Nutrition & Feeding Tubes
Good nutrition is important to everyone. For some people with ALS though, maintaining a healthy diet can be challenging due to chewing and swallowing difficulties.
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.
A nutritionist or therapist can help you put together a healthy diet that works for your specific needs. In general though, below are some tips on maintaining good nutrition despite ALS.
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.
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.
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.
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.
There is not yet any clear evidence that vitamin supplements can help the body fight ALS. It’s been suggested that vitamin E may be beneficial to people living with ALS, but the evidence is inconclusive. However, it is still a good idea to take a daily multivitamin and perhaps an additional vitamin E supplement. Some vitamins come in either solid or liquid form, allowing you to choose whichever is easier for you to consume.
Feeding Tube Nutrition
Eventually, some people living with ALS end up needing a feeding tube, either to supplement or replace eating foods through the mouth.
Nutritional supplements are often used with feeding tubes, but any food can be consumed that way as long as it is liquefied in a blender first. Some feeding tube patients find homemade blended meals to be preferable to store-bought supplements, and making your own meals can also be cheaper than buying supplements.
To blend your own foods for tube feeding, it is best to use an industrial-strength blender. Though such models are more expensive than basic blenders, some brands offer discounts if the blender is being used for medical reasons.