Protein Intake Positively Associates with Body Composition and Quality of Life Independent of Mobility Status in Adults with Muscular Dystrophy

Topic:

Clinical Management

Poster Number: 85 S

Author(s):

Meg Leaver, ANutr, MSc, BSc, University of Birmingham, Isobel Haslam, ANutr, MSc, BSc, University of Birmingham, Paul Morgan, PhD, Manchester Metropolitan University, Paul Orme, The Neuromuscular Centre, Orla Flannery, PhD, Manchester Metropolitan University, Kelly Bowdon-Davies, PhD, Manchester Metropolitan University, Christopher Morse, PhD, Manchester Metropolitan University, Nathan Hodson, PhD, University of Birmingham

Introduction:
In recent years, advancements in clinical care have substantially increased longevity in those living Muscular Dystrophy (MD), yet ambulatory loss still occurs in many individuals (1-3). We have recently observed that adults with MD consume less protein than non-dystrophic individuals and that this intake is associated with body composition, muscle strength and quality of life (QoL). However, habitual dietary differences between ambulatory and non-ambulatory individuals remain unexamined.
Methods:
Secondary analysis from two adult MD cohorts (FSHD, LGMD, BMD, DM1), stratified by mobility: ambulatory (AB, n=37; 56±2 yrs; 27.4±4.5 kg/m²) and non-ambulatory (NAB, n=22; 54±2 yrs; 27.8±5.5 kg/m²) was conducted. Participants completed two 3-day food diaries, validated functional/QoL questionnaires, alongside assessments of body composition, forearm muscle thickness, and upper-limb strength. Group differences were analysed using t-tests or Mann–Whitney U tests, correlations with Pearson’s r or Spearman’s ρ, and protein intake distribution with linear mixed models with Bonferroni- corrected pairwise t-tests performed post hoc. Significance was set at p<0.05, corrected for multiple comparisons where appropriate. Results: Groups did not differ in BMI, lean mass percentage or self-reported physical activity (p>0.05). NAB reported lower absolute (g) (-16%, p=0.003) but not relative (g/kg) (-13%, p=0.088) protein intake, with no difference in total energy intake. Energy and protein intake (g/kg) were both highest at dinner (+30% vs. lunch; +62% vs. breakfast; all p<0.001) with no effect of ambulatory status. NAB exhibited 49–54% lower strength (all p<0.05) but similar forearm muscle thickness. Adjusted for mobility, relative protein intake (g/kg) correlated positively with lean mass (r=0.34, p=0.029), lower limb function (r= 0.386, p = 0.006), and QoL (r=0.353, p=0.013). Conclusion: Non-ambulatory adults with MD consume less protein despite comparable energy intake. Given the observed associations with function and QoL, ensuring adequate protein intake may be critical for maintaining muscle and QoL in MD, independent of mobility status. References: 1.Audhya IF et al. J Neuromuscul Dis. 2022. 2.Tawil R et al. Neurology. 2015. 3.Stimpson G et al. Eur J Neurol. 2024. 4.Andersen G et al. Am J Physiol. 2015. 5.Passerieux E et al. Free Radic Biol Med. 2015.