P176 - MEASUREMENT PROPERTIES OF ASSESSMENT METHODS TO ESTIMATE NUTRITIONAL STATUS IN AMYOTROPHIC LATERAL SCLEROSIS (ALS)

P176

MEASUREMENT PROPERTIES OF ASSESSMENT METHODS TO ESTIMATE NUTRITIONAL STATUS IN AMYOTROPHIC LATERAL SCLEROSIS (ALS)

M. Kuiper^1,2,*, L. Cuppers³, A. Sewell-Green^4,5, W. Kruithof^1,2, N. Broekman-Peters⁶, D. Schröder- van den Nieuwendijk⁷, J. M. Visser-Meily^1,2, A. Beelen^1,2

¹Department of Rehabilitation, Physical Therapy Science and Sports, University Medical Centre Utrecht, ²Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Utrecht, ³Nutrition and Healthcare Alliance, Hospital Gelderse Vallei, Ede, Netherlands, ⁴School of Biomedical Sciences, Faculty of Health, Medicine & Behavioural Sciences, University of Queensland, ⁵Department of Dietetics and Foodservices, Royal Brisbane and Women's Hospital, Brisbane, Australia, ⁶Department of Dietetics, University Medical Centre Utrecht, Utrecht, ⁷Department of Dietetics, Roessingh Rehabilitation Centre, Enschede, Netherlands

Rationale: People with ALS are at high risk of malnutrition, making it essential to monitor their nutritional status through measurements of body composition and energy expenditure¹. However, accuracy of tools to inform nutritional status in ALS is unclear. This review evaluates measurement properties of equation-based tools for estimating body composition and energy expenditure in ALS.

Methods: Electronic databases EMBASE, MEDLINE, CINAHL and Cochrane were systematically searched from inception until July 1^st, 2024. Methodological quality was assessed using the COSMIN risk of bias checklist. Measurement property results were rated as sufficient (+), indeterminate (?) or insufficient (-) based on COSMIN criteria for good measurement properties. Results were qualitatively summarised. 

Results: Thirteen studies were included; five evaluated equations to estimate body composition with Bioelectrical Impedance Analysis (BIA) or anthropometry, eight assessed equations to estimate energy expenditure. No equation was rated as sufficient for criterion validity across studies. The Lukaski and Segal BIA equations were promising in one single study when compared to Dual-energy X-ray absorptiometry. However, standard deviations of mean differences were large and study reporting was limited. One study found potential in a newly developed equation for estimating energy expenditure (Shimuzu), though further validation is needed. Evidence for reliability and responsiveness was lacking for estimating energy expenditure and limited for estimating body composition. 

Conclusion: Equations to estimate body composition and energy expenditure should be used with caution, as no equation could be recommended for use in ALS. ALS-specific equations require further validation.

References: ¹Muscaritoli, Maurizio et al. Nutritional and metabolic support in patients with amyotrophic lateral sclerosis. Nutrition. vol. 28,10(2012):959-66

Disclosure of Interest: None declared