Do patients with amyotrophic lateral sclerosis (ALS) have increased energy needs?

Abstract Background and aims Nutritional status is a prognostic factor for survival in amyotrophic lateral sclerosis (ALS) patients. We investigated the contribution of some of the components contributing to resting energy expenditure (REE) in order to determine whether potentially higher energy nee...

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Bibliographic Details
Published in:Journal of the neurological sciences 2009-04, Vol.279 (1), p.26-29
Main Authors: Vaisman, Nachum, Lusaus, Michal, Nefussy, Beatrice, Niv, Eva, Comaneshter, Doron, Hallack, Ron, Drory, Vivian E
Format: Article
Language:English
Subjects:
Absorptiometry, Photon
ALS
Amyotrophic Lateral Sclerosis - metabolism
Biological and medical sciences
Body Composition
Body Mass Index
Calorimetry, Indirect
Energy Intake
Energy Metabolism
Female
Humans
Male
Medical sciences
Middle Aged
Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis
Neurology
REE
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Summary:Abstract Background and aims Nutritional status is a prognostic factor for survival in amyotrophic lateral sclerosis (ALS) patients. We investigated the contribution of some of the components contributing to resting energy expenditure (REE) in order to determine whether potentially higher energy needs should be considered for these patients. Methods Thirty three ALS patients and 33 age- and gender-matched healthy controls participated. REE was measured by an open-circuit indirect calorimeter, body composition by dual energy X-ray absorptiometry, and estimated caloric intake by 7-day food records. Results Patients had lower body mass indices and lower lean body mass (LBM) than healthy controls. REE values (as a percentage of predicted) was similar but increased when normalized by LBM ( P < 0.001). LBM and REE decreased while REE/LBM increased in ten patients who were reassessed 6 months later. A model for predicting measured REE was constructed based on the different components, with 86% prediction of its variability. Conclusions ALS is associated with increased REE. Various factors, such as poor caloric intake and mechanical ventilation, may mask this tendency. All the above parameters need to be considered during nutritional intervention to prevent additional muscle loss.
ISSN:0022-510X
1878-5883
DOI:10.1016/j.jns.2008.12.027