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Food for Thought: MS and Nutrition

by Denise M. Nowack, RD, with Jane Sarnoff

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Helping yourself 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.

Nutrition basics

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 weight.

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 joint flexibility.

— Strengthen your heart.

— Decrease feelings of fatigue. (Really. Even with MS.)

— Decrease symptoms of depression.

— Maintain regular bowel and bladder functions.

— Minimize the risk of skin breakdown and irritation.

— Protect your weight-bearing bone mass.

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.

The Traditional Healthy
Diet PyramidTrimming 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 you need.

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 appetite!)

Meeting the challenges of changing your diet

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 this brochure.

The Traditional Healthy
Latin American Diet PyramidDeciding 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 flexibility.

        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 community.

The Traditional Healthy
Asian Diet PyramidFeeding your special needs

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 eating.

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.

Download Fiber Facts chart (PDF)

For additional information

* Staying Well

Copyright National Multiple Sclerosis Society, 2003

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