State-of-the-Art and Future Challenges for Nutritional Interventions in Facioscapulohumeral Dystrophy: A Narrative Review.

Facioscapulohumeral dystrophy (FSHD), the second most common inherited muscular dystrophy in adulthood, is characterized by progressive muscle loss, accompanied by an increase in fat mass. Beyond these alterations in body composition, which contribute to the risk of sarcopenic obesity, FSHD is associated with systemic inflammation and oxidative stress. These interconnected mechanisms may worsen muscle atrophy, leading to a decline in physical efficiency and quality of life. While the therapeutic benefits of physical therapy and exercise have been investigated, the impact of dietary interventions remains underexplored. Given the established role of nutrition in managing various chronic diseases, there is growing interest in understanding how it might influence the clinical management of FSHD. By addressing current gaps in the literature, this review aims to investigate the potential role of dietary patterns and specific nutrients in modulating muscle metabolism within the context of FSHD. Some studies have indicated various compounds (flavonoids, curcumin, L-carnitine, coenzyme Q10, and omega-3), vitamins (C and E), and minerals (zinc and selenium) with antioxidant and anti-inflammatory properties as promising treatment strategies for FSHD. Instead, few data regarding the effects of proteins and creatine supplementation are available. Furthermore, the potential benefits of essentials amino acids, β-hydroxy-β-methylbutyrate, and vitamin D in contrasting muscle atrophy and enhancing muscle function remain unexplored. Despite these preliminary findings, the existing body of evidence is limited. Identifying novel therapeutic strategies to complement existing treatments could provide a more comprehensive management framework, aimed at improving the long-term health outcomes and quality of life of FSHD patients.