Nutritional problems in multiple system atrophy - The necessity of early tube feeding and caloric restriction at the advanced stage

Abstract

We investigated nutritional states of 28 patients with multiple system atrophy (MSA) by measuring body mass index (BMI), arm muscle circumference (% AMC) and triceps skin fold thickness (%TSF). We also analyzed retrospectively chronological changes of nutritional status in 13 MSA patients surviving more than 10 years. BMI and %AMC were significantly reduced in patients having tube feeding compared with patients who had oral intake, whereas %TSF was increased in some patients with tube feeding. From the chronological study, patients at the stage of respiratory or swallowing deterioration showed marked malnutrition, whereas patients during the advanced, but stable stages with tracheostomy and gastrostomy showed much fat accumulation even under low calorie intake less than 1,000 kcal/day. Daily amount of calorie intake should be sufficient during respiratory or swallowing deterioration, but it should be restricted at the advanced stable stage to avoid fat accumulation.