How to Eat Well with a Chronic Illness

Eating well with a chronic health condition can be challenging.

Chronic pain, nausea and fatigue are just some common symptoms which can affect our food intake. When you're feeling unwell, food might be the last thing on your mind.

Here we discuss small steps to make this more manageable.


What does ‘Eating Well’ mean?

People talk about ‘eating well’, but what do we actually mean by this phrase?

People may have very different images of what this means for them. Particularly since one diet doesn't fit all. So let’s look at the different food groups included in a healthy, balanced diet.

The Eatwell Guide, published by Public Health England (PHE), provides easy to understand recommendations on what to eat to achieve this balance by following the latest evidence-based advice on dietary recommendations (1).

The main messages include:

  • Eat at least 5 portions of fruit and vegetables a day. Try and aim for variation as greater diversity is thought to have a key role in good gut health.

  • Base meals on potatoes, bread, rice, pasta or other starchy carbohydrates and where possible choose whole grains such as wholemeal pasta. There is strong evidence that a diet high in fibre is associated with a lower risk of heart disease, type 2 diabetes and bowel cancer (2). Don’t let the low-carb craze fool you.

  • Include dairy such as cheese and yoghurt as a good source of protein, vitamins and calcium. If you opt for a plant based alternative such as almond or soya milk, choose unsweetened and calcium-fortified versions.

  • Beans, pulses, fish, eggs, meat and other proteins including 2 portions of fish a week (one should be oily such as salmon).

  • Choose unsaturated oils and spreads such as olive oil and eat in small amounts

  • Keep hydrated by drinking around 6-8 cups/glasses a day, including tea and coffee

In addition, we should all try to reduce our alcohol and caffeine consumption.


Is nutrition advice different if you suffer from a chronic illness?

With a chronic illness, there may be certain foods that you are unable to eat despite them being part of a recommended healthy diet.

For example, it is essential for those with coeliac disease to maintain a gluten-free diet. If you have Inflammatory Bowel Disease (IBD), a low-fibre diet may be helpful during active flare-up. Following a low-histamine diet can help manage allergic type symptoms from everyday foods such as cheddar cheese, avocados and fermented foods in those with histamine intolerance (3, 4, 5).

These diets can be tricky to manage whilst ensuring you don’t miss out on vital nutrients. You may come across a number of diets claiming to have cured everything from MS to IBD by juicing and detoxing. Don’t be fooled, quick fixes and fads don’t work.

There is also a misconception that ‘free-from’ diets are healthier. There is no evidence that a gluten-free diet is beneficial unless you have a medical requirement (i.e. coeliac disease) and in some cases it may lead to a diet lower in fibre and higher in sugars and fats. A vegetarian or vegan diet is only as healthy as the choices made. They can still be high in salt, sugar and saturated fat such as coconut oil.

The point we’re making is that it’s important for you to follow trusted and credible nutrition advice provided by a Registered Dietitian (RD) or Registered Nutritionist (RNutrs).


What are the barriers to eating well with a chronic illness?

Chronic illnesses may have a number of health conditions associated with them.

Some people might find themselves managing a variety of symptoms which are occurring at the same time. Trying to prepare food when experiencing nausea, chronic fatigue, pain, low mood and lack of appetite means that it’s sometimes more difficult to eat well.

When it comes to cooking, it’s important not to let these feelings overwhelm you. With a bit of planning you can manage your symptoms and still eat well.

How to overcome the barriers

When your symptoms get in the way of cooking, don’t be afraid to use ‘ready meals’. There are plenty of nutritious ones available, just try and avoid those high in sugar, salt and fat. Reading the food label on the front of the pack can be useful when selecting a healthier ready meal. There’s more info on this here.

Don’t overlook the benefits of frozen, dried and canned fruits and vegetables too. These forms of foods are often cheaper, and can be kept in your freezer for months. What’s more, there’s some scientific evidence suggesting that ‘processed’ fruits and vegetables are more nutritious than their fresh counterparts.

Nausea can be helped by having smaller meals or snacks rather than aiming for three larger meals. Some people find that sipping cool and refreshing liquids can help too.

Try to make things easy for yourself and make use of online food deliveries—why waste your energy carrying heavy bags? You can even save your usual food shop online so that you can repeat your order at the click of a button each week.

On good days try bulk cooking and then divide into single servings and freeze for later. Remember to label your tupperware with dates so that you know when the food was prepared. Enlisting help from partners or friends can also help to ease the burden of preparing and cooking meals.

It is possible to eat well with a chronic illness. With some trustworthy nutritional advice and small steps you will find a greater sense of control over these barriers.


Written by Sharon Kallos, ANutr. Edited by Harriet Smith, RD