Mona Bostick, RDN, LDN, MSCS

“Currently, at most rehab facilities, there may very well be a dietitian, either on staff or attached to that, but who is only utilized in neurological conditions like stroke, ALS [amyotrophic lateral sclerosis], or Parkinson's—meaning the dietitian is there, and he or she would just need to be informed or educated as to the needs of somebody with MS and how to navigate that.”

While the COVID-19 pandemic facilitated positive changes to health care in the form of telehealth and remote accessibility for patients, a need persists for the care of patients with multiple sclerosis (MS), particularly as it pertains to diet. Dietitians are not consistently included in the care model and face an additional obstacle in that they need to be informed about the needs of patients with MS, and continuing education hours are both expensive and difficult to obtain. 

Mona Bostick, RDN, LDN, MSCS, sat down with 

 to discuss these barriers, noting a specific interaction at the 

2021 Annual Meeting of the Consortium of Multiple Sclerosis Centers

 in Orlando, Florida, where she met a dietitian from Ohio who had recently been hired to exclusively meet the needs and work with patients who have MS. Explaining that this gives her hope that other facilities may follow suit, Bostick further discussed the lack of MS education and training provided to dietitians and the resultant need to provide information to increase comfort levels in serving patients with MS. 

Also discussed was the vulnerability of the MS population, which can be exacerbated by the absence of dietitians on the care team. According to Bostick, patients may opt for alternative practitioners who promise to “heal, beat, reverse, or give control back,” as they are missing the nuance and context around what food can and cannot do for them. 

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Videos

Discussing adaptations to the comprehensive care model in multiple sclerosis, the founder of MS Bites commented on the need to consistently incorporate dietitians. [WATCH TIME: 6 minutes]

Enacting Necessary Changes to the MS Care Model: Mona Bostick, RDN, LDN, MSCS

“Just like if somebody is having difficulty with fatigue and moving around their kitchen, I'm going to refer to an occupational therapist…If nutrition questions come up, I would certainly hope that the patient would be referred to a dietitian.”

Treatment for patients with multiple sclerosis (MS) relies on the collaborative nature of the comprehensive care team. While diet is considered an integral part of overall health and management of comorbidities that often occur in this patient population, dietitians are not traditionally included as a part of the larger team.

To understand more about how information is shared in the care for these patients, we sat down with Mona Bostick, RDN, LDN, MSCS, founder of her private practice, MS Bites. In conversation with 

Bostick discussed the importance of referrals, describing her best practices when seeing patients. If a patient has an unidentified problem with their mouth or swallowing, a referral to a speech pathologist in her network would be the next step, she said. Similarly, Bostick expressed hope that if a patient presents a nutritional or diet-related question, that practitioners would be referred to a dietitian. A common misconception about insurance coverage for dietitians was also discussed, with Bostick stating that, contrary to popular belief, dietitians are actually covered by most insurance services.

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The founder of MS Bites discussed the role of referrals both to and from dietitians, as well as the common misconception that their services are not covered by insurance. [WATCH TIME: 2 minutes]

Dispelling Myths About Dietitians in Multiple Sclerosis Care: Mona Bostick, RDN, LDN, MSCS

“I really root for dietitians to be included in the care team. It is my hope, though, that the dietitians that are included would be those that practice conventionally and that can guide on people how to safely move into alternative modalities, if that's something that is warranted.”

The role of diet in disease management for patients with multiple sclerosis (MS) has remained a topic of discussion within the field. While there is no therapeutic diet that has been proven to alter the course of MS, the way patients eat can have an impact on certain comorbidities; despite this understanding, nutrition is still often cast into the realm of ‘integrative’ approaches.

To discuss the importance of diet for this patient population, 

® sat down with Mona Bostick, RDN, LDN, MSCS, founder of her private practice, MS Bites. Bostick noted that nutrition is a science contributing to overall health, and a lack of precise definition for integrative and alternative approaches leads to varying information from provider to provider. She also focused on the need to include registered dietitians in the comprehensive care model to provide input from conventionally practicing, science-based nutrition professionals and best care for patients. Once that perspective is more regularly available, Bostick said, it then creates an opportunity to guide patients through alternative treatments. 

Have you nominated your Giant of Multiple Sclerosis? Help us recognize and celebrate pioneers, innovators, and leaders in MS.

The founder of MS Bites discussed the role dietitians can play in care of patients with MS, noting that they have not historically been included in the comprehensive care team, and differentiating their approaches to care. [WATCH TIME: 2 minutes]

Differentiating Diet Approaches in Multiple Sclerosis: Mona Bostick, RDN, LDN, MSCS 

“I've noticed that more people with MS—just as I imagine, in the broader community—are struggling with the isolation that has come from the pandemic, and that has had a more subtle impact on symptoms of just eating. There is a very emotional component to eating, and I've noticed that has become more prevalent, and that's something I'm being asked about more regularly.”

Over the course of 2021, care for multiple sclerosis (MS) has evolved and adapted, particularly with the ongoing COVID-19 pandemic. Diet is an integral part of overall health, and the emotional component of eating is something that is compounded by the isolation of lockdowns and quarantine. According to Mona Bostick, RDN, LDN, MSCS, founder of her private practice, MS Bites, she has been asked more about this emotional aspect of nutrition, which is further exacerbated by living with a chronic illness during a global pandemic. 

®, Bostick highlighted the “silver lining” of the pandemic, in that telehealth has allowed for patients with MS to access dietitians and other clinicians in a manner that is inclusive and accessible. Telehealth has also generated the opportunity for practitioners to get an inside look at patients’ living situations, while also addressing questions from care providers that may not otherwise be asked during in-person clinical visits. Bostick further noted the convenience of telehealth for both the patient and provider, increasing access to dietitians, who are not historically included as part of the comprehensive care model for MS. 

The registered dietitian and founder of MS Bites spoke on changes in symptom care for patients with MS, as well as the sustained benefits of telehealth. [WATCH TIME: 2 minutes]

Shifts in Multiple Sclerosis Care, Ongoing Integration of Telehealth: Mona Bostick, RDN, LDN, MSCS

“The role that a dietitian can play in patient care, working with a vulnerable population, like [the one that] exists in multiple sclerosis, is that right off the bat, we can provide myth busting to help sort out fact from fiction, from all the internet fluff that's out there, that is really overwhelming.”

2021 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC)

, October 25-28, Mona Bostick, RDN, LDN, MSCS, founder, Food Matters 365, Greensboro, North Carolina, discussed the multidisciplinary care model for patients with multiple sclerosis (MS) and the vital part that registered dietitians can play in comorbidity management. While they are not always included, Bostick encouraged the incorporation of dietitians as part of the healthcare team, and further advised patients with MS to seek out a local dietitian in their community if need be.

Distinguishing between nutritionists and dietitians was another point Bostick emphasized, as all dietitians are nutritionists, but not all nutritionists are dietitians. According to Bostick, patients can feel confident in what they can expect from a dietitian, due to the required education, training, and knowledge base, but this is not always the case when seeing a nutritionist. Additionally, registered dietitians can help dispel worry and manage misinformation that is often disseminated online and readily available for vulnerable populations, she said.

The founder of Food Matters 365, in Greensboro, North Carolina, commented on the benefits of adding a dietitian to the healthcare team for patients with multiple sclerosis. [WATCH TIME: 3 minutes]

Dietitians and the Multidisciplinary MS Care Team: Mona Bostick, RDN, LDN, MSCS

“At this point, although there is no therapeutic diet that has been shown by science to directly impact the disease process itself, comorbidities are where nutrition can have an enormous impact. My presentation addressed the role of registered dietitians using nutrition interventions to treat and manage comorbid health conditions, and there's a lot of evidence that suggests that by managing those conditions well, we can improve the health outcomes of people with multiple sclerosis.”

Nutrition has been shown to play an integral part in the management of multiple sclerosis (MS), specifically in patients with comorbidities. At the 

, October 25-28, Mona Bostick, RDN, LDN, MSCS, founder, Food Matters 365, Greensboro, North Carolina, gave a presentation entitled, “The Importance of Assessing Nutritional Health in Patients with Multiple Sclerosis,” later sitting down with 

Bostick commented on nutrition’s ability to impact comorbidities for this patient population, noting that there are currently no therapeutic diets that have been proven to alter the disease process of MS. She further provided her thoughts on popular elimination diets, adding that these too have no clinical evidence to validate them. Noting that some patients do report that diet may help to manage symptoms, she cautioned patients to run alterations by the healthcare team to avoid “unintended consequences” from different approaches.

The registered dietitian at Food Matters 365 in Greensboro, North Carolina, discussed the role nutrition can play in treating comorbidities, sharing her thoughts on popular elimination diets. [WATCH TIME: 2 minutes]

Mona Bostick, RDN, LDN, MSCS

Articles

Enacting Necessary Changes to the MS Care Model: Mona Bostick, RDN, LDN, MSCS

Dispelling Myths About Dietitians in Multiple Sclerosis Care: Mona Bostick, RDN, LDN, MSCS

Differentiating Diet Approaches in Multiple Sclerosis: Mona Bostick, RDN, LDN, MSCS

Shifts in Multiple Sclerosis Care, Ongoing Integration of Telehealth: Mona Bostick, RDN, LDN, MSCS

Dietitians and the Multidisciplinary MS Care Team: Mona Bostick, RDN, LDN, MSCS

Diet and Comorbidities in Multiple Sclerosis: Mona Bostick, RDN, LDN, MSCS

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