The association between dietary factors and body weight and composition in boys with Duchenne muscular dystrophy. Issue 5 (1st February 2022)

• Record Type: Journal Article
• Authors: Billich, Natassja; Evans, Maureen; Truby, Helen; Ryan, Monique M.; Davidson, Zoe E.
• Is Part Of: Journal of human nutrition and dietetics. Volume 35:Issue 5(2022)
• Page Start: 804
• Page End: 815
• Publication Date: 2022-02-01
• Subjects: body composition -- dietary intake -- Duchenne muscular dystrophy -- nutrition -- obesity; Dietetics -- Periodicals; Nutrition -- Periodicals; 613.205
• DOI: 10.1111/jhn.12987
• Languages: English
• ISSNs: 0952-3871

Abstract

Abstract: Background: Duchenne muscular dystrophy (DMD) is a X‐linked neuromuscular disorder. Boys with DMD have high rates of obesity, although little is known about dietary factors that may contribute to weight gain in this population. The present study aimed to explore the relationship between dietary factors, body mass index (BMI) z ‐score, body composition and motor function and to describe dietary intake in boys with DMD. Methods: A cross‐sectional analysis of 3‐day food diaries from ambulant and steroid treated boys with DMD aged 5–13 years was conducted. Correlation analysis explored the relationship between dietary factors, BMI z ‐score, fat mass percentage (FM%) and lean mass percentage (LM%). Results: The median age was 8.5 years (interquartile range [IQR] = 7.2–10.5 years). Median energy kg –1 day –1 in those within a healthy weight range ( n = 11) was 316 kJ kg –1 day –1 (IQR = 276–355 kJ kg –1 day –1 ) and greater than estimated requirements and, for those above a healthy weight ( n = 26), energy intake was 185 kJ kg –1 day –1 (IQR = 143–214 kJ kg –1 day –1 ) and lower than estimated requirements. Energy kg –1 day –1 was negatively associated with BMI z ‐score ( r = −0. 650) and FM% ( r = −0.817) but positively associated with LM% ( r = 0.805; all analyses p = <0.01). Younger age was associated ( r = −0.609 p = <0.01) with a higher energy kg –1 day –1 . For all participants, vegetable, grains, meat/alternatives and dairy intakes were sub‐optimal. Conclusions: Younger boys with DMD within a healthy weight range are overconsuming energy dense nutrient poor foods. A focus on improving diet quality during early childhood may prove to be a useful strategy for reducing excess weight gain and supporting healthier eating habits in this vulnerable clinical population. Key points: Younger boys with Duchenne muscular dystrophy (DMD) with better mobility had lower adiposity; however, these boys were consuming more than their estimated energy requirements. Boys with DMD who consumed a higher percentage of energy intake from discretionary foods, higher energy density and a lower protein to energy ratio had a higher total daily energy intake. Dietary quality was poor, with a low intake of grains, meat and alternatives, dairy and vegetables (core foods) and a high intake of discretionary (non‐core) foods. Micronutrient intake was adequate across the majority of participants. The dietary intake of iron and zinc were positively correlated with a higher energy intake.