This information for people who have MS and are underweight or have an unwanted loss of weight has been prepared by State Registered Dietitians working for Multiple Sclerosis National Therapy Centres:

Try to eat and drink regularly – little and often.

Good Food Guide -  Aim for 3 small meals a day, plus 2-3 snacks/milky drinks.
Try to include the following:-

1 pint of milk a day. (Although semi-skimmed milk is lower in fat, you may need to take full cream milk for the extra calories it contains.  Skimmed milk is too low in calories).

Meat, (including red meat), chicken, fish (especially oily), eggs, nuts, (walnuts, almonds and hazelnuts are lower in saturated fat) or pulses (chick peas, lentils, kidney beans, etc) at least twice a day. If you like liver, try to have this once a week (up to 120g/4 oz).

A serving of bread, potatoes, rice, pasta or cereal with each meal.

Fruit and vegetables – aim for 5 portions a day ((500g/1lb).). 1 portion can be taken as a glass of fruit juice or squash fortified with vitamin C.

3 pints/1.7litres of fluid a day (6 mugs/8 cups).  Avoid drinking before a meal as it may make you feel too full.

Sugar and sugar containing foods can help increase your energy intake. Don't cut down on these. Take them as well as the nourishing foods already mentioned - not as a substitute.

Choose sugar containing drinks and desserts rather than diet versions. (If you eat sweets between meals remember to clean your teeth afterwards!)

If you are losing weight it is important that you do not cut down on fat which is energy dense.  (It has more than twice the amount of Calories/energy when compared with starchy foods, sugar or protein).

Use polyunsaturated fats and oils (e.g. sunflower, Soya, corn), in preference to saturated (butter, lard). Avoid low fat spreads. Use polyunsaturated fats in cooking, spread thickly on bread, in jacket potatoes, and add a knob to vegetables before serving.

Eat plenty of foods containing antioxidant nutrients.  These are Vitamin C, Vitamin E, Beta Carotene and selenium, etc. Fresh fruits and vegetables are rich sources.

You may want to consider a vitamin supplement.

Enriching Your Food
This is a way of adding extra calories, without having to eat any more.

To make enriched milk:-

2-4 tablespoons of skimmed milk powder to a pint of milk.  Use in drinks, packet soups, sauces, jelly, milk puddings, custard, and on cereal.

Serve desserts with:-
Enriched custard
A knob of polyunsaturated margarine 
Ice cream
Jam/honey/syrup
Dried fruit
Sugar

To breakfast cereal add:-
Enriched milk
Yoghourt
Syrup, honey, sugar
Fresh or dried fruit

To soup add:-
Grated cheese
Dried skimmed milk powder
Baked beans
Cooked minced meat.
Condensed/packet soups should be made with milk instead of water.

To potatoes and vegetables add:-
Grated cheese
Polyunsaturated margarine     
Mayonnaise
Milk based sauce
Fried onions

Making Meals Easier

If you are able to prepare food, do this at the time of day when you have most energy.
Make more than you need, and freeze some for another day.
Think about you meal times.  Is it easier to eat your main meal in the middle of the day instead of the evening?
If you are finding cooking difficult try some convenience foods for a while. Frozen, chilled or packet ready meals save time and energy.
Try not to choose ones which contain pastry too often, as this is very high in saturated fats.
Cook some additional vegetables (fresh or frozen) or serve with a side salad and polyunsaturated dressing.
Serve small portions attractively. A garnish can make food look more appetising.
If you are unable to manage a main meal, try some enriched soup and a dessert, or a supplement drink such as Complan, Build-Up or Recovery. Savoury/sweet varieties can be bought in larger supermarkets and local chemists.

Marvellous meals (convenience or homemade)
Chicken tikka and rice
Pasta and tuna sprinkled with cheese
Fish pie (potato topping) serve with vegetables glazed with polyunsaturated spread.

Delicious Desserts
Mousse
Fruit fool
Yoghurt (choose full fat varieties).
Tinned fruit in syrup, served with ice cream/evaporated milk.
Meringue and fruit
Instant desserts make with fortified milk   
Egg custard
Milk jelly
Milk pudding served with jam/syrup
Cake/sponge/crumble

Simple Snack Meals
Toast served with pilchards/sardines/baked beans and cheese / scrambled egg/poached egg.
Jacket potato served with tuna and mayonnaise/ratatouille and cheese/baked beans and bacon.
Sandwich/roll filled with cold meat/tinned fish/egg mayonnaise.
Add tomatoes/cucumber/pickles and relishes.

Between meals
Dried fruit and suitable nuts         
Tea cake/scone with polyunsaturated margarine and jam
Cake
Milky drinks

CAUTION !
Avoid taste fatigue. Remember – variety is the spice of life.
Fibre

Fibre foods are rich in B vitamins, (which are good for the nervous system). A high fibre intake also helps to avoid constipation.
Try to include wholemeal bread, wholegrain cereals (wheat or bran types), brown rice/pasta.
Pulses (eg. chick peas, red kidney beans, lentils)
Dried fruit
Nuts (hazelnuts, walnuts, almonds are lower in saturated fat).
Seeds - Linseeds (especially golden varieties) are particularly helpful if you suffer with constipation - start with a teaspoon and slowly increase.
Try making a mix of apricots, raisins, hazelnuts, almonds, pumpkin and sunflower seeds etc. Its great added to cereal, yoghurts or as a between meal snack.

Fluids
It is important to drink plenty. Too little fluid can lead to constipation, bladder infections and consequent incontinence, and dehydration.

Have 3 pints/1.7litres (approx 6 mugs/8 cups) of fluid a day.
Try to keep to a maximum of 4 drinks containing caffeine.
Avoid "diet" varieties of soft drinks -  you need the extra calories from the sugar.
Fruit juice, herbal teas, squash (especially vitamin C fortified), carbonated (fizzy) drinks.
Make coffee/chocolate/malted drinks up with milk for extra calories and protein.

Supplements
If you are eating a healthy diet you do not need any supplements.  However if you have a poor appetite you may wish to consider a multivitamin and mineral supplement.
There are many varieties available.
Choose one which provides a good range of vitamins and minerals at around 100% of the Recommended Daily Amount or RDA/DRV (see product labels) eg. Sanatogen Gold and Centrum.
Forceval vitamins are available on prescription.
There is no evidence that high potency products (containing levels well above the recommended daily amounts) are beneficial as a general supplement.  Dietitians do not usually recommend them.
Avoid taking more than one supplement at once without consulting a dietitian or doctor, as excess doses of some vitamins can be harmful eg Vitamin A and D.

Further Advice

Try to check your weight every month.  If your eating problems do not improve or you continue to lose weight, arrange to see a dietitian.

Some Therapy Centres employ State Registered Dietitians. Your doctor/consultant is also able to refer you to a State Registered Dietitian.

If you have problems swallowing or experience choking, you may benefit from seeing a speech and language therapist. Ask your GP for a referral.