As we talked about in the section on the diet debate that exists within the MS community (here) there are a few specially-developed eating patterns which have been reported to improve symptoms generally; however much of the research supporting these patterns have (understandably) been carried out by the researchers who developed them, there remains questions around the clinical validity of these diets and whether they can, as reported, produce improvements in markers of the disease. We are all about reporting widely accepted research conclusions, and while whole dietary pattern changes cannot be recommended to 'cure' (remember there is no cure for the disease) or diminish the damage caused there has been greater evidence of the benefits of diet in the management of specific symptoms.
Bladder symptoms
Bladder difficulties are common and affect up to three quarters of PwMS. Symptoms can appear in a number of ways from difficulty in emptying the bladder, inability to 'hold on' or constantly feeling like you need to go. Symptoms can become evident at any time but the MS Society indicates that difficulties are more common in those who have difficulty walking.
Some PwMS may limit fluid intake to try to limit the frequency of visiting the bathroom which can compound challenges by increasing the risk of urinary infections. Consuming fizzy drinks, caffeine and alcohol can also cause problems by irritating the lining of the bladder. Recommendations suggest it is best to drink a reasonable amount of pure (non-carbonated) water every day. General recommendations suggest 1.5-2 litres of water per day, but in reality the body loses more than this so water is also obtained through fruit and vegetables.
Constipation
Along with bladder symptoms many PwMS also suffer with constipation. The root cause of this commonality in MS is unknown but it is generally accepted that a lack of fibre may be a contributing factor (MS Trust, 2004).
The majority of the UK population do not consume enough fibre; the recommended daily amount (RDA) is 30g per day. Fibre is found in fruits and vegetables (particularly in the skins eg potatoes), starchy carbohydrates (wholegrain or granary breads), lentils, pulses or chickpeas the NHS Choices website shows a good illustration of what 30g fibre can look like throughout the day (http://www.nhs.uk/Livewell/Goodfood/Pages/how-to-get-more-fibre-into-your-diet.aspx).
Constipation can also affect other MS symptoms and may make spasticity and spasms worse while it can also aggravate bladder symptoms.
Fatigue
The precise nature of the fatigue which can plague PwMS isn't wholly understood; there is much current research ongoing to investigate the causes and nature of fatigue. It is important to eat a balanced diet full of fresh fruits, vegetables, meats and fish with adequate amounts of starchy carbohydrates to provide enough energy throughout the day. Personally, I find that three main meals per day doesn't provide the energy that I need so I include a snack mid morning and afternoon (generally a banana, a handful, nuts or a tablespoon of peanut butter on a couple of oatcakes). On a basic level a poor diet providing an inadequate amount of energy and nutrients can lead to fatigue but to be clear this is NOT the root cause of fatigue but can make a bad situation worse.
It is easy if you are suffering from fatigue to reach for 'quick fix' energy in the form of chocolate or other sugary snacks - this can be counter-productive as it will cause a spike in blood sugar to provide an initial burst of energy, but following thie short-lived respite your blood-sugar will drop again leaving you feeling worse. These convenience foods are low in nutrients and often high in calories which can cause unwanted weight gain. We have some great snack ideas to hep keep your blood-sugar stable here.
It is worth pointing out here that carbohydrates release their energy at different rates; the sugary-processed carbohydrates we mentioned earlier release glucose (energy) quickly, but it is also burned out quickly, leaving you more tired than you were before; these termed 'High Glycaemic index (GI) foods' Other foods such as wholegrain breads, pasta, fresh fruit and vegetables are lower GI foods and release their glucose over a longer period of time leading to more sustained energy release: 'energy for longer'. You can experiment with a mix of lower GI foods to find the optimum combination of lower GI foods to keep your energy constant throughout the day without peaks and troughs. There is some excellent information about GI from the British Dietetic Association here.
Many symptoms of MS including mobility and depression/anxiety can be better tackled with exercise/physical activity rather then diet (see here).
Bladder symptoms
Bladder difficulties are common and affect up to three quarters of PwMS. Symptoms can appear in a number of ways from difficulty in emptying the bladder, inability to 'hold on' or constantly feeling like you need to go. Symptoms can become evident at any time but the MS Society indicates that difficulties are more common in those who have difficulty walking.
Some PwMS may limit fluid intake to try to limit the frequency of visiting the bathroom which can compound challenges by increasing the risk of urinary infections. Consuming fizzy drinks, caffeine and alcohol can also cause problems by irritating the lining of the bladder. Recommendations suggest it is best to drink a reasonable amount of pure (non-carbonated) water every day. General recommendations suggest 1.5-2 litres of water per day, but in reality the body loses more than this so water is also obtained through fruit and vegetables.
Constipation
Along with bladder symptoms many PwMS also suffer with constipation. The root cause of this commonality in MS is unknown but it is generally accepted that a lack of fibre may be a contributing factor (MS Trust, 2004).
The majority of the UK population do not consume enough fibre; the recommended daily amount (RDA) is 30g per day. Fibre is found in fruits and vegetables (particularly in the skins eg potatoes), starchy carbohydrates (wholegrain or granary breads), lentils, pulses or chickpeas the NHS Choices website shows a good illustration of what 30g fibre can look like throughout the day (http://www.nhs.uk/Livewell/Goodfood/Pages/how-to-get-more-fibre-into-your-diet.aspx).
Constipation can also affect other MS symptoms and may make spasticity and spasms worse while it can also aggravate bladder symptoms.
Fatigue
The precise nature of the fatigue which can plague PwMS isn't wholly understood; there is much current research ongoing to investigate the causes and nature of fatigue. It is important to eat a balanced diet full of fresh fruits, vegetables, meats and fish with adequate amounts of starchy carbohydrates to provide enough energy throughout the day. Personally, I find that three main meals per day doesn't provide the energy that I need so I include a snack mid morning and afternoon (generally a banana, a handful, nuts or a tablespoon of peanut butter on a couple of oatcakes). On a basic level a poor diet providing an inadequate amount of energy and nutrients can lead to fatigue but to be clear this is NOT the root cause of fatigue but can make a bad situation worse.
It is easy if you are suffering from fatigue to reach for 'quick fix' energy in the form of chocolate or other sugary snacks - this can be counter-productive as it will cause a spike in blood sugar to provide an initial burst of energy, but following thie short-lived respite your blood-sugar will drop again leaving you feeling worse. These convenience foods are low in nutrients and often high in calories which can cause unwanted weight gain. We have some great snack ideas to hep keep your blood-sugar stable here.
It is worth pointing out here that carbohydrates release their energy at different rates; the sugary-processed carbohydrates we mentioned earlier release glucose (energy) quickly, but it is also burned out quickly, leaving you more tired than you were before; these termed 'High Glycaemic index (GI) foods' Other foods such as wholegrain breads, pasta, fresh fruit and vegetables are lower GI foods and release their glucose over a longer period of time leading to more sustained energy release: 'energy for longer'. You can experiment with a mix of lower GI foods to find the optimum combination of lower GI foods to keep your energy constant throughout the day without peaks and troughs. There is some excellent information about GI from the British Dietetic Association here.
Many symptoms of MS including mobility and depression/anxiety can be better tackled with exercise/physical activity rather then diet (see here).
Sources:
British Dietetic Association: Food Facts: Fibre
MS Society (2017) Diet
MS Trust (2004) Diet Factsheet
British Dietetic Association: Food Facts: Fibre
MS Society (2017) Diet
MS Trust (2004) Diet Factsheet
