Other Dietary Considerations in MS

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Constipation is a frequent complaint in people with MS. One way to improve constipation is to increase the amount of fiber in the diet. Good sources of fiber include whole grain breads and cereals, as well as fruits and vegetables. An increased intake of water and other fluids also may be beneficial for constipation; six to eight 8-oz. glasses of fluid daily generally are recommended. Some people with MS may have frequent urinary tract infections, and increased fluid intake also may be helpful for this problem. Finally, for some people with MS-associated fatigue, it may be beneficial to avoid large increases or decreases in the blood sugar level. This may be accomplished by eating small meals and snacks throughout the day.

Several other dietary factors should be kept in mind. Alcohol may, over the short-term, produce or worsen fatigue, bladder problems, walking difficulty, or clumsiness in the arms and legs. Grapefruit juice may increase the effects of many medications, including some that are commonly used for MS—diazepam (Valium), clonazepam (Klonopin), carbamazepine (Tegretol), sildenafil (Viagra), and sertraline (Zoloft).

Many diets have been recommended for MS with little or no supportive evidence. Avoiding foods that may cause allergies has been suggested. One example of this approach is a diet that does not contain gluten, a major component of wheat and wheat products. One clinical trial of a gluten-free diet in MS found no benefit, and a study of the animal model of MS found that a gluten-free diet actually worsened the disease. Studies of the blood and intestinal lining of people with MS do not indicate a sensitivity to gluten. No evidence supports the use of a pectin-free diet or a severely sugar-restricted diet.

If a specific diet is followed, it is important to always maintain a well-balanced intake of nutrients. Some of the more extreme dietary approaches that focus on one specific aspect of the diet may actually create problems by causing nutrient deficiencies.

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