Maintaining
                             good nutrition
                             with ALS
                             A guide for people with ALS, 
                             families and friends
      The ALS Association is leading the fight 
      to treat and cure ALS through global 
      research and nationwide advocacy 
      while also empowering people with 
      Lou Gehrig’s Disease and their families 
      to live fuller lives by providing them 
      with compassionate care and support. 
                                                                         Maintaining
                                                                         good nutrition
                                                                         with ALS
                                                                        A guide for people with ALS, 
                                                                        families and friends
                                  By                                    Revised and updated 2011 by
                                  Barbara Tanenbaum, M.A., R.D.         Margaret Hucks, M.S., R.D., L.D.
                                  Clinical Study Unit                   Nutrition Department
                                  New England Medical Center            Mayo Clinic
                                  Boston, Massachusetts                 Jacksonville, Florida
                                  James Taft, P.A.C.                    Marcia Larson, R.D., C.D.E.
                                  Department of Neurology               Nutrition Department
                                  New England Medical Center            Mayo Clinic
                                  Boston, Massachusetts                 Scottsdale, Arizona
                                                                        Adele Pattinson, R.D., L.D.
                                  Revised by                            Nutrition Department
                                                                        Mayo Clinic
                                  Dallas Forshew, R.N., B.S.N.          Rochester, Minnesota
                                  Department of Neurology
                                  University of Utah
                                  Salt Lake City, Utah                  Revised and updated 2013 by
                                  1999
                                                                        Lorraine Danowski, M.S., R.D.
                                                                        Department of Family Medicine
                                                                        Stony Brook, NY
                                                                        Kathleen McCloskey, M.A., CCC-SLP
                                                                        Speech and Hearing Department
                                                                        Stony Brook, NY
                                                                        Julia Lehle, B.A.
                                                                        Dietetic Internship Program
                                                                        Stony Brook, NY
                                                                         
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                    TABLE OF CONTENTS
                              Introduction 3 
                              A well-balanced diet                                                   4
                                                                                                        
                                     Reminder about protein                                          5
                              Recommended body weight                                                6
                                     Ways to boost calories                                          6
                              Suggestions for dealing with
                                      Preparing meals and feeding yourself                           7 
                                      Swallowing difficulties                                        7
                                      Tips for safer swallowing                                      8
                                      Diet changes for easier and safer swallowing                   8
                                      Managing saliva secretions                                    10
                              Dehydration 11
                              Fatigue 11
                              Constipation 11
                              Decreased appetite                                                    12
                              Choosing to have a feeding tube                                       13
                              Vitamins 13 
                              Acknowledgments 14
                              Notes                                                             15, 16
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