Thought: MS and Nutrition
by Denise M. Nowack, RD, with Jane Sarnoff
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to a healthier life
MS is an unpredictable disease that affects each person
differently. But a person’s quality of life can often be improved by focusing
on those aspects of health that can be changed. Good health has a lot to do
with what you put on your plate at every meal, so diet is an area where you
can be in control.
Eating for good health is as
simple as A-B-C.
· Aim for fitness
Make a healthy weight your target.
There are many reasons why a person with MS may gain or lose weight—but
controlling weight is the same story for everyone: Watch the calories and do
regular physical activity. Calories are a measure of the energy locked inside
the carbohydrates, fats, and proteins found in foods. This energy fuels our
body but what we don’t use gets stored as fat, and over time results in extra
Physical activity and good nutrition are perfect partners in managing
weight. Not only does physical activity burn calories, it can help you:
— Make the most of your
potential muscle strength, or even build strength, depending on your program.
— Increase your endurance.
— Maximize range of motion and
— Strengthen your heart.
— Decrease feelings of
fatigue. (Really. Even with MS.)
— Decrease symptoms of
— Maintain regular bowel and
— Minimize the risk of skin
breakdown and irritation.
— Protect your weight-bearing
High fat foods and uncontrolled
portion sizes are leading contributors to weight gain. High-fat foods contain
more calories per portion than their carbohydrate or protein counterparts. To
cut back on calories look at ways to trim the fat. Also, keep tabs on portion
sizes. Do a little measuring with raw rice or water to see what 1/2 cup
really looks like. If your portion sizes have crept way up, you may want to
switch to smaller plates and bowls.
· Build a healthy base
Translating good nutrition to your
table takes planning, attention, and some innovation. Let the U.S. Department
of Agriculture’s Food Guide Pyramid provide a starting point. Each part of
the pyramid provides a building block of nutrient-rich foods. The choices are
many and they’re all yours!
Make a variety of grains, fruits,
and vegetables the foundation to your diet plan. Choices from these groups
are rich in vitamins, minerals, carbohydrates, and other substances important
for good health—most help create a feeling of fullness and satisfaction to
keep the snack urge quiet.
Whole grains—such as whole wheat,
brown rice, oats and whole grain corn—provide a fiber boost to the
carbohydrates in your diet. A single serving from this group provides about
70 calories. You can find that in a half-cup of cereal, rice or pasta, or one
slice of bread.
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.
· Choose sensibly
There are many ways to build a
personal pyramid … and lots of room for choice. When in doubt, go easy on
fat, the sugar, and the sodium.
Trimming the fat from your
diet—especially saturated fat—not only cuts calories, but may cut your risk
for chronic diseases, such as heart disease and stroke. Use vegetable oils as
a substitute for solid fats like butter and hard margarine. Choose fat-free
or low-fat dairy products and lean meats. Trim the skin from poultry. The
Nutrition Fact Label on food products can be a useful tool for finding foods
lower in total fat—as well as sodium and cholesterol.
It’s OK to enjoy sweets
occasionally. But don’t let soft drinks or sweets crowd out important foods
To lower salt or sodium intake experiment with low-sodium condiments,
herbs, spices, and seasonings. And if you drink alcoholic beverages, do so
sensibly. Make water and decaffeinated beverages your first choice.
(Variations on the pyramid pictured above can be found throughout
this publication. The basic principles can be applied to many traditions. Bon
Meeting the challenges of changing your
The A-B-C of good nutrition is the goal. But food is not
just about nutrition—it’s about emotions, culture, socializing. Because what
and how we eat is so personal, changing eating habits can be difficult.
Special diets and radical fitness programs sometimes promise the quick fix—or
even the cure. But the best advice for people with MS continues to be what is
recommended for everyone. Eat a low-fat diet with a variety of grains,
vegetables, and fruits, along with some high-protein foods like meat or dairy
products—and balance calorie intake with physical activity. For more
information on special diets, see the “A Look at Special Diets” section of
Deciding to change is the first
step. But the changes don’t have to happen overnight. Start with the easy
changes. Then, one by one, add more kinds of vegetables, reduce portion
sizes, introduce more low-fat foods.
Here’s a checklist:
· Be realistic. Make small changes over time. Small
steps can work better than giant leaps.
· Be adventurous. Expand your tastes by trying new
foods. There are many low-fat recipe books and magazines on the market, as
well as televised cooking shows, which can inspire new ideas.
· Be flexible. Balance what you eat with your
physical activity over the span of several days. Don’t focus on just one meal
or one day.
· Be sensible. Enjoy what you eat. Practicing
moderation doesn’t mean crossing all your favorite foods off your list
forever. Think smaller amounts, less frequently.
· Be active. Choose activities that you enjoy and
that fit into the rest of your life.
Make a move!
Physical activity comes in different shapes and sizes.
Aerobic activities raise your heart rate and breathing, and help promote
cardiovascular fitness. Other activities develop strength and flexibility.
For example, lifting weights helps develop strength and can help maintain
good bone health. Activities like yoga and gentle stretching can improve
· Have a conversation with your doctor about
exercise, your target weight, and special needs. If possible, get a referral
to a physical therapist to help you begin a program.
· Commit to doing what you can do on a consistent
basis. Choosing activities you enjoy will help you keep to your fitness plan.
· Start slowly. If you haven’t been active, introduce
your body to a low level of intensity for short periods of time. As your body
adapts, gradually build the intensity and duration of your program.
· Keep your cool. Overexertion and overheating can
temporarily increase MS fatigue and other MS symptoms. Drink plenty of fluids
before, during and after your activity. Try exercising in cool water or in
air-conditioned space. For some, using a cooling vest or neck wrap helps keep
the core body temperature at an appropriate level.
· Join a group! Exercising with others may give you
the motivation and support to keep going. Contact your chapter of
the National MS Society for referrals to physical activity programs in your
Good nutrition is essential for everyone, but people with
MS may have special considerations and needs. Your MS symptoms or your
medications can impact your nutritional well-being. Talk to your nurse or
doctor about dry mouth, fatigue, and other symptoms that interfere with
MS symptoms can also reduce mobility or physical activity.
If your eating habits remain the same while activity drops off, the usual
result is weight gain. Added weight can increase fatigue, further limit
mobility, put a strain on the respiratory and circulatory systems, and
increase your risk for other chronic illnesses. Ask a registered dietitian or
doctor to recommend an optimal weight, and reasonable daily calorie intake.
To get extra weight under control, put the physical activity and diet
partnership into action!
Being underweight can also compromise your health,
especially if it is caused by lack of appetite or fatigue that limits food
intake. It’s important that you meet your daily nutritional needs to ensure
that your body is able to fight off infection.
For additional information
Copyright © National Multiple
Sclerosis Society, 2003
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