While good nutrition is important for everyone, maintaining proper nutrition and hydration is especially critical for people living with ALS. Sustaining a healthy weight and balanced diet is proven to help improve and maintain quality of life for people struggling with the disease.

Improper nutrition can cause people living with ALS to feel tired, lower their resistance to infection, hasten the loss of muscle mass, contribute to constipation, and lead to a host of other health problems. And for some people with ALS, maintaining a healthy diet can be challenging due to chewing and swallowing difficulties. 

A nutritionist, often part of the multidisciplinary team at ALS certified centers, can help put together a healthy diet that works for your specific needs. In recognition of National Nutrition Month, we’re sharing some general tips on maintaining good nutrition despite ALS. 

Protein

Protein provides the building blocks for muscle, as well as for many other tissues in your body. In fact, excluding water, about three-quarters of your body’s solid mass is made up of protein. If you don’t consume enough protein, your body may break down muscle tissue to supply the protein it requires. 

Protein is therefore very important for people living with ALS, but it can be difficult to consume all the protein they need. Some ways you can add more protein to your diet: 

• Try different sources of protein. Meat (beef, poultry, or fish), eggs, beans, nuts, milk, and cheese are all-natural sources of protein. 
• Mix dry milk powder into regular milk or milk-based dishes. Milk itself has protein, and powdered milk is more than 25% protein by weight, so mixing the two creates a protein-rich “super milk” that is also thicker and easier for people living with ALS to swallow. 
• Coating pieces of meat in gravy or sauce can make them easier to swallow. If swallowing is still difficult, the same food can be pureed in a blender. 

Fiber

Fruits, vegetables, and whole-grain breads and cereals are all good sources of fiber. Unfortunately, fibrous foods can be hard for some people living with ALS to swallow. 

To make sure you are getting enough fiber, try eating: 

• Fruits or vegetables with a soft consistency, such as bananas, canned peaches, or cooked beans. 
• Applesauce or other fruits that have been pureed. 
• Prune juice – add a thickening powder if needed. 
• If you are drinking nutritional supplements, choose one with added fiber. 

Water

Dehydration can be another problem for people with swallowing difficulties, and getting enough water is every bit as important as getting enough food. 

Most people need a half-gallon of water each day, or eight 8-ounce cups of liquid. If you are having trouble swallowing liquid, you can get the water you need by: 

• Drinking thick liquids or adding thickening powder to your favorite beverages. 
• Eating food with a high-water content, such as canned fruits or pudding. 

Calories

Getting enough calories to maintain a healthy weight can be challenging for people living with ALS. Though many people may think that it is healthy to diet or limit fat intake, for people with ALS it is much more important to make sure you’re getting enough calories to fuel your body and prevent it from breaking down muscle tissue. Do not try to lose weight by dieting, even if you feel like you are currently overweight, because it may become harder to eat as the disease progresses. 

Some options that can help you get more calories into your diet: 

• Add a tablespoon of butter or margarine to existing dishes, such as soups, casseroles, pasta, cooked vegetables, rice, potatoes, or bread. 
• Add one or two tablespoons of sour cream, heavy cream, salad dressing, or vegetable oil to your meals. 
• Add extra mayonnaise to chicken, tuna, or egg salad. 
• Spread a tablespoon of jelly, honey, or mayonnaise on bread. 
• Drink milkshakes with instant breakfast powder mixed in. 
• Drink nutritional supplements. 
• If you quickly feel full or grow tired when eating, try having six to eight small meals each day instead of three large ones. 

For more information about maintaining proper nutrition and ALS, visit our website HERE. Additional resources you might find helpful include:

• Maintaining Good Nutrition with ALS - A booklet written to help people with ALS overcome eating obstacles.
• Adjusting to Swallowing Changes and Nutritional Management in ALS – A free resource guide to help you understand how swallowing is affected by ALS and what you can do to maintain nutrition for energy and strength and to keep your airway open.
• High Calorie and Easy to Chew Recipes