Multiple sclerosis (MS) is a chronic disease that affects your central nervous system. Over time it can slow or block the nerve signals that control how well your muscles work together, and how strong they are. It may also cause tingling or pain in parts of your body; and decreased vision (double vision or blurred vision).
People living with MS can have many different nutrition concerns. Some people may be overweight or obese, while others may be underweight. As the disease progresses, some people develop swallowing difficulties and other eating problems. There is also a higher risk for having low levels of certain vitamins and minerals in people living with MS.
Because MS can affect people differently, it is recommended that you see a Registered Dietitian to make sure you meet your nutritional needs, which can change over time. If you are having swallowing difficulties, or any other problem that makes eating difficult, talk with your doctor.
Steps You Can Take
Eat a healthy, well-balanced diet by following "Eating Well with Canada's Food Guide". (For a copy visit www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php or phone 1-800-OCANADA). This will help you to meet your nutrition needs and keep your immune system healthy.
There are many "alternative" diets, such as very low fat, allergenfree and gluten-free diets, that claim to help decrease symptoms or to stop the MS from getting worse. These diets can be low in important nutrients, very low in fat or ask you to strictly avoid many foods. Because of this, they can be harmful, especially if you are already malnourished. They have also not been proven to be helpful.
- Maintain a healthy weight. If unwanted weight loss or weight gain occurs, contact your doctor or dietitian.
- Reduced mobility can result in overweight or obesity, because you are using fewer calories. Some medications, like steroids and antidepressants can also cause weight gain.
- Being underweight and having poor nutrition can be caused by:
- reduced mobility and feeling tired, which can make shopping, cooking and eating difficult
- difficulty getting food or drinks to the mouth
- poor appetite, and
- difficulty swallowing.
If you are having any of these symptoms and they are keeping you from eating, discuss your symptoms with your doctor.
- When you have MS, it is especially important to get the recommended amounts (the Dietary Reference Intakes, or DRIs) of the following vitamins and minerals. If your doctor has diagnosed that you are deficient in any of these, you may be advised to take more. Do not take amounts higher than what is recommended because this can be harmful.
- Calcium and vitamin D. People with MS have a higher risk of low bone mineral density and breaking bones. This may be due to low vitamin D and calcium in the diet, or other factors such reduced physical activity, such as walking. Good food sources of calcium include dairy products (milk, yogurt and cheese), fortified soy and rice beverages, fortified juices, tofu with added calcium and canned fish with the bones. Good food sources of vitamin D include milk, fortified soy and rice beverages, fortified juices, fatty fish, such as salmon, and eggs. If you do not eat these foods daily, you should discuss adding a daily supplement with your doctor or dietitian. Canada's Food Guide recommends that all adults over the age of 50 years take a daily vitamin D supplement of 400 IU.
- Vitamin B12. Vitamin B12 deficiency is common in people with MS. Low levels of vitamin B12 can cause a type of anemia that can make you feel tired. Good food sources of vitamin B12 are dairy products (milk, yogurt and cheese), eggs, meat, fish, poultry, and fortified soy and rice beverages. It is recommended that people over 50 take a vitamin B12 supplement, because as you get older, you don't absorb the vitamin B12 from food very well. The amount of vitamin B12 in a multivitamin is usually enough.
- Zinc and selenium. Zinc and selenium deficiencies are common in people with MS. Zinc is needed for the growth and repair of body cells. Selenium works as an antioxidant to protect body cells from damage. Good food sources of zinc are meat, seafood, dried beans, peas, and lentils, and whole grains. Good food sources of selenium are Brazil nuts, seafood, fish and shellfish, liver and kidney. If these are foods that you don't eat regularly, you may need a supplement. The amounts in a multivitamin mineral supplement are usually enough.
Many people with MS try different herbal or nutritional supplements hoping these will improve their symptoms or prevent MS from getting worse. Ginkgo biloba has been studied in people with MS, and while early studies show some benefit, larger studies need to be done before it can be recommended. Gingko biloba has many side effects and shouldn't be taken by people who have bleeding disorders, who are taking blood thinning medication, or who are planning surgery.
Other supplements, including St. John's wort, ginseng, echinacea and valerian, have not been studied in people with MS, so it is not known if they are effective or safe. Because echinacea can stimulate the immune system, it might make MS symptoms worse.
Some supplements can affect how medications work. If you want to try herbal products, talk with your doctor or pharmacist first.
HealthLinkBC www.HealthLinkBC.ca Medically approved non-emergency health information and advice.
HealthLinkBC File #68e Food Sources of Calcium and Vitamin D www.healthlinkbc.ca/healthlinkbc-files/sources-calcium-vitamin-d
Dietitian Services Fact Sheets available by mail (call 8-1-1) or at www.healthlinkbc.ca/healthy-eating:
Health Canada. Dietary Reference Intakes
- Reference Values for Vitamins www.hc-sc.gc.ca/fn-an/nutrition/reference/table/ref_vitam_tbl-eng.php These tables will show you your vitamin requirements, based on age and gender.
- Reference Values for Elements www.hc-sc.gc.ca/fn-an/nutrition/reference/table/ref_elements_tbl-eng.php These tables will show you your mineral requirements, based on age and gender.
Multiple Sclerosis Society of Canada mssociety.ca
Last updated: April 2011