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?

ABSTRACT

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.