Trabal, J, Leyes, P, Fernández-Solá, J et al. · Nutricion hospitalaria · 2012 · DOI
This study looked at what foods people with severe ME/CFS avoid eating and why. Researchers found that many patients restrict dairy and gluten, but digestive symptoms didn't actually improve when they avoided these foods. The study suggests that some dietary restrictions may be based on advice rather than actual food problems, and recommends that dietary changes should only be made when there's a proven allergy or intolerance.
Many ME/CFS patients struggle with digestive symptoms and may unnecessarily restrict their diets, potentially leading to nutritional deficiencies. This study highlights the risk of blanket dietary recommendations and emphasizes the need for individualized, evidence-based nutritional counseling rather than ad-hoc food avoidance.
This study does not prove that dairy or gluten are safe for all ME/CFS patients, nor does it establish that dietary restrictions are ineffective for individual patients with documented intolerances. The small sample size and cross-sectional design mean the findings cannot establish causation or be generalized to the broader ME/CFS population. The study also does not evaluate whether patients who restricted foods had undergone proper allergy or intolerance testing.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Trabal, J, Leyes, P, Fernández-Solá, J, Forga, M, & Fernández-Huerta, J (2012). Patterns of food avoidance in chronic fatigue syndrome: is there a case for dietary recommendations?. Nutricion hospitalaria. https://doi.org/10.1590/S0212-16112012000200046
BibTeX
@article{mecfsatlas-trabal-2012-patterns-food,
author = {Trabal, J and Leyes, P and Fernández-Solá, J and Forga, M and Fernández-Huerta, J},
title = {Patterns of food avoidance in chronic fatigue syndrome: is there a case for dietary recommendations?},
journal = {Nutricion hospitalaria},
year = {2012},
doi = {10.1590/S0212-16112012000200046},
note = {PubMed: 22732998},
url = {https://www.mecfsatlas.com/evidence/trabal-2012-patterns-food},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/trabal-2012-patterns-food
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