a woman in the kitchen chops fresh herbs from her herb garden

The Gravis Gourmet

Myasthenia gravis (MG) brings challenges on many levels. Fatigue and weakness are only the beginning. Chewing and swallowing can become more difficult. Reflux is often common. Worst case, food can be aspirated and lead to serious illness.1

For many people with MG, eating becomes a constant challenge. The consequences of poor nutrition can lead to more serious symptoms. Preparing enticing meals that are easy to swallow and packed with value can be one of the most important contributions a caregiver can provide.2

For a person with MG, the goals for fine dining involve 3 Ts: Taste, texture, and timing. The good news is that the efforts you make in that area can almost all be used by others in the family.

Add flavor to meals

First, think about taste. When a person is tired or weak, it might be difficult to find the desire to eat. While some MG drugs like prednisone can sometimes increase appetite, others like pyridostigmine can be associated with a wonky stomach and discourage eating.3,4

To add taste to a standard recipe, don’t rely on salt. Try fresh herbs (an herb garden is a great stay-at-home hobby). Cook fresh and fast whenever possible. That preserves both flavor and vitamins. Don’t hesitate to take advantage of meal services where they are available.

Consider the texture

The second important feature of the ideal meal for myasthenia gravis is texture. Some may encounter weakness in the tongue and swallowing that can range from inconvenient to dangerous.5

Reflux or ineffective swallowing can lead to aspiration- the leakage of food into the windpipe and eventually into the lungs. The worst case is aspiration pneumonia, a potentially life-threatening condition.5

The easiest foods to swallow safely are thick and smooth. Purees are ideal, but a lot of standard foods can be made swallow-safe with sauces and salad dressings. That means that the same meal the rest of the family is eating can be modified as well.6,7

Food thickening powders or gels, available at most drug stores, are tasteless and effective for soups. You can also purchase tiny envelopes of them to carry in a purse or bag for eating out. And some standard nutritional drinks (like Boost™ and Ensure™) can be purchased online in pudding form.

Timing matters

Finally, timing counts. MG causes muscles to fatigue easily, so swallowing can get more difficult as a meal goes on.

A number of small meals may be far easier to get down than a few large ones.7 And since the danger of reflux aspiration is far greater if reclining too soon after a meal, people with MG should eat early and sit upright for a few hours after eating.6

Fortunately, the challenge of preparing great and nutritional meals is one of the most enjoyable parts of being a caregiver— and one that everyone in the circle of family and friends can enjoy together. So à votre bonne santé and Bon Appétit.

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