Nutrition is “the process of providing or obtaining the food necessary for health”, growth, and aging. We tend to forget it but food is an important part of everybody’s health. For people living with LGMD2I and other muscular dystrophies, an adapted nutrition plan is an important first step to maintain wellbeing. While we are not aware of any study on the effects of nutrition and supplementation on the wellbeing of people with LGMD2I, there has been nutritional guidance given to people with other forms of muscular dystrophy. People with LGMD2I might better understand the relationship between nutrition and disease after reviewing the nutritional guidance provided in the links at the bottom of this page.
Very little data:
It is important to note that the scarce studies about the benefit of certain diets or foods in neuromuscular diseases have been inconclusive. Notably, while the NINDS (National Institute of Neurological Disorders and Stroke) recommended in 2011 a high-fiber, high-protein, low-calorie diet with proper fluid intake for most patients with muscular dystrophy, there is today no clinical evidence suggesting that patients affected with LGMD2I or other forms of muscular dystrophy require additional protein intake compared to people without muscle disease (Salera 2017 Nutrients).
Interestingly, a comparative study in a mouse model for Duchenne showed that a high fat diet might have more benefit than a high protein diet. On high fat diet, the Duchenne mice did not show any of the signs of obesity (weight gain, increased body fat, and elevated inflammatory cytokines), which became quickly present in the non dystrophic mice. This observation led the authors to suggest that Duchenne mice had a energy metabolism different than the non-dystrophic mice. This kind of observation could help people with muscular dystrophies adapt their diet to their condition. However, while the benefit of a high fat diet is quite intriguing, the results of this work need to be confirmed and understood before it can be recommended. Importantly, there is no evidence today that these results are true in other types of muscular dystrophy.
The main challenge in studying dietary consequences in muscular dystrophies is the design of a proper clinical study. Past attempts in testing diets’ therapeutic effects on diseases suggested that
- The number of participants needs to be very high, with most studies enrolling thousands of participants (often tens of thousands)
- The length of study needs to be in years (10 years? 20 years?)
- The type of therapeutic effect is not clear
Nutritional Guidance in other Muscular Dystrophies:
The objective of an adapted diet should be to
- Control extreme weight gain or extreme weight loss
- Provide lasting energy
- Diminish constipation (more prevalent in non ambulant individuals)
Some nutrition experts have individually designed diets for people with muscular dystrophy. Below is an example of such diet
- Start off the day with a protein rich breakfast. AVOID sweets and sugary based food by consuming foods that contain less than 9g sugar/serving
- Increase water intake. Amount of daily water needs is equal to ½ your body weight i.e. for a person weighing 60 pounds, his minimum water intake should be 30 oz.
- AVOID foods high in sodium. Don’t add salt and use low sodium food products
- Grill, Bake, & Broil proteins. Use lean fish and poultry.
- Include a salad at lunch and dinner
- Eat less starchy foods – replace with less starchy vegetables
- AVOID Constipation by consuming adequate water and increasing fiber consumption
From Barbara J. Godshall, MMSc, RD, CSP, LD, CD, CNSC, Registered Dietitian, at the Cincinatti’s childrens” Comprehensive Neuromuscular Center (www.cureduchenne.org/care/nutrition/#1500412851749-e92ef0f2-17c5)