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Nutrition for Multiple Sclerosis

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Nutrition and Multiple Sclerosis

Multiple sclerosis (MS) is a chronic degenerative inflammatory neurological disease that affects the brain and spinal cord. Dietary recommendations for people with MS are similar to those for the general population. Recommendations are based on the Food Guide Pyramid.

Take Plenty of

• Whole grains, like bran, whole-wheat flour, whole cornmeal, wheat bran cereals (All Bran, Bran Buds, Bran Chex), bran flakes (Raisin Bran), Grape-Nuts, or Shredded Wheat, for energy.
• Cooked green leafy vegetables and fresh fruit, for fibre and energy
• Adequate fluid intake, preferably water - six to eight 8-ounce glasses per day, to avoid constipation.
• Polyunsaturated fats from oily fish and sunflower, safflower, corn and soya oils.
• Dried fruits such as raisins, prunes, or figs.

Cut down on

• Saturated fats (full-fat dairy products, fatty red meat)

Avoid

• Alcohol
• Smoking

Tips

• Make a variety of grains, fruits, and vegetables the foundation to your diet plan. Whole grains—such as whole wheat, brown rice, oats and whole grain corn—provide a fiber boost to the carbohydrates in your diet
• When it comes to fruits and vegetables, enjoy five a day—at least three servings of vegetables and two servings of fruit. It doesn't take much to make a serving—just one cup of raw leafy vegetables, a half-cup of other vegetables or fruit, or six ounces of fruit juice. Choose dark-green leafy vegetables and brightly colored fruits and vegetables often.
• Next add low-fat choices from the protein and dairy level of the pyramid to the nutritional groundwork you have laid. This includes lean meats, fish and poultry, low-fat or non-fat dairy products, dried beans, tofu, and other plant sources of protein.
• Individuals with MS should follow the American Heart Association guidelines on fat intake:
• 30% of total calories should come from fat
• 7%-10% saturated fat sources
• 10% polyunsaturated fat sources
• 10% monounsaturated fat sources

Some studies on the possible benefits of the omega-6 and omega-3 essential fatty acids , used in the maintenance and repair of the central nervous system, have suggested that supplements might slow the progress of the disease and reduce the severity and duration of relapses, the effect is modest and is still undergoing investigation.

One of the diets that has received a lot of attention is the low-fat diet of Professor Roy Swank of Portland, Oregon, USA. He claims that patients following a diet low in saturated fats less than 20g ( 3/4 oz )per day - and high in polyunsaturated fats had less frequent relapses, more energy and an increased life expectancy. Although its specific effects on MS remain to be proved, the Swank diet is at least a well-balanced one, in line with current recommendations on reducing intake of saturated fats and cholesterol, and is unlikely to pose any nutritional risks to MS sufferers.

• It's OK to enjoy sweets occasionally. But don't let soft drinks or sweets crowd out important foods you need.
• To lower salt or sodium intake experiment with low-sodium condiments, herbs, spices, and seasonings.
• Make water and decaffeinated beverages your first choice.
• Start with the easy changes. Then, one by one, add more kinds of vegetables, reduce portion sizes, introduce more low-fat foods.

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Feeding your special needs

The main role of diet in MS is to enable people to manage common problems which include fatigue, incontinence and constipation and to help them avoid exacerbating other symptoms. Chronic fatigue is one of the most debilitating symptoms of MS. A nutritious, low-fat breakfast and plenty of complex carbohydrates such as jacket potatoes and brown rice at other meals will help energy levels throughout the day. This can also help to keep weight under control as part of a calorie-controlled diet. Excessive weight gain can be a problem because of the decrease in energy expenditure associated with the condition, especially if sufferers also come to depend on convenience foods that are low in nutrients or eat too many 'comfort' foods which are often high in fat and sugar.

As the disease progresses, swallowing problems may occur. Swallowing problems may result in weight loss, malnutrition, dehydration, constipation, loose dentures, reduced strength, tiredness, and loss of general well being.

• Foods to avoid:
• Mixed textured foods and liquids, i.e., vegetable soup.
• Food that needs lots of chewing, i.e., caramel candy or taffy.
• Stringy food, i.e., bacon or celery.
• Hard, coarse food, i.e., nuts, toast, crackers, or chips.
• Foods that can become sticky in the mouth, i.e., bread or lettuce.

Thicker drinks may not be appropriate, depending on the dysphasia.

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Alcohol, incontinence and constipation

Alcohol can be taken in moderation but some sufferers may find that it can temporarily exacerbate MS symptoms such as problems with speech and coordination. More importantly, it inhibits the vital conversion process of essential fatty acids, increases the level of saturated fat in the blood and depletes the body's supply of valuable nutrients. Smoking also depletes blood levels of vitamin C and can worsen the symptoms of the disease.

MS often affects the nerve fibres of the bladder, causing incontinence.  This can indirectly affect the balance of the diet if sufferers severely restrict their fluid intake, especially if they cut down on vitamin and mineral-rich milk and fruit juices. Reducing fluid intake can often cause a dry mouth, which may lead to a loss of appetite and difficulty in swallowing. Long-term incontinence can also increase the risk of urinary tract infections such as Cystitis. Cranberry juice can be effective in helping to avoid this.

Fluid restriction can contribute to the common problem of constipation, especially when it is combined with decreased mobility and if the bowel is also affected. Plenty of water-at least 1.7 liters ( 3 pints ) a day-and fibre-rich foods such as whole grains, cooked green leafy vegetables and fresh fruit will help to prevent constipation.

It is essential to remember that MS affects each individual differently and that relapses and remissions also play a key role in determining a person's dietary needs. People with MS should seek professional nutritional advice throughout the course of their illness.

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