Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, is a progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord. ALS can make it difficult for individuals to swallow, chew, and breathe, leading to weight loss, malnutrition, and other health complications. Nutritional support and a balanced diet are essential for people with ALS to maintain their health and quality of life.
How ALS Affects Eating
ALS can affect the muscles of the jaw, mouth, and throat, leading to difficulty swallowing. This problem may affect up to 80% of people with ALS. In addition, ALS can affect the limbs, making it harder for you to use your hands to manoeuvre food to your mouth. In 20-25% of ALS cases, the muscles for speaking, swallowing, and breathing are the first to be affected. This is known as bulbar onset ALS.
If your condition is affecting your ability to swallow, you may experience some of these symptoms:
• Leaking of food or liquid from your mouth or nose
• Difficulty chewing or trying to swallow
• Coughing or needing to clear your throat during or after eating and drinking
• Feeling unable to clear your throat or mouth
• The sensation of food stuck in your throat
• A wet-sounding or gurgly voice
• You also may not feel interested in eating and may avoid eating with other people. You may feel frustrated, embarrassed, or anxious about eating.
Maintaining Weight and Muscle Mass
One of the most significant challenges for individuals with ALS is maintaining their weight and muscle mass. As ALS progresses, it can cause muscle wasting and weakness, making it difficult for individuals to eat and digest food. Nutritional support, such as a high-calorie diet and supplements, can help individuals with ALS maintain their weight and muscle mass.
Preventing Malnutrition
Malnutrition is a common problem for people with ALS, as it can make it difficult to eat and properly digest food. Malnutrition can lead to a range of health complications, including weakness, fatigue, impaired immune function, and increased risk of infections. A balanced diet with adequate protein, calories, vitamins, and minerals is essential to prevent malnutrition and maintain optimal health.
Managing Symptoms
ALS can cause various symptoms affecting an individual's ability to eat and digest food. For example, difficulty swallowing (dysphagia) is a common symptom of ALS, making it challenging to eat solid foods. Liquid nutritional supplements and pureed foods can help individuals with dysphagia get the necessary nutrients while reducing the risk of choking and aspiration.
Improving Quality of Life
A well-balanced diet that meets the nutritional needs of individuals with ALS can help improve their quality of life. Adequate nutrition can help reduce fatigue, increase energy levels, and improve mental and physical function. Proper nutrition can also help individuals with ALS maintain their independence and continue engaging in activities they enjoy.
Tips for Maintaining Good Nutrition
When diagnosed with ALS, patients or caregivers need to monitor the deterioration of chewing and swallowing functions. As those living with the condition develop facial weakness and fatigue, they can become discouraged from eating sufficient food enough times a day to maintain their health and nutrition. In this case, caregivers can use multiple strategies to keep mealtime as comfortable as possible, including:
Using plate guards and modified utensils to facilitate food scooping.
Placing the plate on the same plane as the patient’s mouth.
Adjusting the feeding set up to make it more comfortable.
Providing smaller meals more times a day and adding snacks.
Giving patients softer foods that require less chewing.
Cutting food into smaller bite sizes or using a blender to make it easier to eat.
Lubricating foods with sauces or gravy.
Minimizing distractions during meals.
Using a feeding tube.
In conclusion, nutrition is essential for individuals with ALS to maintain their health and quality of life. A balanced diet with adequate protein, calories, vitamins, and minerals can help prevent malnutrition, manage symptoms, and improve overall well-being. Nutritional support, such as high-calorie diets and supplements, can help individuals with ALS maintain their weight and muscle mass.
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