Good nutrition is important for everyone, regardless of their medical condition. But it’s even more important in people living with myasthenia gravis (MG). Over time, people with MG are at risk of poor nutrition, dehydration and weight loss. A healthy, balanced diet is an essential part of living with this chronic autoimmune disease and managing its symptoms. Here are some tips on how to ensure optimal nutrition when living with MG.
Why is nutrition important in MG?
In MG, the muscles used to chew and swallow can become weak and fatigued, causing dysphagia (trouble swallowing) in around two-thirds of people with the disease. When meals are tiring and stressful, patients may not eat enough to get all the vitamins, nutrients and calories they need. The resulting malnourishment negatively affects the body’s strength, immune system and patients’ overall well-being.
Additionally, many of the medications used to treat MG can impact nutritional needs. For example, long-term corticosteroid use can put patients at an increased risk for osteoporosis. To prevent bone loss, it’s important to get adequate vitamin D — but too much can negatively affect the immune system. Some MG medications can also cause diarrhea; patients with this side effect need to prioritize fluids, sodium and potassium.
Nutrition tips for MG
While more research needs to be done into the impact of nutrition on people living with MG, there are certain existing dietary recommendations that are thought to support good nutrition. These are based on MG being an autoimmune disease and the need to protect the body against the side effects of medications such as corticosteroids and acetylcholinesterases.
As well as making sure you’re eating a balanced diet of nutrient-dense foods, keep in mind the following advice:
- Nutrient-rich foods at the start of a meal may help prevent fatigue from setting in.
- Find ways to incorporate protein, such as adding an egg to pureed vegetables.
- Anti-inflammatory foods such as fruit, vegetables and fiber-rich foods are recommended to support gut health. The Mediterranean diet, which avoids saturated fats, sugars and processed foods, is a good starting point.
- Vitamin supplements such as omega-3s, calcium, vitamin A, D, E and zinc are useful in managing inflammation. Check the recommended dosage with your healthcare team.
- Avoid magnesium and melatonin supplements; there is some evidence they may make muscle weakness worse.
- Avoid high-fat foods and spices to help protect the intestine.
- Choose foods that are easy to digest.
- Stay hydrated with regular fluid intake, especially if you have gastrointestinal symptoms.
Before undertaking any changes to your diet, it is important to consult your healthcare team, namely your dietitian.
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Making meals easier
In addition to prioritizing nutrient-dense foods, making eating easier in general can help you manage mealtime fatigue and consume more of the right foods. Try these tips:
- Adapt the consistency of foods to allow for easier chewing and swallowing.
- Consider smoothies and milkshakes as they can be full of nutrients and easy to consume.
- Be aware of your fatigue levels and choose to eat when you’re feeling most rested.
- If you feel mealtime fatigue while chewing or swallowing, take a break and come back. Don’t risk choking or aspirating your food.
- Small, frequent meals that are easy to chew and swallow provide nutrition, fiber and calories that are easier to digest.
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