Body Fat Percentage and Availability of Oral Food Intake: Prognostic Factors and Implications for Nutrition in Amyotrophic Lateral Sclerosis

Park, Jin‐Woo; Kim, Minseok; Baek, Seol-Hee; Sung, Jung‐Joon; Yu, Jae-Guk; Kim, Byung Jo

doi:10.3390/nu13113704

Cited by 10 publications

(7 citation statements)

References 44 publications

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“…Lee et al 26 also suggested that loss of fat is correlated with faster disease progression in ALS patients (n = 20), indicating the positive effects of fat in ALS. Consistently, Park et al 27 found longer survival in ALS patients (n = 53) with an increased body fat rate. Future studies with larger sample sizes are needed to explore the effect of body fat on the prognosis of ALS patients.…”

Section: Discussionsupporting

confidence: 57%

Correlation of weight and body composition with disease progression rate in patients with amyotrophic lateral sclerosis

Sun

Cai

et al. 2022

Sci Rep

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This study aims to observe the nutritional status of Chinese patients with amyotrophic lateral sclerosis (ALS), further investigating its effect on disease progression. One hundred consecutive newly diagnosed ALS patients and fifty controls were included. Weight and body composition were measured by bioelectrical impedance analysis at baseline and follow-ups. The revised ALS functional rating scale (ALSFRS-R) was used to calculate the rate of disease progression. Patients with ALS had a significantly lower BMI than controls, while no significant difference was found in body composition. Weight loss occurred in 66 (66%) and 52 (67.5%) patients at diagnosis and follow-up, respectively. Patients with significant weight loss (≥ 5%) at diagnosis had significantly lower BMI, fat mass (FM), and FM in limbs and trunk than those without. Fat-free mass (FFM), FM, and FM in limbs were significantly decreased along with weight loss at follow-up (p < 0.01). Patients with lower visceral fat index, lower proportion of FM, and higher proportion of muscle mass at baseline progressed rapidly during follow-ups (p < 0.05). Multivariate linear regression showed that FFM and weight at follow-up were independently correlated with disease progression rate at follow-up (p < 0.05). Weight loss is a common feature in ALS patients, along with muscle and fat wasting during the disease course. Body composition may serve as a prognostic factor and provide guidance for nutritional management in ALS patients.

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Section: Discussionsupporting

confidence: 57%

Correlation of weight and body composition with disease progression rate in patients with amyotrophic lateral sclerosis

Sun

Cai

et al. 2022

Sci Rep

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“…Body fat mass (BFM, kg) and appendicular skeletal muscle mass (ASM, kg) were measured using a multifrequency 80-electrode body impedance analyzer (Inbody770 ® system, InBody Corp, Seoul, Korea). The Inbody770 ® system has been commonly used in previous research for measuring individual body components [ 21 , 22 , 23 ] and the validation of its use has been described previously [ 24 , 25 , 26 , 27 , 28 ]. Thirty impedance measurements were obtained at six different frequencies (1, 5, 50, 250, 500, and 1000 kHz) for five body segments (both arms and legs and trunk).…”

Section: Methodsmentioning

confidence: 99%

Predictors of Step Length from Surface Electromyography and Body Impedance Analysis Parameters

Park

Baek

Sung

et al. 2022

Sensors

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Step length is a critical hallmark of health status. However, few studies have investigated the modifiable factors that may affect step length. An exploratory, cross-sectional study was performed to evaluate the surface electromyography (sEMG) and body impedance analysis (BIA) parameters, combined with individual demographic data, to predict the individual step length using the GAITRite® system. Healthy participants aged 40–80 years were prospectively recruited, and three models were built to predict individual step length. The first model was the best-fit model (R2 = 0.244, p < 0.001); the root mean square (RMS) values at maximal knee flexion and height were included as significant variables. The second model used all candidate variables, except sEMG variables, and revealed that age, height, and body fat mass (BFM) were significant variables for predicting the average step length (R2 = 0.198, p < 0.001). The third model, which was used to predict step length without sEMG and BIA, showed that only age and height remained significant (R2 = 0.158, p < 0.001). This study revealed that the RMS value at maximal strength knee flexion, height, age, and BFM are important predictors for individual step length, and possibly suggesting that strengthening knee flexor function and reducing BFM may help improve step length.

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“…Weight loss before or during disease, and/or throughout the disease course is associated with shorter survival [3][4][5][6]. Moreover, faster fat mass loss is associated with faster disease progression [7] and earlier death [8]. By contrast, dietary intervention to prevent or slow weight loss in ALS is associated with longer survival in fast-progressing patients [9].…”

Section: Introductionmentioning

confidence: 99%

Associations of postprandial ghrelin, liver‐expressed antimicrobial peptide 2 and leptin levels with body composition, disease progression and survival in patients with amyotrophic lateral sclerosis

Howe,

Holdom,

McCombe

et al. 2023

Euro J of Neurology

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Background and purposeLoss of appetite contributes to weight loss and faster disease progression in amyotrophic lateral sclerosis (ALS). Impairment of appetite control in ALS may include altered production or action of orexigenic (i.e., ghrelin) and anorexigenic (i.e., liver‐expressed antimicrobial peptide 2 [LEAP2] and leptin) hormones. We aimed to determine if postprandial circulating ghrelin levels, LEAP2 levels, LEAP2:ghrelin molar ratio and leptin levels differ in ALS patients compared to non‐neurodegenerative disease controls, and whether they are associated with disease progression and body composition.MethodsIn this prospective natural history study, we assessed postprandial plasma levels of ghrelin, LEAP2 and leptin in patients with ALS (cases; n = 46) and controls (controls; n = 43). For cases, measures were compared to changes in body weight, body composition and clinical outcomes.ResultsPostprandial ghrelin level was decreased by 52% in cases compared to controls (p = 0.013). LEAP2:ghrelin molar ratio was increased by 249% (p = 0.009), suggesting greater ghrelin resistance. Patients with lower LEAP2:ghrelin tended to have better functional capacity at assessment, as inferred by the ALS Functional Rating Scale‐Revised (τ = −0.179, p = 0.086). Furthermore, ghrelin and LEAP2:ghrelin molar ratio correlated with diagnostic delay (ghrelin, τ = 0.223, p = 0.029; LEAP2:ghrelin, τ = −0.213, p = 0.037). Baseline ghrelin level, LEAP2 level, LEAP2:ghrelin ratio and leptin level were, however, not predictive of change in functional capacity during follow‐up. Also, patients with higher postprandial ghrelin levels (hazard ratio [HR] 1.375, p = 0.048), and lower LEAP2:ghelin ratios (HR 0.828, p = 0.051) had an increased risk of earlier death.ConclusionsReduced postprandial ghrelin levels, coupled with increased LEAP2:ghrelin molar ratios, suggests a loss of ghrelin action in patients with ALS. Given ghrelin's actions on appetite, metabolism and neuroprotection, reduced ghrelin and greater ghrelin resistance could contribute to impaired capacity to tolerate the physiological impact of disease. Comprehensive studies are needed to explain how ghrelin and LEAP2 contribute to body weight regulation and disease progression in ALS.

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Body Fat Percentage and Availability of Oral Food Intake: Prognostic Factors and Implications for Nutrition in Amyotrophic Lateral Sclerosis

Cited by 10 publications

References 44 publications

Correlation of weight and body composition with disease progression rate in patients with amyotrophic lateral sclerosis

Correlation of weight and body composition with disease progression rate in patients with amyotrophic lateral sclerosis

Predictors of Step Length from Surface Electromyography and Body Impedance Analysis Parameters

Associations of postprandial ghrelin, liver‐expressed antimicrobial peptide 2 and leptin levels with body composition, disease progression and survival in patients with amyotrophic lateral sclerosis

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