Research study on progression

[Nikki J]

https://onlinelibrary.wiley.com/doi/10.1111/ene.15589

 

[MupstateNY]

I looked at the abstract. It gave me a rationalization for being about 10 pounds overweight (with the result that I can't fit into most of my clothes).

Thanks for posting.

 

[Nikki J]

There is old research that a bmi closest to 31 correlates with longer survival. That isn’t attainable for many of us but usually fluffy is good

 

[Buglaw]

Yeah, since I have bulbar onset and I know I’m going to lose the ability to eat at some point, I’ve been making sure to eat all the foods I love while I still can. I’ve gained probably 15 pounds in the 13 months or so I’ve been symptomatic and am outside of normal BMI (barely) for the first time in my life. The nutritionist at the ALS clinic and I chatted about how her job here is different than all her prior roles. Instead of encouraging people to lose weight, she runs around telling people how to add more calories to their diet and tells folks gaining weight like me to keep it up.

 

[Greeneyes]

My brother who was newly diagnosed has lost a significant amount of weight in the last 8 months. I suggested he increase his calories per day to maintain his weight. He likes Ensure Max. Encouraging high protein smoothies too. Any other suggestions would be helpful. Thanks.

 

[lgelb]

Greeneyes (and always feel free to use the Search function up top), some of the building blocks of a "real food, high protein, good fat" diet for PALS include eggs, nut butters, dairy (cheese, ice cream, cottage cheese, puddings, milk) or nut milk equivalents, deboned fish like salmon, tender or pureed meats, produce that may exclude kernels/seeds/tough skins, (cooked and canned may go down more easily) included, and products made from whole grain flour.

To make food easier to swallow and increase consumption generally, there are a lot of options, like using lots of syrup, cream, sauce. Some spices may be good, others not.

Hydration is equally important.

 

[Buglaw]

A suggestion I would include is to keep a food log that includes calories for all of the food they eat. Before I started having all these health problems that turned out to be ALS, I was pretty into powerlifting. Whenever we were looking to put on weight, we kept diaries of all the food we ate. If we weren’t gaining like we wanted to, we added 500 calories a day and then reassessed in a couple weeks. If we still weren’t gaining weight, we’d add another 250-500 a day until we did. It’s literally impossible to do this and not gain weight so long as you are being consistent in how you measure/estimate calories. I will flag that it causes you to feel full all the time and a little uncomfortable, but that’s to be expected when you are eating 10-25% more calories than you are used to.

In terms of food being eaten, I would also caution against eating too healthy if you are losing weight or having trouble gaining weight. It’s basically impossible to gain weight while burning a bunch of calories on a diet that is predominately fruits, veggies, whole grains and lean proteins. Most people simply get too full. Add in fattier cuts of meat (if you can eat them. Slow cooked tough cuts of meat go down pretty easy if cooked right), richer sauces, syrups and other sweetners. Adding a tablespoon or so of Nutella to a banana, peanut butter and milk smoothie makes it taste worlds better, doesn’t change the fact that its a mostly healthy meal that is very easy to consume and adds 100 calories or so.

 

[KimT]

I think you can eat healthy and gain weight. I think my morning smoothies are a good example. Also, low fat is not healthy for anyone. The low fat craze was started by big sugar to sell their unhealthy products.

My morning smoothie: Greek yogurt, bananas, blueberries, flax seeds, walnut milk, raw cocoa and an avocado. It is around 800 - 1,000 calories depending on how much flax and avocado I add. If I wanted more calories, I'd probably add some organic extra virgin olive oil or nuts. This can be blended in a Vitamix to whatever consistency you need by adding more liquid or more solid. Mine tastes like a creamy chocolate shake.

Eggs are another healthy powerhouse food that got a bad rap just because of the dietary cholesterol. Most of your cholesterol is made by your liver and dietary cholesterol doesn't raise serum cholesterol. I eat eggs at least twice a week (4 at each meal) along with some wild salmon and several veggies. Another higher fat but healthy meal.

I agree that a food log is good and there are calorie and nutrition calculators online that are easy to use.

 

[Greeneyes]

Thank you for your suggestions. I will use the search function for further information.

 

[Greeneyes]

Thanks. He is drinking Ensure Complete now which has 350 calories per drink. I think he drinks a few a day and drinks shakes made with ice cream and protein.