Nutritional status and dietary intake in children and adolescents with spinal muscular atrophy types II and III on treatment with nusinersen

Summary: Background: There are few assessments of nutritional care needs of children and adolescents with spinal muscular atrophy (SMA) after disease-modifying treatments became available. Aims: To assess nutritional status, dietary intake and feeding difficulties in children and adolescents with S...

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Main Authors: Hanna S. Vetlesen, Merete Wik-Klokk, Sean Wallace, Magnhild Rasmussen, Anette Hjartåker, Marianne Nordstrøm
Format: Article
Language:English
Published: Elsevier 2024-02-01
Series:Clinical Nutrition Open Science
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2667268523000748
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author Hanna S. Vetlesen
Merete Wik-Klokk
Sean Wallace
Magnhild Rasmussen
Anette Hjartåker
Marianne Nordstrøm
author_facet Hanna S. Vetlesen
Merete Wik-Klokk
Sean Wallace
Magnhild Rasmussen
Anette Hjartåker
Marianne Nordstrøm
author_sort Hanna S. Vetlesen
collection DOAJ
description Summary: Background: There are few assessments of nutritional care needs of children and adolescents with spinal muscular atrophy (SMA) after disease-modifying treatments became available. Aims: To assess nutritional status, dietary intake and feeding difficulties in children and adolescents with SMA II and SMA III on treatment with nusinersen, and to explore possible associations between feeding difficulties and dietary intake. Methods: Nutritional status was assessed by anthropometric measures and blood samples from annual follow-up appointments over a three-year period. Three 24-hour dietary recalls by phone were used to assess dietary intake. Feeding difficulties were assessed by the Egen Klassifikation- 2 scale. Results: This study included 20 participants with SMA II with a median age of 7.0 (Q1 2.0; Q3 12.9) years and 20 participants with SMA III with a median age of 8.4 (Q1 4.3; Q3 12.2) years. Adequate intake of iron and vitamin D was dependent on use of supplementation. Iron deficiency was implied in 17.5 %, whereas vitamin D deficiency was documented in 5 % and vitamin D insufficiency in 37.5 % of the total SMA cohort. Growth failure with small mean decrease in height-for-age z-score over time was observed in both subgroups, however only significant in the SMA II group (P=0.02). Feeding difficulties were associated with reduced intake of protein -4.6 grams per day, 95 % CI [-7.3; -1.8], P=0.002. Conclusions: Systematic monitoring of nutritional status continues to be important in pediatric patients with SMA II and SMA III on disease-modifying treatment. Attention in clinical care should be on prevention and treatment of nutritional deficits, with emphasis on iron and vitamin D status and adequate protein intake in persons with feeding difficulties.
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spelling doaj.art-69e474b5071b421085d762e1c762e9002024-01-25T05:23:53ZengElsevierClinical Nutrition Open Science2667-26852024-02-01535767Nutritional status and dietary intake in children and adolescents with spinal muscular atrophy types II and III on treatment with nusinersenHanna S. Vetlesen0Merete Wik-Klokk1Sean Wallace2Magnhild Rasmussen3Anette Hjartåker4Marianne Nordstrøm5Department of Nutrition, University of Oslo, NorwayWomen and Children's Division, Department of Clinical Neurosciences for Children, Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, NorwayWomen and Children's Division, Department of Clinical Neurosciences for Children, Oslo University Hospital, Norway; Department of Neurology, Unit for Inborn and Hereditary Neuromuscular Disorders, Oslo University Hospital, NorwayWomen and Children's Division, Department of Clinical Neurosciences for Children, Oslo University Hospital, Norway; Department of Neurology, Unit for Inborn and Hereditary Neuromuscular Disorders, Oslo University Hospital, NorwayDepartment of Nutrition, University of Oslo, NorwayDepartment of Nutrition, University of Oslo, Norway; Department of Neurology, Unit for Inborn and Hereditary Neuromuscular Disorders, Oslo University Hospital, Norway; Frambu Resource Center for Rare Disorders, Siggerud, Norway; Corresponding author. Frambu Resource Center for Rare Disorders Sandbakkveien, 18 1404, Siggerud, Norway. Tel.: +47 98241760.Summary: Background: There are few assessments of nutritional care needs of children and adolescents with spinal muscular atrophy (SMA) after disease-modifying treatments became available. Aims: To assess nutritional status, dietary intake and feeding difficulties in children and adolescents with SMA II and SMA III on treatment with nusinersen, and to explore possible associations between feeding difficulties and dietary intake. Methods: Nutritional status was assessed by anthropometric measures and blood samples from annual follow-up appointments over a three-year period. Three 24-hour dietary recalls by phone were used to assess dietary intake. Feeding difficulties were assessed by the Egen Klassifikation- 2 scale. Results: This study included 20 participants with SMA II with a median age of 7.0 (Q1 2.0; Q3 12.9) years and 20 participants with SMA III with a median age of 8.4 (Q1 4.3; Q3 12.2) years. Adequate intake of iron and vitamin D was dependent on use of supplementation. Iron deficiency was implied in 17.5 %, whereas vitamin D deficiency was documented in 5 % and vitamin D insufficiency in 37.5 % of the total SMA cohort. Growth failure with small mean decrease in height-for-age z-score over time was observed in both subgroups, however only significant in the SMA II group (P=0.02). Feeding difficulties were associated with reduced intake of protein -4.6 grams per day, 95 % CI [-7.3; -1.8], P=0.002. Conclusions: Systematic monitoring of nutritional status continues to be important in pediatric patients with SMA II and SMA III on disease-modifying treatment. Attention in clinical care should be on prevention and treatment of nutritional deficits, with emphasis on iron and vitamin D status and adequate protein intake in persons with feeding difficulties.http://www.sciencedirect.com/science/article/pii/S2667268523000748Spinal muscular atrophiesChildAdolescentNutritional statusFeedingNutrients
spellingShingle Hanna S. Vetlesen
Merete Wik-Klokk
Sean Wallace
Magnhild Rasmussen
Anette Hjartåker
Marianne Nordstrøm
Nutritional status and dietary intake in children and adolescents with spinal muscular atrophy types II and III on treatment with nusinersen
Clinical Nutrition Open Science
Spinal muscular atrophies
Child
Adolescent
Nutritional status
Feeding
Nutrients
title Nutritional status and dietary intake in children and adolescents with spinal muscular atrophy types II and III on treatment with nusinersen
title_full Nutritional status and dietary intake in children and adolescents with spinal muscular atrophy types II and III on treatment with nusinersen
title_fullStr Nutritional status and dietary intake in children and adolescents with spinal muscular atrophy types II and III on treatment with nusinersen
title_full_unstemmed Nutritional status and dietary intake in children and adolescents with spinal muscular atrophy types II and III on treatment with nusinersen
title_short Nutritional status and dietary intake in children and adolescents with spinal muscular atrophy types II and III on treatment with nusinersen
title_sort nutritional status and dietary intake in children and adolescents with spinal muscular atrophy types ii and iii on treatment with nusinersen
topic Spinal muscular atrophies
Child
Adolescent
Nutritional status
Feeding
Nutrients
url http://www.sciencedirect.com/science/article/pii/S2667268523000748
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