PD564 - OPTIMIZING NUTRITION IN NEUROMUSCULAR DISEASE: OBSERVING CHANGES IN BODY COMPOSITION FOLLOWING A PROTEIN-ENRICHED, CALORIE-ADJUSTED DIET

PD564

OPTIMIZING NUTRITION IN NEUROMUSCULAR DISEASE: OBSERVING CHANGES IN BODY COMPOSITION FOLLOWING A PROTEIN-ENRICHED, CALORIE-ADJUSTED DIET

D. Grote^1,*, F. J. Walter², S. Thiele², C. Wendel², E. Malm², M. Bischoff¹, M. C. Walter², G. Bischoff¹

¹Center for Nutritional Medicine, ²Friedrich-Baur-Institute, Munich, Germany

Rationale: Neuromuscular diseases (NMD) are often associated with reduced muscle mass and increased fat mass, predisposing patients to sarcopenia and obesity. This prospective observational pilot study monitored body composition changes in patients with NMD following a protein-enriched, calorie-adjusted diet.

Methods: Patients received individualized nutritional counseling on a protein-rich (1.2–1.4 g/kg body weight/day), calorie-adjusted diet, supplemented by monthly online group sessions. Body composition parameters – including appendicular skeletal muscle mass index (ASMI) and fat mass index (FMI) – were assessed using bioelectrical impedance analysis (BIA) at three time points over 8 months.

Results: 11 NMD patients (age 42.5±13.4 years; BMI 25.7±5.3 kg/m²) achieved mean protein intake of 1.2±0.2 g/kg/day (54.5% meeting ≥1.2 g/kg/day target; 90.9% using supplements). One patient (9.1%) was classified as underweight (BMI <18.5 kg/m²). Sarcopenic obesity was identified in one patient, defined as BMI ≥30 kg/m² and low ASMI (<7 [male]/<6 [female] kg/m²). Using BIA fat mass cut-offs as reference for obesity, 81.8% overall showed excessive fat mass (45.5% with sarcopenia), which decreased from 31.3±8.3 to 29.3±6.8 kg (p=0.080). This corresponds to a reduction in FMI from 10.4±2.8 to 9.7±2.2 kg/m² (p=0.068). ASMI declined slightly (6.5±2.0 to 6.3±1.9 kg/m², p=0.121), equating to a reduction in skeletal muscle mass of 0.5±0.6 kg (p=0.157).

Conclusion: BMI is inadequate for body composition assessment in NMD patients, as elevated fat mass persists despite normal BMI. Nutritional counseling with a protein-rich, calorie-adjusted diet induced fat mass reduction while maintaining relative ASMI stability - crucial for preserving functional capacity in this vulnerable population. Further data from larger cohorts of patients with NMD are needed to validate these preliminary findings.

Disclosure of Interest: None declared