements, when necessary (e.g. iron, vitamin B12, carbohydrates, etc), can prevent you from feeling like the living dead. Do something proactive about your constant tiredness today!

- (Dr IV van  Heerden, DietDoc, July 2011)

Any questions? Ask DietDoc

Read more:

Are you always tired? (Diet and exhaustion - Part 1)
10 rules for a balanced diet
Find a registered dietician

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