From the Guidelines
The best diet for multiple myeloma patients is a balanced, nutrient-rich diet that includes plenty of fruits, vegetables, whole grains, lean proteins, and healthy fats, while limiting processed foods, added sugars, and excessive salt, as recommended by the most recent guidelines 1. This diet can help manage symptoms and support overall health during treatment. Key components of this diet include:
- Consuming plenty of fruits, vegetables, whole grains, lean proteins, and healthy fats
- Limiting processed foods, added sugars, and excessive salt
- Staying well-hydrated to help the kidneys filter out excess calcium and other breakdown products from bone damage Some patients may benefit from increasing calcium and vitamin D intake to support bone health, but this should be discussed with healthcare providers first as calcium levels can sometimes be elevated in multiple myeloma, as noted in general guidelines for cancer patients 1. Maintaining adequate protein intake (about 0.8-1.2 grams per kilogram of body weight daily) supports immune function and helps preserve muscle mass during treatment. Many patients experience treatment-related side effects like nausea, taste changes, or mouth sores that can affect eating; working with a registered dietitian who specializes in oncology can help develop personalized nutrition strategies, taking into account the latest research on the gut microbiome and healthy eating 1. Some evidence suggests that anti-inflammatory foods like fatty fish, nuts, olive oil, and colorful fruits and vegetables may provide additional benefits, though these should complement, not replace, standard medical treatments for multiple myeloma. It's also important to limit intake of highly processed foods that are high in refined grains, saturated fat, salt, and sugar and low in nutrients, as recommended by recent studies on healthy eating 1.
From the Research
Diet and Multiple Myeloma
- The relationship between diet and multiple myeloma has been studied, with a focus on the role of vitamin D and omega-3 fatty acids in disease prevention and treatment 2, 3, 4, 5.
- Vitamin D deficiency is common among patients with multiple myeloma, with 42.3% of participants in one study identified as having a vitamin D deficiency 2.
- Omega-3 fatty acids, particularly EPA and DHA, have been shown to induce apoptosis and enhance drug sensitivity in multiple myeloma cells, while not affecting normal peripheral mononuclear cells 3, 4, 5.
Omega-3 Fatty Acids and Multiple Myeloma
- EPA and DHA have been found to reduce multiple myeloma exosome-mediated suppression of NK cell cytotoxicity, and may have a role in the treatment of multiple myeloma as an adjuvant treatment 3.
- Pretreatment with DHA/EPA has been shown to increase bortezomib chemosensitivity in multiple myeloma cells by promoting glutathione degradation 5.
- The nuclear factor erythroid 2-related factor 2 (NRF2)-activating transcription factor 3/4 (ATF3/4)-ChaC glutathione specific gamma-glutamylcyclotransferase 1 (CHAC1) signaling pathway may be implicated in the GSH degradation caused by pretreatment of DHA/EPA prior to bortezomib 5.
Limitations and Future Directions
- While the studies suggest a potential role for omega-3 fatty acids in the treatment of multiple myeloma, further research is needed to fully understand their effects and to determine the optimal dosage and treatment regimen 3, 4, 5.
- The relationship between vitamin D and multiple myeloma is not yet fully understood, and further studies are needed to determine the potential benefits of vitamin D supplementation in patients with multiple myeloma 2.
Note: Study 6 is not relevant to the question of the best diet for multiple myeloma, as it focuses on the effect of omega-3 fatty acids on multiple sclerosis.