The Relation Between Nutritional Intake and Body Weight in 4-18 Year Old Patients with DMD: What could possibly be done to prevent weight gain?

BACKGROUND

Overweight is a common problem in Duchenne muscular dystrophy (DMD) and is associated with reduced mobility and quality of life. The influence of nutritional intake on (over)weight is unclear.

OBJECTIVE

To investigate weight and energy and macronutrients intake compared to age-specific requirements in DMD patients (4-18 years).

METHODS

We assessed weight and body mass index (BMI) and the amount of energy (kcal/day) and macronutrients based on self-reported nutrition diaries. Nutritional intake was compared to requirements for 3 age-groups according to the Dutch Healthy Diet Guideline (4-8/9-13/14-18 years) using a student's t-test, and relations with age and BMI were investigated by means of Pearson's correlations.

RESULTS

Forty-eight patients participated, 22 ambulatory, median age 10.8 years. The majority used corticosteroids (N = 41). Overweight (BMI z-score > 2.07) was present in 19 patients; 6% (4-8 years), 73% (9-13 years) and 47% (14-18 years). Overweight was more common in non-ambulatory (61.6%) than ambulatory patients (13.6%). Patients aged 4-8 received 290 kcal/day more than required (p < 0.001). Patients aged 9-13 received 349 kcal/day (p = 0.005) less than required. Overall, intake of fibre, nuts, meat/fish/eggs/legumes and dairy was lower than recommended (p < 0.05). The difference between energy intake versus requirement correlated moderately to age (r = -0.549, p < 0.001) and BMI (r = -0.562, p < 0.001).

CONCLUSIONS

Overweight was found especially in patients aged 9-18 even though they received less energy than required. Younger patients (4-8) had good weight but consumed more energy than required. All patients did not consume enough fibre, nuts, meat/fish/eggs/legumes and dairy. Limiting energy and increasing fibre/protein intake at an early age may prevent overweight at a later age.