Affiliations: [a] Department of Dietetics and Social Work, Leiden University Medical Center, Leiden, The Netherlands
| [b] Department of Orthopedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| [c] Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
Correspondence:
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Correspondence to: Daphne Bot, MSc, Leids Universitair Medisch Centrum, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. Tel.: +31 71 526 3040; E-mail: d.bot@lumc.nl.
Note: [1] These authors contributed equally to this work.
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.
Keywords: Duchenne muscular dystrophy, dietary intake, nutritional intake, body mass index, body weight
