Fatigue & nutrition

Most people with multiple sclerosis experience fatigue, and some people describe fatigue as their most troublesome symptom.  As you hit an energy slump this can have you reaching for the high sugar snacks such as sweets or chocolate and caffeinated drinks in an effort to keep going. These "comfort" foods and drinks give you a short energy boost and buzz, followed quickly by an even worse energy slump. They are not a good option.
 
Diet can play an important role in helping to manage the debilitating effects of MS-related fatigue. Likewise, a poor diet can exacerbate fatigue. For instance, one study of more than 2,000 adults with MS found that fatigue was associated with unhealthy dietary habits. 1,2 Reduced fatigue was associated with the consumption of moderate amounts of alcohol, regular exercised and taking vitamin D and flaxseed oil (omega 3) supplements. 1,2

Eating a healthy diet will help provide you with the nutrients necessary for energy production. Instead of reaching for the high fat, high sugar snack foods, try some of the following if you’re feeling fatigued:   

Energy Food Tips:

  • Follow the healthy eating guidelines and eat plenty of fruit and vegetables, seafood, lean meat and unsaturated fats and low-fat dairy foods.
  • Minimize temptation by removing sugary snacks such as biscuits, cakes, sweets, chips, crisps and junk foods from your home.  Restock with wonderful delicious options such as nuts, fruit, low fat natural yoghurt, rice cakes, seeds and check out the ideas below.
  • Surround yourself with healthy snacks which are within reach. Stash your snacks in your car, in your desk at work, in your home pantry and fridge / freezer.
  • Remember fruit is a great portable fast food. There's a good reason the Tour de France cyclists stock up on bananas as a good slow energy-release food, and they boost your mood too. 
  • Hydration is the key. Ensure you have adequate water intake.  Being even slightly dehydrated can make you more tired.  Some people with multiple sclerosis limit the amount of fluid they drink because they are concerned about bladder problems.  However, too little fluid can make multiple sclerosis symptoms worse by contributing to the risk of constipation, headaches and bladder infections. Talk to your GP about some strategies to assist you with anxiety about bladder issues.
  • Avoid skipping meals and try to eat regularly. Even small meals help prevent blood sugar levels from falling low enough to make us feel fatigued. Eat low GI carbohydrates often to keep your blood sugars steady. The rate at which sugars are released from foods is called the glycaemic index (GI).  Meals and snacks that are rich in low GI carbohydrates will help reduce fatigue throughout the day. They will provide you with a slower, more sustained energy release than foods with a high GI. Check www.glycemicindex.com for a list of foods and their GI.

Tips:

  • Speak to your GP and check your iron levels and thyroid function; if these are low, they will have a direct effect on your energy levels.
  • Speak with your GP or an Accredited Practicing Dietitian to discuss possible vitamin B supplementation if needed. B vitamins are essential for energy production.
  • Maintain a healthy weight as best you can as being over or underweight will make you feel tired.
  • Big meals and large serving sizes can leave you feeling bloated and sluggish, so eat small meals more often. You could even try eating slowly and mindfully and enjoy every mouthful. Take your time to eat and for your food to be digested.
  • Caffeine is a stimulant.  For many people drinking coffee or energy drinks will keep them awake at night, and of course, if your sleep is affected you will be more fatigued. Some people tolerate caffeine better than others, but as a general rule, if you are a coffee drinker then avoid caffeine after midday.
  • Minimise your intake of alcohol 
  • Try to be physically active and exercise regularly. This can help with feeling energised and refreshed and also help you sleep well. 

 Top 10 healthy snacks to keep close:

  1. Fruit = your fast food; grab some red grapes, crunch on an apple, enjoy a banana, mandarin or pear and scoff as many berries as you can!! Eat with a handful of nuts or some natural yoghurt to help stabilise blood sugar levels.
  2. Trail mix of nuts and seeds
  3. Veggie sticks and hommus or beetroot dip or tahini.
  4. Lightly Toasted Nut Balls recipe.
  5. Linseed and Date Balls recipe.
  6. Bliss Balls recipe.
  7. Loaded yoghurt - add 1 tablespoon of LSA (ground linseed, sunflower and almond mix), lecithin, plus berries of your choice.  Or add any combination of fresh fruit and nuts that you love.
  8. Wholegrain crackers with hommus, beetroot dip, dhal, nut butter, spinach, tuna, salmon, sliced tomato or avocado or variations of.
  9. Bananas, honey and tahini on toast - it's so much better than it sounds!
  10. Healthy Muffins - check out some recipes in our recipe section.

 Top 10 Quick Nutritious Meal Ideas

  1. Beans on wholegrain toast.
  2. Avocado on wholegrain toast.
  3. Jacket potato and tuna.
  4. Sardines on toast.
  5. Mini egg frittata (cooked in muffin tins).
  6. A soft-boiled free-range egg on its own or on top of great grainy bread.
  7. Soup or a vegetable juice.
  8. Sushi rolls.
  9. Homemade minestrone soup - cook vast amounts when you feel up to it and then freeze for when you need it.
  10. Let us know your favourite to include on our website.  If you can, send a photo and some information about yourself. Email to: recipe@ms.org.au

 Energy Saving Food Prep Ideas:

  • Use online grocery shopping.
  • Cook in bulk when you feel less fatigued and freeze in single serves (snap lock bags are great for this) for use at a later date.
  • Accept help from friends, family and home help.
  • Keep your freezer full of ready, nutritious meals.
  • Organise the kitchen to keep commonly used items close to hand.
  • Keep the kitchen as cool as possible, as many people with multiple sclerosis feel more fatigued when it is hot.
  • Cook at times of the day when energy levels are higher.
  • Sit rather than stand to prepare and cook meals.
  • Get all the ingredients and utensils together before starting to cook.
  • Make use of equipment or labour-saving devices where possible, such as electric mixers, can openers and knives.
  • Use ready-prepared foods such as prewashed salads and ready-cut frozen vegetables.
  • Use wire baskets in pans rather lifting heavy pans.
  • Invest in a one-pot cookery book to save on washing up.
  • Use a slow cooker to prepare warm, delicious, simple meals.
  • A trolley is useful to avoid extra walking and carrying in the kitchen and when serving.
  • Soak dishes rather than washing up straight away.
  • Consider a good quality meals delivery service.

 


[1] Dietary Interventions and Multiple Sclerosis. Curr Neurol Neuroscience Rep 2017, Ghadah Altowaijri et al.
[2] The Role of Diet in Multiple Sclerosis: A review , Nutritional Neuroscience 2017, Sabrino Esposito et al..

 

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