P819 - EVALUATING THE IMPACT OF WEIGHT LOSS AND ACCURACY OF ENERGY EQUATIONS IN AUSTRALIANS WITH AMYOTROPHIC LATERAL SCLEROSIS

P819

EVALUATING THE IMPACT OF WEIGHT LOSS AND ACCURACY OF ENERGY EQUATIONS IN AUSTRALIANS WITH AMYOTROPHIC LATERAL SCLEROSIS

A. Sewell-Green^1,2,*, R. Capstick¹, K. Matthews-Rensch^2,3, S. Ngo^4,5, R. Henderson⁵, F. Steyn^1,5

¹School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, ²Department of Dietetics and Foodservices, Royal Brisbane and Women’s Hospital, ³Queensland Centre for Mental Health Research, The Park Centre for Mental Health Treatment, ⁴Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, ⁵Department of Neurology, Royal Brisbane and Women’s Hospital, Brisbane, Australia

Rationale: Malnutrition and lower body weight are associated with worse prognosis in Amyotrophic Lateral Sclerosis (ALS)¹. This study evaluated the impact of negative energy balance on prognosis and survival in people living with ALS (plwALS), and suitability of current energy equations to support weight management in an Australian cohort.

Methods: A prospective case-control study (March 2016 to October 2024), assessed 170 plwALS for body composition (BodPod), metabolism (REE), functional capacity (ALSFRS-R), and survival, comparing baseline measures to 173 non-neurodegenerative disease controls. plwALS were categorised by GLIM weight loss criteria (0-5% stable, 5-10% minor, >10% major), comparing changes between groups over 20 months. 82 plwALS provided 3-Day-Food-Diaries for nutritional intake assessment (FoodWorks); comparing daily estimated energy requirements (EER) from 13 ALS-specific equations to daily energy intake (EEI) and weight status.

Results: Weight loss, driven by fat mass loss (p <0.01), was associated with faster functional decline (ALSFRS-R) and earlier death (HR 5.58, p<0.001). No EER equation performed well; however, equations incorporating body mass and ALS-validated activity levels predicted weight status more accurately. Adjusting for higher ideal body weight improved prediction accuracy for weight loss.

Conclusion: Weight loss, suggesting calorie deficit, is associated with worse prognosis in an Australian ALS cohort. Incorporating disease-specific activity, injury factors, and body mass targets into predictive energy equations may improve their accuracy, promote weight maintenance and prevent malnutrition in plwALS.

References:         1. Marin B, Desport J-C, Kajeu P, Jésus P, Nicolaud B, Nicol M, et al. Alteration of nutritional status at diagnosis is a prognostic factor for survival of ALS patients. BMJ Publishing Group; 2010. p. 628.

Disclosure of Interest: None declared