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Nutrition for Duchenne 6, 7
Nutrition is the act or process of nourishing or being nourished. Research has indicated that proper nutrition is one component that can improve the overall quality of life for a person living with Duchenne muscular dystrophy. While there are several considerations regarding caloric consumption, including: physical activity, capability of ambulation, and steroid use, specialists in the field suggest that daily caloric consumption should be 80% of what individuals without Duchenne muscular dystrophy consume. Avoidance of excessive intake overall, salt intake not more than 1500 mg daily, and adequate calcium intake are recommended.
Keep in mind, it’s never too late to start! Meal planning is often an effective means with which to involve all members of the family. Engage support from your Health Care team, including a registered dietitian nutritionist or registered dietitian to develop a plan customized to your individualized needs.
Vitamins & Supplements 5
Daily calcium needs are based on actual intake. First step is to collect information on what intake is obtained from food and then determine if sufficient. When under the ideal amount, supplements can be added. It is important to determine the actual from food and then decide if additional is needed. A body can get TOO much calcium so it is imperative to work with your health care team to determine a plan best tailored to your child’s needs.
It is recommended to take a daily multivitamin that includes mineral supplements. Examples include: for young boys, chewable tablets such as Flintstones and for teens- Men’s multi-vitamins.
There are many different supplements for Duchenne patients.
This is one family’s regimen (not developed by a physician) and is listed only as an example. CureDucehenne does not endorse this in any way. Please check with your physician before adding any supplements and/or medications. Doses are based on body weight. Please note: Haelan is very costly and tastes bitter; it should be given on an empty stomach with a drop of honey to reduce the bitterness.
| UPON WAKING | |
|---|---|
| Haelan 951 | 2 oz |
| WITH BREAKFAST | |
| Deflazacort | .9 grams per kilo |
| Q-10 | 100mg |
| MultiVitamin | 2 tablets |
| Green Tea Extract (Caffeine free) | ½ dropper |
| Protandim | 1 pill |
| Arginine | 3 grams |
| Losartan | 50mg |
| Omega 3’s | 1280mg |
| AFTERNOON | |
| Arginine | 3 grams |
| Creatine | 5 grams |
| Glutamine | 6 grams |
| WITH DINNER | |
| CLA | 1 gram |
| HMB | 2 grams |
| Alpha Lipoeic Acid | 600mg |
| Q-10 | 100mg |
| Calcium | 1200 |
| Vitamin D | 2000 |
| Quercetin | 1000mg |
| BEDTIME | |
| Human Growth Hormone | 1.6mg |
The details should be completed following a 3 Day Food Intake Record in collaboration with your child’s Dietitian.
| Calories | Calories/day | |
| Protein | Grams/day | |
| Fluids | Ounces/day | |
| Calcium | Milligrams/day | |
| *Additional Calcium supplement | *when indicated | |
| Vitamin D3 | 1,000-4,000 | International units/day |
| Sodium | 1,500 | Milligrams/day |
| Multivitamin/Mineral | 1 per day | Suggested Brand(s): Flintstones Complete Centrum Liquid Centrum Complete |
| *Other supplements | *when indicated |
Click image to enlarge
Use child’s hand along with this quick guide to gauge portion sizes.
What is it?
Fiber is the portion of plant foods that cannot be digested. There are two kinds of fiber, and both are keys to a healthy diet and a healthy digestive system:
- Soluble fiber aids in bulking and moving food through the gut. It forms a gel when mixed with liquid.
- Insoluble fiber does not mix with liquids and passes through the GI tract mostly intact. It is sometimes called “roughage.”
Why do I need to eat it?
Fiber has many important roles:
- Helps maintain regular bowel movements. More fiber can improve both diarrhea and constipation.
- Reduces the risk of developing hemorrhoids.
- Lowers LDL or “bad” cholesterol levels, which lowers risk of heart disease.
- Regulates blood sugar levels in people with diabetes.
- Provides a feeling of fullness, and may help with weight loss.
How much do I need?
The Academy of Nutrition and Dietetics recommends:
- For women, 25 grams per day under age 50.
- For men, 38 grams per day under age 50.
What foods are the best sources?
Plant foods contain fiber, but some more than others. Best choices are:
- Whole grains and high fiber cereals.
- Dried beans and legumes.
- Fruits and vegetables, especially fresh.
What the heck does that stand for?
- Fermentable
- Oligosaccharides (oligo –“few,” saccharide – “sugar”)
- Disaccharides (“two sugars”)
- Monosaccharides (“one sugar”)
- And
- Polyols (these are sugar alcohols)
OK, but what are FODMAPs and who should avoid them?
FODMAPs are a type of carbohydrate, or “sugar,” found in certain foods. Carbohydrates give us energy, along with fat and protein. People with irritable bowel syndrome (IBS), a slow moving gut, or other bowel disorder may not tolerate foods with FODMAPS. This is because FODMAPS are not easily absorbed by the bowel.
Symptoms of FODMAP intolerance include gas, abdominal discomfort, distention, bloating, fullness, nausea, and/or pain after eating foods containing FODMAPS.
Carbohydrates that are Considered FODMAPS
Fructans and Galactans:
- Fructose
- Lactose
- Fructooligosaccharides
- Galactooligosaccharides
Polyols:
- Sorbitol
- Mannitol
- Xylitol
- Maltitol
Foods that do not contain carbohydrates are not a concern. This includes meat, poultry, fish, eggs, butter, oils, and hard cheeses.
Additional Resources
Below are additional resources you may find useful.
Sources Referenced
1 Bushby K, et al. (2009). Diagnosis and management of Duchenne muscular dystrophy, part 1: implementation of multidisciplinary care. The Lancet Neurology, 73-93.
2 Bushby, K. et al. (2009). Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care. The Lancet Neurology, 177-189.
3 Estimate Serving Sizes With Household Objects (Or Your Hands…). (2012, February 7). Retrieved from TopsyTasty: http://topsytasty.com
4 From The Diagnosis and Management of Duchenne Muscular Dystrophy : A Guide for Families. (2010).
5 Gloss, D., Moxley, R. T., Ashwal, S., & Oskoui, M. (2016). Practice guideline update summary: Corticosteroid treatment of Duchenne muscular dystrophy. Neurology, 465–472.
6 Godshall, LD, CCHMC, B. (n.d.).
7 Ramos-Platt, Neurologist, L. (n.d.).
8 Simona, S., Francesca, M., Maurizio, M., Sophie, G., Sciacco, M., & Susanna, E. (2017). Nutritional Challenges in Duchenne Muscular Dystrophy. Nutrients.
9 University of Virginia Health System: Digestive Health Center. (2014, October). Low FODMAP Diet. Retrieved from www.GInutrition.virginia.edu
10 University of Virginia Health System: Digestive Health Center. (2015, October). High Fiber. Retrieved from www.GInutrition.virginia.edu
Please be advised that the contents within the CureDuchenne site include a compilation of articles, advisements, and references from the community. The intent of this shared content is to serve as a point of reference for informational purposes. Please refer to your health care provider(s) for your individualized, specific care management needs.
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