Nutrition may improve quality of life and outcomes in people with myelodysplastic syndromes (MDS).

Myelodysplastic syndromes (MDS) are a type of blood cancer.

Typically, blood stem cells mature into white blood cells, red blood cells, or platelets. In MDS, these blood stem cells don’t mature. The abnormal blood cells die earlier and don’t work like healthy blood cells. They can also block the production of healthy cells.

MDS often causes low levels of red and white blood cells and platelets.

A low white blood cell count makes fighting infections harder for your body. A low red blood cell count, called anemia, can leave you feeling low in energy and short of breath. A lack of platelets makes it harder to stop bleeding.

There are no specific foods proven to prevent or treat MDS, but getting enough to eat and eating a variety of healthy foods can improve your quality of life.

MDS can take a toll on your physical and emotional health. Eating a healthy, balanced diet is something you can do to support your health.

Eating a healthy diet can:

  • support your immune function
  • improve your mood
  • maintain or improve your energy level
  • prevent muscle loss
  • help you to avoid nutrient deficiencies
  • help to prevent or manage other chronic conditions
  • help you to tolerate treatments better

A balanced, healthy diet is recommended for people with MDS.

Include the following foods in your diet:

  • a variety of fruits and vegetables for vitamins, minerals, antioxidants, and fiber
  • meat and meat alternatives (nuts, beans, soy products, eggs) for protein, iron, zinc, and B vitamins
  • milk and alternatives for protein, calcium, and vitamin D
  • whole grain products such as oats, whole grain wheat, quinoa, and brown rice for B vitamins and fiber
  • healthy fats from foods such as fatty fish, nuts, nut butters, avocado, olive oil, and seeds

If your energy is low

Living with anemia can leave you feeling exhausted. This can make it very difficult to grocery shop and prepare meals. Try these ideas to make it a little easier to give your body the nutrients it needs.

  • Write down a few simple meal and snack ideas so that when it’s time to eat, it’s easier to make a decision.
  • Do some batch cooking and keep extra servings in the freezer to be reheated when you need them.
  • Keep lots of ready-to-eat options around for when your energy is low such as frozen meals, trail mix, yogurt, and cereal.
  • Ask family and friends to help you with groceries and meal prep.
  • Look into grocery delivery services.
  • Explore whether there are any meal delivery programs in your area.

If your appetite is low

MDS and its treatments may cause a low appetite, making it hard for you to eat enough. If you’re having trouble with low appetite, try these ideas:

  • Eat small, frequent meals.
  • Set a timer to remind you to eat something every few hours.
  • Sip away at nutritional supplement drinks between meals to add more nutrients to your diet.
  • Increase the calories in what you are eating by adding sauces, dressings, and spreads.
  • Add high calorie foods like nuts, avocado, butter, oil, cheese, and whole milk to your diet.
  • Try bland foods such as toast, crackers, pretzels, rice, and pasta.
  • Sip fluids between meals to avoid filling up on fluids at your meal.

Food safety is important for anyone. If your white blood cell count is low, you are at an increased risk of foodborne illness.

Here are things you can do to keep your food safe:

  • Thoroughly wash all produce, or remove the peel before eating.
  • If you’re eating away from home and not sure about the produce, avoid raw fruit and vegetables and opt for cooked instead.
  • Cook food to a safe temperature: 165°F (75°C) for poultry, any leftovers, and casseroles, 160°F (70°C) for other ground meats, and 145°F (65°C) for fish, shellfish, and cuts of beef, pork, lamb, and veal.
  • Choose pasteurized dairy products.
  • Avoid cross-contamination by keeping raw and cooked food separate.

High-iron foods

If you’re getting blood transfusions for anemia and you’re at risk of iron overload, you may need to limit or avoid these foods that are very high in iron:

  • liver and kidney
  • clams, mussels, and oysters

Before limiting or avoiding these foods, you should discuss your dietary needs with your doctor.

There is ongoing research to find out if any vitamins, minerals, or other supplements might be helpful for people with MDS. Here are some supplements that show promise.

Before starting any supplements, it’s important to discuss them with your doctor.

Vitamin K2

Research suggests that vitamin K2 may increase levels of white and red blood cells. It seems to work even better when combined with vitamin D. Vitamin K plays a part in the production of healthy blood cells.

Vitamin D

Azacitidine is considered a first-line treatment for MDS, but not everyone responds well to this. A study from 2017 explored whether a person’s vitamin D level might be a factor.

The researchers found that people with higher levels of vitamin D before treatment had better outcomes compared to people with low vitamin D levels.

Older research also suggested that vitamin D supplementation might reduce the risk of progression from MDS to leukemia.

Coenzyme Q10 (CoQ10) and carnitine

Your body makes a bit of coenzyme Q10 (CoQ10) and carnitine naturally. CoQ10 is an antioxidant and carnitine helps your body use energy.

A study from 2020 showed that people with MDS who supplemented CoQ10 along with carnitine had improvements in their anemia. Even in people whose blood cell levels did not increase, the supplements significantly improved quality of life measures.

Melatonin

Melatonin is a hormone produced by your body to regulate wake and sleep cycles. Many people use melatonin supplements to help with sleep.

Research has found that melatonin supplements can increase red blood cell production. It may also have antioxidant effects and help to destroy cancer cells.

Vitamin B5

Vitamin B5 (also known as pantothenic acid) plays a role in producing healthy red blood cells.

A study from 2023 showed that vitamin B5 supplements could boost healthy red blood cell production in people with MDS.

Vitamin C

A low level of vitamin C is common in people with MDS.

Research from 2019 found that supplementing vitamin C increased the numbers of blood stem cells that matured normally. More research is needed to understand exactly who may benefit from vitamin C supplements.

Iron

Iron deficiency is a leading cause of anemia in the general population. In people with MDS, anemia is more likely cause by a low production of healthy red blood cells. Iron won’t fix that.

If you have anemia and iron deficiency, your doctor may recommend an iron supplement. For other people with MDS, an iron supplement can cause harm by increasing the risk of iron overload.

If you’re getting blood transfusions to increase your blood cell count, your healthcare team will monitor to ensure you’re not getting too much iron.

Good nutrition can be helpful during MDS treatment for several reasons. Eating a balanced diet that includes a variety of foods can support your immune system, mood, and energy.

If you are able to eat well, you are more likely to respond to treatments. A study of people with MDS showed that those who were better nourished had improved survival rates.

If you’re dealing with difficult side effects of treatments, changing how you eat might help.

MDS may progress to a type of leukemia called acute myeloid leukemia (AML). It’s estimated that one in three people with MDS will develop AML.

We don’t understand exactly why some people progress to AML while others don’t. It’s possible that eating a healthy diet and staying well-nourished may help.

Even if diet can’t prevent progression, eating well can improve your quality of life.

There is no specific diet for MDS, but a general healthy diet can improve your quality of life. Being well-nourished can also help treatments work better.

At this point, there are no supplements proven to help with MDS treatment, but there are several that may play a role in improving blood levels.