Foods to Avoid for Multiple Myeloma Patients: Dietary Guidelines for Better Health and Treatment Outcomes
Multiple myeloma is a complex blood cancer that affects plasma cells in the bone marrow. While medical treatments such as chemotherapy, steroids, and immunomodulatory drugs play a central role in managing the disease, nutrition also significantly influences patient outcomes—especially when dealing with complications or treatment side effects. A well-balanced, carefully planned diet can help reduce symptoms, support immune function, and improve overall quality of life during therapy.
Why Diet Matters in Multiple Myeloma Management
Patients diagnosed with multiple myeloma often experience a range of systemic issues due to both the disease itself and its treatments. One of the most common symptoms is bone pain, affecting up to 75% of individuals. Many patients suffer from weakened bones, fractures, or spinal compression, which may lead to prolonged bed rest. Reduced mobility increases the risk of constipation, making digestive health a top priority. To maintain regular bowel movements, it's essential to consume plenty of dietary fiber from sources like whole grains, legumes, fruits (e.g., apples, pears), and vegetables (e.g., broccoli, carrots).
Avoid Constipation-Inducing Foods
In addition to increasing fiber intake, patients should stay well-hydrated by drinking adequate water throughout the day. However, they should avoid low-fiber, processed foods such as white bread, pastries, and fast food, which can worsen constipation. Including probiotic-rich foods like unsweetened yogurt or kefir may also support gut health and promote smoother digestion.
Protecting the Immune System Through Smart Eating
Another hallmark of multiple myeloma is impaired humoral immunity, leaving patients highly susceptible to infections—including respiratory, urinary tract, and gastrointestinal infections. Because the body's defense mechanisms are already compromised, certain dietary choices can further increase infection risks.
Spicy and irritating foods—such as hot peppers, excessive garlic, chili oils, and heavily seasoned dishes—should be limited or avoided. These can inflame mucous membranes in the throat and digestive tract, potentially triggering discomfort or secondary infections. Additionally, many traditional "tonic" supplements marketed for boosting energy or immunity—like ginseng, deer antler velvet, or other warming herbal products—can create internal heat according to traditional frameworks, possibly exacerbating inflammation or infection susceptibility in immunocompromised individuals.
Focus on Immune-Supportive Nutrients Instead
Rather than relying on unregulated supplements, patients are encouraged to strengthen their immune systems through nutrient-dense whole foods. Foods rich in vitamin C (e.g., oranges, strawberries, bell peppers), zinc (e.g., lean meats, pumpkin seeds), and antioxidants (e.g., berries, spinach) provide safer, more effective immune support without overstimulating inflammatory pathways.
Managing Steroid-Related Side Effects With Diet
Steroids such as dexamethasone or prednisone are commonly used in multiple myeloma treatment regimens—often administered in cycles, such as eight days of steroid use within a 21-day period. While effective against cancer cells, long-term steroid use comes with significant metabolic side effects, including elevated blood sugar levels and increased risk of steroid-induced diabetes.
To counteract this, patients should minimize consumption of high-sugar foods like sodas, candies, sweetened cereals, and baked goods. They should also moderate their intake of high-glycemic carbohydrates such as white rice, potatoes, and refined pasta, which can rapidly spike glucose levels. Choosing complex carbs like oats, quinoa, and sweet potatoes helps maintain more stable blood sugar.
Monitor Blood Glucose Levels Regularly
Working with a registered dietitian to develop a low-glycemic meal plan can be extremely beneficial. Regular monitoring of blood glucose, especially during steroid cycles, allows for timely dietary adjustments and reduces the risk of developing long-term metabolic complications.
Supporting Bone Health During Long-Term Treatment
Although hypercalcemia (high calcium levels) is sometimes present at diagnosis due to bone breakdown, prolonged steroid therapy has the opposite effect over time—it promotes calcium loss from bones, increasing the risk of osteoporosis and fractures. Even after initial calcium levels normalize with treatment, ongoing bone demineralization remains a concern.
In addition to prescribed calcium and vitamin D supplements, patients should incorporate calcium-rich foods into their daily diet. Excellent natural sources include:
- Dairy products like milk, cheese, and yogurt
- Fish with edible bones, such as canned sardines and salmon
- Crustacean shells and small dried shrimp (commonly used in Asian cuisine)
- Fortified plant-based milks and juices
- Leafy greens like kale and bok choy
Balance Is Key
While increasing calcium intake is important, it should be done thoughtfully and under medical supervision to prevent rebound hypercalcemia or kidney strain. Pairing calcium-rich foods with vitamin D and weight-bearing physical activity (as tolerated) enhances absorption and supports skeletal integrity.
In summary, dietary choices have a profound impact on the well-being of multiple myeloma patients. By avoiding sugary, processed, and irritating foods, emphasizing fiber and immune-supportive nutrients, and actively managing treatment-related side effects through nutrition, individuals can take meaningful steps toward better health outcomes and improved resilience throughout their cancer journey.