Nutrition Brochure of the Myasthenia Gravis Foundation

Nutrition and Myasthenia Gravis

Eating the proper foods and good nutrition are important for everyone, and especially when you or a family member has Myasthenia Gravis. Three meals a day is one of the first requirements to a balanced diet. Regular and balanced meals help insure a healthy body. Each meal should include the four basic food groups. These include:

Milk and dairy products for calcium, vitamins, and minerals to maintain bones
Fish, poultry, meat, and eggs/ which provide protein for overall general well being
Fruits and vegetables which supply energy, vitamins, and minerals
Bread and cereals which supply the body with carbohydrates to supply energy

Chewing and Swallowing
The person who has myasthenia gravis may have special concerns when eating. When the muscles are weakened, an MG patient may experience difficulty chewing and swallowing. To help with these difficulties, the patient should:

Eat slowly and rest between bites as necessary.
If fatigue is a problem late in the day, have the main meal earlier in the day.
Schedule meals when muscle strength is best, possibly one hour after medication such as Mestinon or Neostigmine.
Try soft foods, such as mashed potatoes or oatmeal, in small portions.
Avoid sticky foods (such as peanut butter) which can be hard to swallow.
Take sips of fluids to help moisten food and help in swallowing.
Always sit upright in a chair, in a calm atmosphere, to avoid choking.
Have regular dental exams to keep teeth and/or gums healthy.

Diarrhea
Occasionally medication such as Mestinon or Neostigmine can cause cramping and diarrhea. Some tips for this situation:

Consider that the dosage of medicine may need to be reduced to levels which do not produce diarrhea; check with the doctor.
Drink plenty of liquids, including water, diluted fruit juices, and flavored drink mixes.
Avoid caffeinated beverages because they can make the diarrhea worse.
Broths and bouillon can be used to replace salt which may have been lost.
Avoid foods such as milk which are harder to digest.
Eat bananas, mangos, diluted orange and nectar juice to replace minerals.
Eat low fiber foods, such as white rice, white bread, cooked fruits and vegetables, without the skin.
If diarrhea persists, despite reducing the dosage, there may be another cause. Be sure to tell your doctor about any over-the-counter drugs which have been taken for diarrhea.

Fluid Retention
Some medications can cause the body to hold water or fluids. Medications such as Prednisone and other steroids can cause this problem. To lessen retention of fluid when taking these medications:

Avoid salt. Remove the salt shaker from the table. Try to either cook with salt substitutes or other spices.
Try to stay away from fried foods. Request baked or broiled foods when possible.
Avoid pre-prepared foods such as packaged mixes or TV dinners which contain more salt.
Avoid smoked and cured meats, canned soups and vegetables and canned or smoked fish products which are especially high in salt.
Develop the habit of reading the labels on foods packages. The list of ingredients in foods are listed from the highest to the least amount of an ingredient. Avoid foods if salt or sodium is listed as one of the top three ingredients.
Try to stay away from junk foods which are very high in salt. Potato chips, nuts, and pretzels are some examples.

Weight Gain
Some medications can cause weight gain. Talk with your doctor or dietitian about a low calorie diet that can be worked in the daily schedule. A few tips are:

Eat low calorie snacks such as fresh vegetables or fruits.
Use caution when looking at "fad" diets which may not be best when it comes to balanced nutrition. Contact your doctor before starting any diet.
Order carefully in restaurants and ask about foods low in fat, salt, and calories. Many restaurants have "health conscious" selections or will cook the food without salt and supply low calorie (lite) salad dressings. Request any salad dressings, creams, or sauces on the side so you have control of the amount wanted.

These simple tips on eating and nutrition will maximize the natural sources of energy we all need.

Reviewed/compiled by: Catherine Higgins, RD, LDN, Clinical Nutrition Specialist, University of North Carolina Hospitals and Janet Derrickson, RN, Neurology, University of North Carolina Hospitals. Edited by Tina M. Vassar, RN, MSN, CS.

This publication has been approved by the National Medical Advisory Board.
Myasthenia Gravis Foundation, 1996.

This brochure is funded by the members of the Arizona chapter of the Myasthenia Gravis Foundation of America in honor of Jim Walker, recipient of the MGFA Lifetime Achievement Award for his unselfish years of support to the Myasthenia Gravis Foundation of America.

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