Jean Mendolia, RD is the clinical dietician at The ALS Association Certified Treatment Center of Excellence at Holy Cross Health - Phil Smith Neuroscience Institute ALS Clinic & Research Center. For National Nutrition Month, The ALS Association Florida Chapter asked Jean for the best nutrition advice she'd give to people living with ALS. 

Research has found that a BMI of 25-30 has been associated with decreased risk of disease, later onset and prolonged survival.

"When I meet with patients weekly, I stress maintaining a healthy body weight."

People living with ALS can experience loss of appetite, weight loss, hypermetabolism, fatigue and trouble swallowing (dysphagia), so receiving adequate nutrition can be very difficult. Each patient gets a nutritional assessment determining their energy, protein and fluid needs. A high calorie, high protein diet is recommended to intake enough energy, protein, fiber, vitamins, minerals and fluids. Meeting protein needs prevents muscle breakdown in ALS  - which already affects motor neurons and muscles. 

Jean's advice includes increasing calories, including the use of high protein oral supplements and texture modifications. Supplements, shakes and protein powders can be added to patient's daily routines when they are too tired to eat, have no appetite or have difficulty chewing or swallowing. When intaking food orally does not consistently meet 75% of needs for people living with ALS, we commonly recommend early hypercaloric enteral feedings via a gastrostomy tube. Enteral feedings are used to prevent aspiration, maintain healthy body weight and stay adequately hydrated. Many patients remain able to consume food orally after peg tube placement.

"We strive to offer as many proactive nutrition tips for our ALS patients to hopefully keep them as healthy as possible."