# Nutrition in multiple myeloma
Nutrition plays a supportive role in the treatment of multiple myeloma. Research into specific dietary patterns in this disease is growing, particularly in relation to side effects of new therapies, gut microbiome health, and the body's ability to tolerate treatment well. This tab describes which nutritional approaches are being investigated and what is currently known about them.
Mediterranean dietary pattern
ResearchediPositive results in clinical studies, not yet standard treatment
The Mediterranean dietary pattern consists of plenty of vegetables, fruit, whole grains, fish, olive oil, and moderate amounts of dairy products, with limited red meat. This pattern is known for its ability to reduce inflammation in the body and support the immune system.
In multiple myeloma, specific research into this pattern is still limited, but because many myeloma patients receive treatments that strain their immune system (such as cancer cell-killing drugs and CAR-T cell therapy), dietary patterns that can help regulate inflammation are regularly discussed. General practitioners and dietitians recommend this pattern in practice as a foundation, especially because it is also well-tolerated by people who have difficulty eating (which many myeloma patients experience).
Specific studies on the Mediterranean dietary pattern and multiple myeloma itself are scarce; however, the pattern is considered generally beneficial because it is flexible and can be adapted to individual tolerance.
Protein-rich nutrition
ResearchediPositive results in clinical studies, not yet standard treatment
High-protein food contains relatively more protein from sources such as meat, fish, eggs, dairy, nuts, legumes, and grains. In myeloma, protein is important because many treatments target cells and the body needs extra building blocks for recovery.
Research shows that nutritional composition – including protein intake – plays a role in how well myeloma patients tolerate intensive treatments (such as CAR-T cell therapy) and how quickly they recover. Patients with better nutritional status have fewer complications in some studies. Protein also helps prevent muscle wasting, which occurs frequently in chronic illness.
However, it is important to be cautious: excessive protein breakdown in the body can also cause problems in myeloma (because tumor cells produce protein-like substances). A dietitian can help determine what is appropriate.
Nutrition adapted to taste changes
ResearchediPositive results in clinical studies, not yet standard treatment
Many myeloma patients – particularly those receiving immunotherapy – experience changes in taste and smell. Food can taste metallic, too bitter, or bland. Recent research is focusing on how nutritional composition and certain food components (natural substances that can help restore taste) might alleviate this side effect.
Research (2026) into immunotherapy-related taste changes (dysgeusia) shows that microbiome health (the bacteria in your gut) and food choices work together. Patients with greater dietary variety and healthier gut bacteria recover more quickly from taste disorders.
Practically speaking, adaptations to food – soft, nutritious, but also attractively prepared – can help make eating more tolerable. However, this is very personal.
Nutrition to support the gut microbiome
ResearchediPositive results in clinical studies, not yet standard treatment
The microbiome – the collection of bacteria in your gut – plays a role in how well your immune system works and how your body processes medication. In myeloma patients receiving intensive treatments, the microbiome can become damaged.
Food with plenty of fiber (vegetables, whole grains, fruit) and fermented products (yogurt, sauerkraut) help healthy gut bacteria grow. In myeloma, it is recognized that patients with a healthier microbiome respond better to therapies and have less severe side effects.
However, this is still a growing field of research; guidelines are not uniform and must be tailored to each patient.
Nutrition with antioxidants
ResearchediPositive results in clinical studies, not yet standard treatment
Antioxidants are natural substances in food (from vegetables, fruit, nuts, tea) that can neutralize harmful substances in body cells. Because myeloma and its treatment cause inflammatory reactions and cell damage, antioxidant protection seems logical.
Research into blood markers in myeloma patients shows that redox status (the balance between harmful and protective substances) is disrupted. A diet rich in antioxidants can help restore this balance. However, this is not a cure-all; the goal is to support the body alongside treatment.
Note: very high supplement doses of certain antioxidants can sometimes interfere with certain chemotherapies. This must always be discussed with a doctor.
Calorie-rich food for weight loss
ResearchediPositive results in clinical studies, not yet standard treatment
In multiple myeloma, many patients lose weight unintentionally because they can eat less, experience nausea, or the disease consumes a lot of energy. Calorie-rich food – not necessarily more of it, but food with more energy per bite – helps counteract this.
This can be achieved with healthy fats (olive oil, nuts, avocado), full-fat dairy, and energy-dense healthy foods. The goal is to allow food without overburden.
Weight maintenance is important because being underweight causes complications and reduced treatment tolerance.
Food with restriction of certain minerals
ResearchediPositive results in clinical studies, not yet standard treatment
In multiple myeloma, kidney function and mineral balance can become disrupted. Some patients suffer from calcium accumulation or phosphate problems. Individual dietary adjustments – for example, restriction of certain minerals – may be necessary.
However, this strongly depends on current blood values and the disease phase. A dietitian and nephrologist can provide advice together.
Fasting or periodic fasting
ExperimentaliOngoing in study setting, outcome still unknown
Periodic fasting – periods without food alternated with normal eating – is being researched for cancer treatment, including in myeloma. The theory is that fasting can make tumor cells more vulnerable to therapy and help the body recover.
However, research is limited and cautious. With myeloma, where eating can already be difficult, strict fasting can be risky. No research specific to myeloma currently supports periodic fasting as standard practice.
This should only be considered under medical supervision.
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**Dietary choices in multiple myeloma are highly individualized.** They depend on your current nutritional status, which treatment you receive, your kidney function, your blood values, and how your body tolerates food. A dietitian, preferably someone with experience in oncology, can help you create a plan that fits your situation and preferences. In fact, nutritional support can be part of your treatment team.
_This information never replaces a doctor's judgment. Always discuss your dietary choices with your own healthcare provider or a specialized dietitian._