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'''Caloric restriction''' or '''calorie restriction''', also known as '''energy restriction''' or a '''hypocaloric diet''', is a type of dietary regimen that reduces caloric intake without incurring [[malnutrition]] and getting all essential [[nutrients]].<ref name="MacDonald2011">{{Cite journal | title = Calorie restriction attenuates LPS-induced sickness behavior and shifts hypothalamic signaling pathways to an anti-inflammatory bias | date = 2011-07-01 | url = https://journals.physiology.org/doi/full/10.1152/ajpregu.00057.2011 | journal = American Journal of Physiology-Regulatory, Integrative and Comparative Physiology | volume = 301 | issue = 1| pages=R172–R184 | last = MacDonald | first = Leah | last2 = Radler | first2 = Morgan | last3 = Paolini | first3 = Antonio G. | last4 = Kent | first4 = Stephen|doi=10.1152/ajpregu.00057.2011|issn=0363-6119}}</ref> == Uses == The main use of calorie restriction diets is for [[weight loss]]. Clinically caloric restriction is often used to reduce [[obesity]] levels, and to treat or manage illnesses that are associated with increased rates of obesity, for example cardiovascular disease, type 2 diabetes and [[metabolic syndrome]]. <ref name="MacDonald2011" /> Clinical trials have also been carried out on critically ill patients, especially where obesity is a risk factor for the illness, and in people requiring enteral or parental feeding (tube feeding).<ref name="Petros2014" /> ==Theory== There is some evidence that caloric restriction reduces the impaired immune function caused by aging, reduces the risk of age-related illnesses, and extends lifespan.<ref name="MacDonald2011" /> Calorie restriction or other dietary changes and [[exercise]] are the main approaches recommended for weight loss in healthy people. == ME/CFS == Caloric restriction has not been suggested as a core treatment or cure for [[ME/CFS]], since it is not a nutritional or lifestyle related disease, however it may help some patients with certain comorbidities or reduce some ME/CFS symptoms. Obesity is common in Americans with ME/CFS and the exercise intolerance experienced by ME/CFS patients means that dietary change is likely to the main aporoach for those wishing to lose weight.<ref name="UScoalition2020">{{Cite web | title = Diagnosing and Treating Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | last = U.S. ME/CFS Clinician Coalition |edition=2 | date = July 2020 | url= https://bridgesandpathways.org.au/wp-content/uploads/2021/02/DiagnosingAndTreatingMECFSV2_USCoalition_2020.pdf | pages = 4}}</ref><ref name="ICC2011primer"/> [[Fibromyalgia]] patients may experience a reduction in pain and other symptoms.<ref name="Slim2015"/> Many people with ME/CFS are of normal weight, and some patients with [[Severe and very severe ME|very severe ME]] have severe gastrointestinal dysfunction causing severe weight loss and [[malnutrition]], this means caloric restriction will not be safe for all patients.<ref name="ICC2011primer"/> Small studies have shown that hypocaloric diets can reduce [[inflammation]] in people without ME/CFS,<ref name="Hermsdorff2011"/><ref name="Petros2014"/> which may improve some ME/CFS symptoms since raised inflammation markers and [[neuroinflammation]] are caused by ME/CFS.<ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | author-link1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | author-link2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | author-link3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | author-link4 = Nancy Klimas | last5 = Broderick | first5 = G | author-link5 = Gordon Broderick | last6 = Mitchell | first6 = T | author-link6 = Terry Mitchell | last7 = Staines | first7 = D | author-link8 = Donald Staines | last8 = Powles | first8 = ACP | author-link8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | author-link10 = Rosamund Vallings | last11 = Bateman | first11 = L | author-link11 = Lucinda Bateman | last12 = Bell | first12 = DS | author-link12 = David Bell | last13 = Carlo-Stella | first13 = N | author-link13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | author-link14 = John Chia | last15 = Darragh | first15 = A | author-link15 = Austin Darragh | last16 = Gerken | first16 = A | author-link16 = Anne Gerken | last17 = Jo | first17 = D | author-link17 = Daehyun Jo | last18 = Lewis | first18 = DP | author-link18 = Donald Lewis | last19 = Light | first19 = AR | author-link19 = Alan Light | last20 = Light | first20 = KC | author-link20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | author-link21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | author-link22 = John McLaren-Howard | last23 = Mena | first23 = I | author-link23 = Ismael Mena | last24 = Miwa | first24 = K | author-link24 = Kunihisa Miwa | last25 = Murovska | first25 = M | author-link25= Modra Murovska | last26 = Stevens | first26 = SR | author-link26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf}}</ref><ref name="Craig2015"/> Reducing inflammation may reduce [[pain]]. Hypocaloric diets are flexible enough to combine with other forms of dietary plan in order to maximise possible benefits.<ref name="Craig2015"/><ref name="Pisanu2020"/> ==Evidence== Evidence is very weak due to a lack of trials. It is not generally recommended by clinicians specializing in ME/CFS.<ref name="Craig2015"/> ==Risks and side effects== Risks in people with ME/CFS are unclear due to a lack of clinical trials.<ref name="Craig2015"/> Navarro et al. report that hypocaloric diets that restrict calorie intake too severely, for example to 1,000kcal or less per day, are dangerous rather than beneficial.<ref name="Navarro2013">https://pubmed.ncbi.nlm.nih.gov/24010747/</ref> Rapid weight loss caused by inadequate food take in a known cause of [[fatigue]] and can cause harmful metabolic changes, including [[muscle atrophy|rapid reduction in muscle]].<ref name="Navarro2013"/> People with ME/CFS are known to have nutritional deficiencies caused by the disease rather than by diet, so it is not clear how a long-term hypocaloric diet may need to be adapted to avoid [[malnutrition]].<ref name="ICC2011primer"/><ref name="canadianconsensus-CCC">{{Citation | last1 = Carruthers | first1 = Bruce M. | author-link1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | author-link2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | author-link3 = Kenny De Meirleir | last4 = Peterson | first4 = Daniel L. | author-link4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | author-link5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | author-link6 = Martin Lerner | last7 = Bested | first7 = Alison C. | author-link8 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | author-link8 = Pierre Flor-Henry | last9 = Joshi | first9 = Pradip | author-link9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | author-link10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | author-link11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | author-link12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols| journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02| url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf}}</ref> ==Costs and availability== Inexpensive and no particular foods are needed, although it will generally be more expensive than low quality highly processed foods. ME/CFS commonly causes significant [[disability]], this may mean any dietary change involving additional cooking or meal planning may worsen symptoms,<ref name="ICC2011primer"/> however this is true of almost all dietary changes, and a hypocaloric diet does not exclude pre-prepared foods. ==Notable studies == *2011, A legume-based hypocaloric diet reduces proinflammatory status and improves metabolic features in overweight/obese subjects<ref name="Hermsdorff2011">{{Cite journal | title = A legume-based hypocaloric diet reduces proinflammatory status and improves metabolic features in overweight/obese subjects | date = 2011-02-01 | url = https://doi.org/10.1007/s00394-010-0115-x | journal = European Journal of Nutrition | volume = 50 | issue = 1 | pages = 61–69 | last = Hermsdorff | first = Helen Hermana M. | last2 = Zulet | first2 = M. Ángeles | last3 = Abete | first3 = Itziar | last4 = Martínez | first4 = J. Alfredo|language=en|doi=10.1007/s00394-010-0115-x|issn=1436-6215}}</ref> [https://www.academia.edu/download/46305040/s00394-010-0115-x20160607-5679-cxzbdc.pdf (Full text)] *2014, Hypocaloric vs Normocaloric Nutrition in Critically Ill Patients: A Prospective Randomized Pilot Trial<ref name="Petros2014">{{Cite journal | title = Hypocaloric vs Normocaloric Nutrition in Critically Ill Patients | date = 2014-04-03 | url = https://doi.org/10.1177/0148607114528980 | journal = Journal of Parenteral and Enteral Nutrition | volume = 40 | issue = 2 | pages = 242–249 | last = Petros | first = Sirak | last2 = Horbach | first2 = Monika | last3 = Seidel | first3 = Frank | last4 = Weidhase | first4 = Lorenz|doi=10.1177/0148607114528980|issn=0148-6071}}</ref> [https://doi.org/10.1177/0148607114528980 (Full text)] *2015, Mitoprotective dietary approaches for myalgic encephalomyelitis/chronic fatigue syndrome: caloric restriction, fasting, and ketogenic diets<ref name="Craig2015">{{Cite journal | title = Mitoprotective dietary approaches for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Caloric restriction, fasting, and ketogenic diets | date = Nov 2015 | url = https://pubmed.ncbi.nlm.nih.gov/26315446/ | journal = Medical Hypotheses | volume = 85 | issue = 5 | pages = 690–693 | last = Craig | first = Courtney | author-link = |doi=10.1016/j.mehy.2015.08.013|pmc=|pmid=26315446|access-date=|issn=1532-2777|quote=|via=}}</ref> [https://www.ncbi.nlm.nih.gov/pubmed/26315446 (Abstract)] *2015, The effects of gluten-free diet versus hypocaloric diet among patients with fibromyalgia experiencing gluten sensitivity symptoms: protocol for a pilot, open-label, randomized clinical trial<ref name="Slim2015">{{Cite journal | title = The effects of gluten-free diet versus hypocaloric diet among patients with fibromyalgia experiencing gluten sensitivity symptoms: protocol for a pilot, open-label, randomized clinical trial | date = Jan 2015 | url = https://pubmed.ncbi.nlm.nih.gov/25485857/ | journal = Contemporary Clinical Trials | volume = 40 | issue = | pages = 193–198 | last = Slim | first = Mahmoud | author-link = | last2 = Molina-Barea | first2 = Rocio | author-link2 = | last3 = Garcia-Leiva | first3 = Juan Miguel | author-link3 = | last4 = Rodríguez-Lopez | first4 = Carmen Maria | author-link4 = | last5 = Morillas-Arques | first5 = Piedad | author-link5 = | last6 = Rico-Villademoros | first6 = Fernando | author-link6 = | last7 = Calandre | first7 = Elena P.|doi=10.1016/j.cct.2014.11.019|pmc=|pmid=25485857|access-date=|issn=1559-2030|quote=|via=}}</ref> [https://www.researchgate.net/profile/Elena-Calandre/publication/269281904_The_effects_of_gluten-free_diet_versus_hypocaloric_diet_among_patients_with_fibromyalgia_experiencing_gluten_sensitivity_symptoms_Protocol_for_a_pilot_open-label_randomized_clinical_trial/links/5b09bed3a6fdcc8c253250a8/The-effects-of-gluten-free-diet-versus-hypocaloric-diet-among-patients-with-fibromyalgia-experiencing-gluten-sensitivity-symptoms-Protocol-for-a-pilot-open-label-randomized-clinical-trial.pdf (Full text)] *2020, Impact of a Moderately Hypocaloric Mediterranean Diet on the Gut Microbiota Composition of Italian Obese Patients<ref name="Pisanu2020">{{Cite journal | title = Impact of a Moderately Hypocaloric Mediterranean Diet on the Gut Microbiota Composition of Italian Obese Patients | date = 2020-09-04 | url = https://doi.org/10.3390/nu12092707 | journal = Nutrients | volume = 12 | issue = 9 | pages = 2707 | last = Pisanu | first = Silvia | last2 = Palmas | first2 = Vanessa | last3 = Madau | first3 = Veronica | last4 = Casula | first4 = Emanuela | last5 = Deledda | first5 = Andrea | last6 = Cusano | first6 = Roberto | last7 = Uva | first7 = Paolo | last8 = Vascellari | first8 = Sarah | last9 = Boi | first9 = Francesco | last10 = Loviselli | first10 = Andrea | last11 = Manzin | first11 = Aldo|doi=10.3390/nu12092707|pmc=PMC7551852|pmid=32899756|issn=2072-6643}}</ref> [https://doi.org/10.3390/nu12092707 (Full text)] ==Learn more== * ==See also== * [[Healthy, balanced diet]] ==References== {{Reflist}} [[Category:Potential treatments]] [[Category:Diets]]
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