# Nutrition in mitochondrial disorders
Energy requirements and nutrient balance
Mitochondrial disorders are associated with impaired energy production in cells. This means the body struggles to efficiently convert nutrients into usable energy (ATP). As a result, certain nutrients may have greater importance than in healthy people.
ProveniIncluded in official guidelines, or approved by EMA or FDA
It has been demonstrated that people with mitochondrial disorders may need adjusted energy intake, because their body processes food differently. This varies greatly between individuals and between types of mitochondrial disorder.
ProveniIncluded in official guidelines, or approved by EMA or FDA
In practice, regular, smaller meals (instead of three large ones) are often better tolerated, because large amounts of food at once require a lot of energy from the digestive system.
Fats and ketogenic approach
Fats are an alternative fuel that the body can use directly without first going through complicated steps in the mitochondria. This is why some mitochondrial conditions (especially certain forms) have been studied with ketogenic or high-fat diets.
ResearchediPositive results in clinical studies, not yet standard treatment
Ketogenic diet (very low in carbohydrates, high in fats) has been positive in a few small studies for specific mitochondrial epilepsies. However, this does not work for all types of mitochondrial disorder and is absolutely not standard.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Medium-chain triglycerides (MCT) — a certain type of fat — are more easily absorbed and used than long-chain fats. For those for whom this is relevant, a dietitian can elaborate on this further.
*For all dietary fats and possible nutritional interventions with fats: first discuss with your healthcare provider or dietitian whether this is appropriate for your situation.*
Carbohydrates and blood sugar
Because mitochondrial disorders disrupt energy metabolism, the way the body processes sugars can also be affected. This is especially relevant when there is fatigue or brain fog.
ResearchediPositive results in clinical studies, not yet standard treatment
A stable, non-fluctuating blood sugar level seems to feel more comfortable for many patients, although this is not equally important for everyone. You achieve this by eating regularly and not combining fast sugars (such as pure glucose) with little other food.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Slowly absorbed carbohydrates (whole grain, vegetables, legumes) put less strain on the digestive system than fast sugars.
Antioxidants and anti-inflammatory effects
Mitochondrial disorders are often associated with more 'oxidative stress' — harmful substances that arise when energy production does not work properly. This has received attention in recent research.
ResearchediPositive results in clinical studies, not yet standard treatment
Diet rich in antioxidants (dark leafy greens, berries, nuts) could theoretically provide a buffer against this damage. This has been studied in various diseases, but there is no guarantee of improvement.
UnproveniNo scientific evidence that it works
The idea that many antioxidant supplements can cure mitochondrial disease is not supported. Too much of certain supplements can even be harmful.
Protein and muscle function
Muscle weakness is a common symptom in mitochondrial disorders. Adequate protein is important for maintaining muscle mass, although muscle weakness in these disorders cannot be solved by diet alone.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Regular, adequate protein intake (spread throughout the day) helps the body maintain muscle mass, even when fatigue makes exercise difficult.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Proteins from food (fish, meat, eggs, dairy products, legumes) are better absorbed than synthetic amino acid supplements, unless digestion is severely impaired.
Vitamins and minerals
Mitochondria need numerous vitamins and minerals for their work (such as B vitamins, magnesium, coenzyme Q10, carnitine). A deficiency can worsen the problems.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Certain deficiencies (B12, folate, magnesium, iron) occur more frequently in mitochondrial disorders and can worsen symptoms. A doctor can check via blood tests whether this is the case.
ResearchediPositive results in clinical studies, not yet standard treatment
L-carnitine and coenzyme Q10 have been used in studies because they play a role in energy production, but the evidence that they help is weak and results are highly individual.
Advised againstiProven ineffective or harmful, or dangerous in combination with your treatment
Taking uncontrolled amounts of supplements can be harmful, especially if certain medications are affected by them. Always discuss this with your doctor first.
Digestion and nutrient absorption
Many people with mitochondrial diseases have gastrointestinal complaints: nausea, diarrhea, abdominal pain or constipation. This directly affects how well nutrients are absorbed.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Food that is easy to eat and digest (soups, smoothies, soft vegetables, well-cooked grains) can prevent complaints and improve absorption.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Certain substances can worsen digestive problems: very fatty food, a lot of fiber at once, lactose (milk sugar) or fructose (fruit sugar), depending on the person.
ResearchediPositive results in clinical studies, not yet standard treatment
Timing of food intake around medication can be important, because some medications affect digestion. This varies greatly between individuals.
Fluid balance
Exhaustion and digestive problems can cause or worsen dehydration (fluid deficiency), which can increase fatigue and dizziness.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Drinking small amounts regularly works better than a lot at once. This is especially true for people with nausea or abdominal pain.
ResearchediPositive results in clinical studies, not yet standard treatment
Isotonic drinks (containing salts and glucose) can be useful in severe fatigue or gastrointestinal complaints, but this is highly individual.
Personal nutrition planning
Mitochondrial diseases manifest very differently from person to person and by type. What helps one person can be useless or harmful to another.
ProveniIncluded in official guidelines, or approved by EMA or FDA
A dietitian with experience in metabolic diseases or rare conditions can help develop a nutrition plan that suits your symptoms and laboratory values.
It is important to be careful about making many changes to your diet at the same time, because it becomes difficult to see what helps and what actually causes problems.
---
_This information never replaces a doctor's judgment. Always discuss your situation with your own healthcare provider._