Relationship of Nutritional Profile and Supplementation Protocols in the Clinical Evolution of Patients with Amyotrophic Lateral Sclerosis

Abstract

INTRODUCTION: Nutritional profile may contribute to the worsening and progression of Amyotrophic Lateral Sclerosis (ALS). OBJECTIVE: Relate the nutritional profile with the clinical condition of the patient with ALS and determine which supplementation protocol with vitamins C and E yields the best results for the clinical condition of the patient with ALS.METHODS: A total of 110 patients with sporadic ALS were assessed regarding weight (current/usual), body mass index (BMI) and percentage of weight loss (WL). Patients were divided according to a supplementation protocol: G1 (400 mg/day: vitamin E e 250 mg/day: vitamin C) and G2 (400 mg/day: vitamin E e 500 mg/day: vitamin C). Serum concentrations of vitamins and the cut-off points adopted were <4.6 mg/L and 5.0 mg/L for vitamins C and E, respectively. For assessment of motor dependency, the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS) was used. RESULTS: Mean percentage of weight loss (17.7±10.4%) was significantly higher in patients who died when compared to those who survived (10.9±8.1%) (p=0.003). Patients with the worst ALSFRS scores showed significantly lower serum concentrations of vitamin C (4.3±4.5 mg/L) than patients with the best scores (8.3±4.9 mg/L) (p=0.048). In relation to the groups, the mean of survival time in G1 (50.9±5.9 months) was significantly lower than the mean of survival time in G2 (58.1±3.6 months) (p=0.046). CONCLUSION: We recommend monitoring the nutritional profile and the vitamins supplemented, especially vitamin C, to minimize disease progression and prolong survival.