February 11, 2019
Surprising Diet Tips for Managing MS Symptoms
Food and beverage choices can't eliminate multiple sclerosis symptoms, but they can make managing some of them easier.
Food is a big part of staying healthy for everybody, and in some cases, the right food and beverage picks can make managing multiple sclerosis (MS) symptoms a little easier.
Registered dietitian nutritionist Mona Bostick, who blogs about living with multiple sclerosis at Food Matters 365, shares some tips on what to eat and drink.
Drinking enough fluids is important for both bladder and bowel function.
A cold drink or Popsicle can help you cool down if you get overheated.
Spice up bland foods with low-salt flavorings for good taste and good health.
Problems with bladder function are common in MS. They can include both overactive bladder, in which you may need to go urgently or frequently, and underactive bladder, in which it may be hard to start urinating, and the bladder may fail to empty completely.
The first step in dealing with any bladder problem is to be evaluated by a physician. Untreated bladder problems can lead to urinary tract infections, worsened MS symptoms, and eventually, kidney infection or even an infection in the bloodstream.
While there is no known dietary modification that can correct bladder dysfunction that has a neurologic origin, Bostick says there are behavioral changes that can be helpful, such as establishing regular times to eat and go to the bathroom.
"The body tends to like routine. If you plan trips to the restroom shortly after meals, that can be useful. If you're going to get on a bus or not have access to restrooms, wait to eat until you arrive somewhere that does," Bostick says.
Staying hydrated with plenty of water and high-water foods, such as leafy greens, broccoli, squash, and watermelon, is helpful, too.
"It is important not to avoid fluids in an attempt to prevent accidents. Restricting fluid intake for more than two hours (or doing so frequently) can result in dehydration and contribute to the risk of infection by interfering with the normal flushing of the bladder and concentrating the urine," says Bostick.
Signs and symptoms of dehydration include a dry mouth, fatigue, headache, irritability, and confusion.
Bowel dysfunction in multiple sclerosis can include constipation, diarrhea, and loss of control of the bowels, or fecal incontinence.
Bowel problems can exacerbate bladder problems, so it's important to seek help when they occur.
For constipation, "Staying active and well hydrated and eating a balanced diet that contains lots of fiber from sources like fruits, veggies, whole grains, seeds, nuts, and beans can help to keep things moving," says Bostick.
If you increase fiber in your diet, make sure to increase your fluid intake as well.
"Water helps move foods through the system. Eating a lot of fiber without consuming enough fluids could actually worsen constipation," notes Bostick.
Establishing a daily restroom routine --- such as visiting the bathroom shortly after a meal --- can also help with constipation.
For diarrhea, Bostick says foods that cause trouble for some people include fatty or greasy foods, high-sugar foods, lactose, foods high in insoluble fiber (such as wheat bran), gas-producing foods, sorbitol-containing foods, caffeine, and alcohol. She suggests keeping a food and symptom diary to track patterns.
Many drugs can cause or contribute to constipation or diarrhea.
"If there is a concern that a medication or supplement is impacting bowel regularity, it is important to speak with your healthcare team," says Bostick.
Many people with MS experience temporary worsening of symptoms if they become overheated due to weather, fever, physical activity, a hot bath, or anything else.
While nutrition choices can't necessarily keep you from becoming overheated, consuming cold drinks and foods, such as slushies or fruit juice popsicles, can help you cool down.
And if hot soups, beverages, or other foods heat you up too much, steer clear of them.
Staying hydrated can also help to keep you cool in hot weather or if you have a fever or are exercising.
People with MS --- particularly those who are unable to engage in weight-bearing activities such as walking --- are at increased risk of osteoporosis and bone fractures. Prolonged or excessive use of corticosteroid drugs also raises the risk of osteoporosis.
To maintain strong bones, "It's important to get enough calcium, vitamin D, and other vitamins and minerals that support bone health," says Bostick.
A well-balanced diet that includes dairy, fatty fish, leafy greens, and a variety of other colorful vegetables should provide enough of the bone-supporting nutrients you need every day. Good food sources of vitamin D include fortified milk, fortified breakfast cereals, salmon, and low-sodium canned sardines. High-calcium foods include leafy greens such as kale, spinach, turnip and collard greens, broccoli, and beans.
If your diet doesn't include many sources of calcium and vitamin D, ask your physician about whether to take supplements and how much. Also be aware that these supplements can contribute to diarrhea and constipation.
Loss of Taste
As many as 1 in 4 people with MS have a diminished sense of taste, according to a study published in April 2016 in Journal of Neurology, and lesions in the brain are responsible for this loss. The study found that the ability to taste sweet, sour, bitter, and salty tastes could all be affected.
What to do when formerly favorite foods lose their appeal?
"We can make foods more palatable or turn up the volume on flavor with citrus juices, spices like red pepper, salsas, and fresh herbs or products like Mrs. Dash," says Bostick.
However, she cautions, "Resist the temptation to reach for the salt shaker, because diets high in sodium may have a negative impact on MS, something which is currently being studied."
Warm meals can also help, because the scent may be more noticeable.
By the same token, "If you're bothered by smells, I encourage people to choose cooler foods for the same reason," adds Bostick.
Fatigue is one of the most common symptoms of MS, and although good nutrition can't totally solve the problem, it can help. Lean proteins, colorful fruits and vegetables, whole grains, nuts, seeds, and beans will give your body the nutrients and energy it needs to function.
"If you're too tired to eat, sometimes we go for the easy fix, which might be a drive-thru, TV dinner, or vending machine snack. These are nutritionally empty foods, meaning they don't have vitamins, minerals, or nutrients, but they taste good, and make you crash," says Bostick.
Skipping meals also tends to make your energy dip, contributing to feelings of fatigue.
Bostick suggests planning meals ahead of time, so when you're tired, you don't have to think about what to eat.
Also, consider limiting caffeine and alcohol, which are known to interfere with sleep quality and can contribute to fatigue.
"Alcohol, even though it makes you sleepy at first, interrupts your sleep cycle and can leave you feeling fatigued the next day," notes Bostick.
When swallowing issues arise with MS, a speech-language pathologist is most qualified to diagnose what is causing the problem and to recommend strategies to improve your ability to swallow.
For some people, selecting foods with a different texture, or changing the texture of the foods and fluids they consume, can help. In many cases, this means consuming pureed foods and thickened liquids. (A number of commercial thickening powders are sold for this use.)
However, "Eating like this day after day can be frustrating. Many people find texture-modified diets to be unpleasant. While the speech pathologist is working with you to strengthen your swallowing ability, a dietitian can help ensure you're getting adequate nutrition and improve the tolerability and likability of food," says Bostick.
If you think you or your loved one has a swallowing problem, let your doctor know, and don't make adjustments on your own. The swallowing process is complicated, and the recommended treatment will depend on the underlying cause of the problem.
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