Improving Nutrition in ALS

Increasing Quality of Life for Those with Lou Gehrig's Disease

Jul 8, 2009

Recognizing and treating the causes of malnutrition in ALS, can help promote an increased quality of life

Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease after a famous baseball player afflicted with the disease, is a progressive neuron disease that destroys nerve cells. ALS is characterized by skeletal muscular weakness, muscle wasting and exaggerated reflexes. Currently there is no effective treatment that can cure or slow down the disease progression. ALS usually progresses to death in 2-6 years.

Malnutrition is present in 16-50% of ALS patients and can decrease survival rates. Research shows that patients have decreased body fat, lean body mass, muscle power and an increased resting metabolic rate. It is important to start the management of good nutrition in the early stages of ALS. Preventing malnutrition may help to improve quality of life. It is important to be aware of the problems that occur with ALS that can contribute to malnutrition.

Dysphagia

Dysphagia, a difficulty swallowing, may make it challenging to ingest enough food to maintain health. In early stages of ALS taking small bits and chewing thoroughly is all that may be needed. As the disease progresses a pureed (baby food textured) diet may be required. Foods that are difficult to swallow such as raw fruits and vegetables, dry breads and crackers, and tough meats should be avoided. Thin liquids may also be difficult to swallow. Thin liquids can be thickened with products such as “Thick it” to appropriate textures. A time may come when the patient cannot consume enough to fill his nutritional needs; supplemental tube feeding can be used to help meet calorie and fluid needs.

Fatigue

Because ALS causes muscle weakness it may become difficult for patients to feed themselves or they may become tired after only eating small amounts of food. Small frequent meals may help increase intake. It also is important that the food eaten is nutrient dense and high in calories. A nutrition supplement such as Boost or Ensure can help provide calories and nutrients and are also easy to consume.

Dehydration

Inadequate fluid intake can contribute to fatigue and cause thickened saliva which can make swallowing difficult. For people with ALS it is important to emphasize the need for fluid intake. They may intentionally limit intake because of difficulty with toileting or not liking thickened liquids. A fluid intake of at least 2 quarts a day is required to prevent dehydration. Fluids should be sipped throughout the day to help meet this goal. It is recommended to avoid drinks that include caffeine as they can increase dehydration.

While ALS can be a devastating disease, good healthy nutrition can help prevent malnutrition and increase quality of life. It is important to recognize the problems that can contribute to decreased food and fluid intake early and start taking the necessary steps to prevent nutrition related concerns.

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The copyright of the article Improving Nutrition in ALS in Balancing Meals is owned by Melissa Black. Permission to republish Improving Nutrition in ALS in print or online must be granted by the author in writing.