Ask the Doc: Q & A with Edward Kasarskis, MD, PhD

Edward Kasarskis, MD, PhD is Director of the University of Kentucky ALS Multidisciplinary Clinic at Cardinal Hill Rehabilitation Hospital in Lexington, Kentucky, professor in the Department of Neurology at the University of Kentucky, and Chief of Neurology at the VA Medical Center in Lexington KY. 

Dr. Kasarskis

Q:  Will improving my nutrition help me stay healthier or affect the progression of ALS?

Dr. Kasarskis:  Nutrition is important for people with ALS. I often get questions from people wondering if they should be taking nutritional supplements, herbal remedies, or vitamins. Only a few studies have looked at these questions and none of them were definitive. There is still probably a great deal we don’t know about nutrition and dietary supplements for ALS.

But there are several things we absolutely do know. It is very important for people with ALS to avoid excessive weight loss. Just having ALS puts you at risk nutritionally because it is harder to maintain adequate food and fluid intake. Depending on the direction your disease has taken, you may have trouble chewing, swallowing, or just getting the food on a fork and into your mouth. These issues lead to fatigue and frustration, and certainly reduce the pleasure of eating. Meals take longer and prolonged meal times are associated with an increased likelihood of inadequate food intake. 

It’s important to focus on maintaining your weight by maximizing your caloric intake. Be sure to eat foods you like and enjoy them in sufficient quantities. If you see your weight decrease, talk with your physician about the best approach to good nutrition. Ask for a referral to a nutritionist to help evaluate how you can maintain your weight and get the intake you need. This may include diet modification, swallowing strategies, mobile arm supports for self-feeding, and alternative routes of nutritional intake via a PEG (feeding gastrostomy tube). 

Even people without ALS will lose muscle mass, muscle power, and will experience fatigue if they don’t take in the necessary calories. Coupled with ALS, a calorie deficit can have an enormously negative impact on your health. Consider getting the calories you need as good preventive medicine.

Each issue we feature a leading neurologist specializing in ALS responding to a question. If you would like to submit questions for a future Q & A, please send your questions to Amber Walters. Please understand that we won’t be able to address all questions and we won’t be able to respond to individuals personally.