Fighting fatigue with food

I just gave a talk to a group of doctors, nurses, and medical researchers on how to help cancer survivors physically recover. Fatigue is a major problem in people who have undergone cancer treatment, but when I asked this presumably healthy group of healthcare providers to raise their hands if they felt completely well rested, no one did.  This is not surprising. Studies show that one of the most common complaints that patients share with their primary care physicians is that they are tired. Chances are, you would like to have more energy—most of us would!

While there are many ways to fight fatigue, one important (and easy) way to do this is to change your diet. Here's what you might want to consider:

1.      Make sure to get enough complex carbohydrates and protein in your diet—these are good energy sources or "fuel" for your body. It's reasonable to have between 45%-65% of your calories come from carbohydrate sources and 15%-20% should come from protein sources. Complex carbohydrates include whole grains as well as fruits and vegetables.

2.      Don't skip meals. It's easy to use coffee as a pick-me-up to start the day, but it doesn't work very well in the long run, because the caffeine is not really the kind of fuel that will drive your body.  It's a stimulant that gives you the feeling of being more alert.  Instead, begin your day with a healthy breakfast that will provide you with real energy for a busy day.

3.      Try eating three small to medium meals each day, with two nutritious snacks in between. This is a good way to keep your blood sugar level up so that you don't have periods of the day when you become very hungry and tired. You might be surprised that eating in this way will help you maintain or lose weight.

4.      Avoid refined sugar and simple carbohydrates (such as sweets, crackers, and chips). These can provide a quick energy boost by spiking your blood sugar, but it's followed by a precipitous drop that can leave you feeling tired and sluggish.

5.      Get enough calories (but not too many!).  If you don't eat enough, you'll pay for this in a lack of energy. Of course, for most people, eating too little is not a problem!

6.      If you are anemic (or suspect that you might be), talk to your doctor about whether you should eat more iron-rich foods or even take a supplement. Examples of iron-rich foods include fortified cereals, almonds, beans, bran, and leafy green vegetables. While it's safe to eat a lot of iron-rich foods, it is not necessarily safe to take iron supplements. Also, since there are several kinds of anemia, it's important not to assume that iron is the problem.  If you have anemia, talk to your doctor about what is causing it and how best to treat it.

7.      Stay well hydrated. The best drinks for hydration are water, fruit and vegetable juices, and milk. It's best to avoid or limit consumption of caffeinated drinks (including coffees and teas), sodas, and alcohol.

Since I'm a vegetarian, one of the questions people ask me constantly is how I'm able to get enough protein in my diet to keep my energy level high. Here's a partial list of vegetarian sources of protein (of note is that dairy products would not be considered vegan sources of protein but many vegetarians, including me, do eat dairy products):

• Brown rice
• Cheeses
• Cottage cheese
• Eggs
• Legumes
• Lentils
• Meat analogs (e.g., veggie burgers)
• Nut and seed butters
• Quinoa
• Seeds
• Soy milk
• Tempeh
• Tofu
• Yogurt

While I hope that these suggestions are helpful, keep in mind that if you have persistent fatigue, it's important to talk to your doctor about your symptoms. Fatigue is often the result of an undiagnosed or inadequately treated medical condition. In the meantime, though, these are generally safe and easy tips to try.

Let me know if these tips help you to have more energy. I'd love to hear if you have food-energy suggestions as well!

Julie K. Silver, M.D., is an assistant professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. She is also the Chief Editor of Books for Harvard Health Publications.

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