What significance does nutrition have for the prognosis?

Weight loss has an unfavorable prognostic significance in ALS and should be avoided or effectively treated through optimal nutritional care. The prognostic significance is based on the results of various clinical studies. In a large observational study of ALS patients, it was shown that patients with an increase in blood lipids (cholesterol and triglycerides) had an improved prognosis.

Other studies have shown that severe weight loss (with a body mass index below 18.5 kg/m²) leads to increased mortality. The unfavorable effect of weight loss persisted even when the breathing of the underweight ALS patients was intact. It is not yet known in detail by what mechanism weight loss leads to a deterioration in prognosis. A weakening of the immune system and an associated susceptibility to infections as a result of the negative energy balance is conceivable. It cannot be ruled out that a food and energy deficit can also have a direct effect on the resistance of motor neurons. In addition, it is known that a weight loss of more than 10 % of the initial weight (which existed before the onset of the disease) is associated with an increased 30-day mortality rate after the installation of a PEG.

Weight loss may lead to physical weakness, making recovery from the surgical stress of the PEG (and possibly other operations) more difficult. Due to the clinical and scientific evidence that a higher body weight has a positive influence on the course of the disease, it makes sense to place particular importance on maintaining your own body weight and avoiding weight loss.