During my years of clinical practice, I was repeatedly asked, “Is there something that I can feed my child to help slow down, or stop, the effects of Duchenne?” The absolute answer is – we don’t know. But a new article out this week has endeavored to address this question.
As people living with Duchenne age and grow, their muscles are constantly undergoing a process of muscle death, inflammation, and regeneration, all of which require energy. As a result of these processes, the body needs a basal level of energy, referred to as energy expenditure, or “EE.” The controversy is around whether the EE in Duchenne is increased or decreased, and how best to help the body to adapt to the changes in energy requirements (i.e., are more or less calories needed, what foods might best supply those calories, etc.).
A newly released study of mdx mice has demonstrated an increase in EE at all stages of disease. The results of this increase in EE, and lack of appropriate calories and nutrition to counterbalance the increased energy need, resulted in blunted growth of the mice. This study surmises that, in mdx mice, a diet of increased fat and protein may be beneficial. This study supports an earlier study in mdx mice, demonstrating that high fat diets may reduce the muscle damage resultant from Duchenne.
Can nutrition help to protect the muscles of people living with Duchenne? We know that the results of mice studies cannot be extrapolated directly to people - a fact that has been repeatedly demonstrated. Many questions remain: Does stage of disease affect energy needs? What are the energy needs during human growth and development? Are EE and the energy needs of the body altered by supplements, steroids or other medications, such as growth hormones, etc.? There is much work to be done. It may be possible in the future to tailor diet to an individual’s energy needs to reduce disease severity. While we certainly are not to that point yet, studies such as this one may be leading the way.