Myelofibrosis is a rare type of chronic leukemia characterized by scarring in the bone marrow, which can impede the growth of normal, healthy blood cells. While some individuals with myelofibrosis may not experience noticeable symptoms, others can suffer from a range of issues, including anemia, fatigue, itching, fever, shortness of breath, and frequent infections. Managing these symptoms and maintaining a good quality of life often involves a combination of medical treatments and lifestyle adjustments, including dietary modifications. This article aims to provide a comprehensive overview of dietary recommendations for individuals with primary myelofibrosis, drawing upon current research and expert opinions.
Understanding Myelofibrosis and Its Impact
Myelofibrosis is a slow-developing cancer, and many patients may initially present with no symptoms. The curative treatment for myelofibrosis is an allogeneic stem cell transplant, but this treatment carries significant risks. Many medications used to treat myelofibrosis have side effects, such as weight gain and shingles associated with JAK [Janus kinase] inhibitors. Given the unique needs of patients with myelofibrosis, providers need to be concerned with blood clots. Chronic health conditions, such as cardiovascular issues, diabetes, obesity, and smoking, increase the risk for blood clots, and lifestyle modifications can help mitigate this risk.
Symptoms are an important part of life for patients with myelofibrosis. In managing myelofibrosis, it is important for providers to review blood counts with patients, but there also needs to be a continuous discussion about medication, side effects, and nutritional needs.
The Role of Diet in Managing Myelofibrosis
Maintaining a balanced diet is important for people with myelofibrosis as proper nutrition can help support energy levels, immune function, and more.
While there is no specific "myelofibrosis diet," adopting a balanced dietary pattern rich in fruits, vegetables, whole grains, protein sources, and healthy fats may help lower inflammation.
Read also: The Hoxsey Diet
Inflammation and Myelofibrosis
Research has demonstrated that inflammation can affect the symptoms, progression, and outlook of myeloproliferative neoplasms (MPNs) like myelofibrosis due to the abnormally high inflammatory cytokine evident in this patient population. Experts suggest that people with myelofibrosis eat smaller meals and eat foods rich in anti-inflammatory compounds like fruits and vegetables, specifically fruits and berries and green leafy vegetables. Cytokines are proteins released by cells that play a role in cell signaling. Some promote inflammation. Studies show inflammatory cytokines are abnormally high in people with myelofibrosis. Inflammation has been shown to affect the symptoms, progression, and outlook of MPNs like myelofibrosis.
Key Dietary Recommendations
- Consume Nutrient-Dense Foods: Healthcare professionals also recommend people with myelofibrosis focus on consuming nutrient-dense foods rich in anti-inflammatory compounds like fruits and vegetables.
- Smaller, Frequent Meals: Healthcare professionals who specialize in treating people with myelofibrosis tend to recommend overall healthy dietary patterns, such as limiting highly processed foods and eating smaller meals more frequently. Dietitians or nutritionists may devise strategies for timing the frequency of meals to prevent early satiety, nausea, and discomfort during meals.
- Foods to Support Blood Health and Immunity: Because treatments for myelofibrosis can weaken these patients’ immune systems, which can lead to increased risk for infection, experts also recommend they consume food that supports the immune system, including iron, vitamin A, vitamin C, copper, folate, vitamin B12, vitamin E, and vitamin D.
The MPN Research Foundation recommends including the following foods that are high in nutrients important for people with MPNs:
- Fruits and berries
- Green leafy vegetables
- Turmeric
- Nuts
- Whole grains
- Oily fish
- Green tea
Anemia is prevalent in myelofibrosis patients. If you have anemia, you may experience fatigue and weakness. Nutritional deficiencies such as iron, folic acid, and vitamin B-12 can also produce anemia. Vitamin D is important for your body because it helps with calcium and phosphorus absorption.
Foods to Avoid or Limit
Experts recommend that people with MPNs reduce their consumption of ultra-processed foods that may contribute to inflammation and other health concerns.
In general, a nutritious diet limits the following foods:
Read also: Walnut Keto Guide
- Fast food
- Sugary foods and beverages
- Ultra-processed snack foods
- Heavy amounts of alcohol
Myelofibrosis treatments may also weaken your immune system and increase your risk of infection. Try to avoid eating:
- Raw meat, fish, or eggs
- Unpasteurized dairy
- Unwashed fruits and vegetables
The NIH-AARP Diet and Health Study: Insights into Dietary Factors and MPN Risk
The NIH-AARP Diet and Health Study, a prospective cohort study involving 463,049 participants, investigated the relationship between dietary factors and the risk of myeloproliferative neoplasms (MPNs), including primary myelofibrosis (PMF). The study identified 490 MPN cases after a median follow-up of 15.5 years.
The study found that the risk of MPN overall, PV, or ET was not influenced by the intake of protein, fat, meat, red meat or processed meat. Neither total vegetable and fruit intake nor total vegetable intake exhibited an association with the risk of MPN overall, PV, or ET. However, participants whose carbohydrate intake was in the third (i.e., highest) tertile had a higher risk of PV compared with those with carbohydrate intake in the first (i.e., lowest) tertile. Compared with individuals who had low fruit consumption (≤1.20 cups/day), those with high levels of fruit consumption (≥2.27 cups/day) had a significantly increased risk of MPN.
Key Findings from the NIH-AARP Study
- Fruit Consumption: Higher levels of fruit consumption were associated with an increased risk of MPN overall and polycythemia vera (PV).
- Specific Fruits: A closer examination of specific groups of fruits revealed a statistically significant, increased risk of MPN in cohort participants who had high levels of citrus, melon, and berry intake.
- Sugar Intake: A higher level of sugar consumption was associated with an increased risk of MPN, particularly PV. This association appeared to be driven by PV.
- Carbohydrate Intake: PV patients also had a higher intake of total carbohydrate, sugar, and fructose.
- No Association with ET: None of these factors were associated with the risk of essential thrombocythemia (ET), another common type of MPN.
The NIH-AARP study suggests a potential link between higher sugar and fruit consumption and an increased risk of MPN, particularly PV. However, these findings should be interpreted with caution, and further research is needed to confirm these associations and elucidate the underlying mechanisms.
Additional Considerations
- Individualized Nutrition Plans: A person with myelofibrosis should work with their healthcare team, including a registered dietitian, to come up with a dietary pattern that works best for their specific health needs. People with myelofibrosis can work with their healthcare team to develop a meal plan that supports healthy body weight maintenance and energy levels that meets their specific health needs.
- Weight Management: Good nutrition and eating habits can help you maintain a moderate weight. A 2020 study found being either underweight or overweight may increase or worsen symptoms for those with myelofibrosis. Dietary plans should be made in discussion with ones physician and depend on whether one is underweight or overweight. People with myelofibrosis may experience symptoms like early satiety and weight loss. If a person with myelofibrosis is experiencing weight loss or a decreased ability to eat from feelings of early fullness, their healthcare team can help them come up with solutions to ensure proper nutrient intake.
- The Mediterranean Diet: An ongoing trial is exploring whether the Mediterranean diet may benefit people with MPNs, including myelofibrosis. Researchers with the NUTRIENT Trial hope this diet pattern will reduce inflammation in the body to improve MPN symptoms.
- Open Communication with Healthcare Providers: It is important to encourage open communication with patients and to specifically ask about medication side effects. In addition, each patient will receive the MPN [myeloproliferative neoplasms] symptom assessment form to complete at each visit. This assessment allows the patient to ask questions or bring up any concerns and help track a response to their current medication. The provider also asks the patient about any concerns with their treatment.
Lifestyle Changes and Self-Care Tips
Lifestyle changes added to medications and other treatments can have a great impact on your cancer journey. Myelofibrosis (a form of blood cancer) can be a long-term condition, but taking good care of yourself can help you enjoy a happier, healthier life.
Read also: Weight Loss with Low-FODMAP
- Make Time for Enjoyable Activities: Make time for things you enjoy. This can be anything from reading to taking a walk to relaxing in a warm bath.
- De-stress: De-stress. Prayer or meditation might help with this. And deep breathing or relaxation techniques can also make a difference.
- Seek Support: Let people help. Your friends might be happy to give you a hand. When they ask what they can do, think about what you need and let them support you. Maybe you could use a little help with housework, or you might need a ride to a medical appointment. As a member of a support group, you can learn how other people deal with the same issues that affect you. You also can connect with people through telephone counseling lines or online groups.
- Address Emotional Well-being: Talk with someone if you need to. Emotional ups and downs are normal, but if you get the blues and can’t shake them off in a couple of weeks, check with your medical team -- counseling might help. Depression is an illness, and your all-around health gets a lift when you treat it.
- Regular Exercise: Being active is good for you in a lot of ways. Exercise can:Give you more energyBrighten your moodHelp control your weightKeep you more mobile over the yearsHelp keep diseases away
- Establish a Sleep Routine: Get into a routine for sleeping. Regular rest can help with the fatigue that can happen with myelofibrosis. Try to wake up and go to bed at the same times every day. Keep your bedroom quiet and at a comfy temperature. Don’t drink coffee, tea, or alcohol close to bedtime. Don’t use your computer before bedtime, either.
- Avoid Tobacco: Avoid tobacco. That means all kinds, from cigarettes to chewing tobacco to cigars. If you need help quitting, your medical team can help.
tags: #primary #myelofibrosis #diet #recommendations