Eat a healthy, well-balanced diet by following "Eating Well with Canada's Food Guide" This will help you to meet your nutrition needs and keep your immune system healthy. There are many "alternative" diets, such as very low fat, allergenfree and gluten-free diets, that claim to help decrease symptoms or to stop the MS from getting worse. These diets can be low in important nutrients, very low in fat or ask you to strictly avoid many foods. Because of this, they can be harmful, especially if you are already malnourished. They have also not been proven to be helpful. ● Maintain a healthy weight. This information is not meant to replace advice from your medical doctor or individual counseling with a registered dietitian. It is intended for educational and informational purposes only. ❍ Reduced mobility can result in overweight or obesity, because you are using fewer calories. Some medications, like steroids and antidepressants can also cause weight gain. ❍ Being underweight and having poor nutrition can be caused by: ■ reduced mobility and feeling tired, which can make shopping, cooking and eating difficult ■ difficulty getting food or drinks to the mouth ■ poor appetite, and ■ difficulty swallowing. If you are having any of these symptoms and they are keeping you from eating, discuss your symptoms with your doctor. ● When you have MS, it is especially important to get the recommended amounts (the Dietary Reference Intakes, or DRIs) of the following vitamins and minerals. If your doctor has diagnosed that you are deficient in any of these, you may be advised to take more. Do not take amounts higher than what is recommended because this can be harmful. ❍ Calcium and vitamin D. People with MS have a higher risk of low bone mineral density and breaking bones. This may be due to low vitamin D and calcium in the diet, or other factors such reduced physical activity, such as walking. Good food sources of calcium include dairy products (milk, yogurt and cheese), fortified soy and rice beverages, fortified juices, tofu with added calcium and canned fish with the bones. Good food sources of vitamin D include milk, fortified soy and rice beverages, fortified juices, fatty fish, such as salmon, and eggs. If you do not eat these foods daily, you should discuss adding a daily supplement with your doctor or dietitian. Canada's Food Guide recommends that all adults over the age of 50 years take a daily vitamin D supplement of 400 IU. ❍ Vitamin B12. Vitamin B12 deficiency is common in people with MS. Low levels of vitamin B12 can cause a type of anemia that can make you feel tired. Good food sources of vitamin B12 are dairy products (milk, yogurt and cheese), eggs, meat, fish, poultry, and fortified soy and rice beverages. It is recommended that people over 50 take a vitamin B12 supplement, because as you get older, you don't absorb the vitamin B12 from food very well. The amount of vitamin B12 in a multivitamin is usually enough. ❍ Zinc and selenium. Zinc and selenium deficiencies are common in people with MS. Zinc is needed for the growth and repair of body cells. Selenium works as an antioxidant to protect body cells from damage. Good food sources of zinc are meat, seafood, dried beans, peas, and lentils, and whole grains. Good food sources of selenium are Brazil nuts, seafood, fish and shellfish, liver and kidney. If these are foods that you don't eat regularly, you may need a supplement. The amounts in a multivitamin mineral supplement are usually enough. ● Many people with MS try different herbal or nutritional supplements hoping these will improve their symptoms or prevent MS from getting worse. Ginkgo biloba has been studied in people with MS, and while early studies show some benefit, larger studies need to be done before it can be recommended. Gingko biloba has many side effects and shouldn't be taken by people who have bleeding disorders, who are taking blood thinning medication, or who are planning surgery. Other supplements, including St. John's wort, ginseng, echinacea and valerian, have not been studied in people with MS, so it is not known if they are effective or safe. Because echinacea can stimulate the immune system, it might make MS symptoms worse. Some supplements can affect how medications work. If you want to try herbal products, talk with your doctor or pharmacist first.