Q: I've been feeling too tired to exercise. My doctor thinks I have chronic fatigue syndrome (CFS). What can you tell me about it?
A: Doctors sometimes cannot find a valid reason for unexplained weakness and tiredness. In some cases, a patient is depressed. Depression saps drive and strength. For others, doctors will conduct extensive tests, often finding nothing -- no anemia, no diagnosable infection such as mononucleosis, no mineral deficiency, no hidden cancer and no low-thyroid function.
Some doctors believed such patients suffered from chronic mononucleosis. However, research has demonstrated that the mononucleosis virus has nothing to do with CFS.
Unfortunately, when patients cannot get a clear diagnosis or treatment from their physician, many seek out others who prescribe treatments that are of questionable value, such as megavitamin therapy, enemas, gamma globulin injections, yeast medications, yeast-free diets, minerals and ginseng.
Research shows the viruses HTLV-2 or a spumavirus, may cause some cases of chronic fatigue syndrome. However, we don't know if these viruses are really the cause and, even if they are, there is still no effective treatment.
Q: What do you think about reports that meat processors are going to start adding oat bran to replace the fat in meat?
A: The average American ingests 85 grams of fat each day, increasing his or her chances of having a heart attack and acquiring cancer. It's perfectly OK for people to eat fatty foods, provided that those individuals with normal blood cholesterol levels consume fewer than 50 grams of fat a day while those who have abnormal blood cholesterol ratios keep their intake below 20 grams.
Given the average American diet, such goals can be difficult to attain. A 1/2 -pound of cooked ground beef contains 25 grams of fat, which is more than a heart-attack prone individual should ingest in an entire day -- and which is already half of the upper limit for those who aren't at risk!
There is definitely a need for low-fat meat. Oat bran may help. Research has shown that oat bran lowers blood cholesterol levels by reducing fat intake. Thus, substituting the fat in meat with oat bran will help reduce a meat eater's intake of fat.
Dr. Mirkin is a practicing physician in Silver Spring specializing in sports medicine and nutrition.