Ingesta nutricional en pacientes afectados de esclerosis lateral amiotrófica en una consulta ambulatoria de nutrición artificial en Portugal

Introduction: Amyotrophic lateral sclerosis (ALS) is a chronic and progressive neurodegenerative pathology, which causes motor neuron death. It results in weight loss, loss of muscle mass and increased nutritional deficiencies. There is a link between nutritional intake and the pathogenesis of ALS. The aim of this analysis was to describe the sociodemographic, anthropometric and clinic characteristics as well as the nutritional intake in a sample of Portuguese ALS patients. Material and Methods: A brief clinical history was taken. Body weight was measured according to the protocol of the International Society for the Advancement of Kinanthropometry (ISAK) and height was taken from the patient’s clinical record. A dietary-nutritional anamnesis and a dietary record were performed. Nutritional intake was analysed with the Nutrition and Health® software and compared with the dietary reference intakes (DRI). The nutritional adequacy index was consider below recommendations when it was ≤80%. Results: 13 patients (7 men) aged 53-83 years were analysed. 69.20% presented bulbar ALS. 54% were normal weight. All patients had dysphagia and dysarthria and 84.62% had constipation. Compared to the DRI, in both sexes, nutritional deficiency of fiber, vitamin D, E, B₈, B₉, calcium, magnesium and iodine was identified, accompanied by a nutritional excess of protein, lipids, saturated fatty acids and sodium. Conclusions: The finding of these nutritional deficiencies is relevant because the nutrients involved influence pathogenic mechanisms of ALS, because they are antioxidant, anti-inflammatory and contribute to normal motor neuron function. Identified nutritional excesses are associated with oxidative stress, inflammation and increased risk of ALS. Further research in larger sample sizes are needed to contribute to the understanding of the associations between nutritional excess and deficiencies and risk of ALS development and/or progression.