title: Do patients with amyotrophic lateral sclerosis (ALS) have increased energy needs?
abstract: OBJECTIVE
  Nutritional status is a prognostic factor for survival in amyotrophic lateral sclerosis (ALS) patients. We investigated the contribution of some of the components contributing to resting energy expenditure (REE) in order to determine whether potentially higher energy needs should be considered for these patients.
  
  
  METHODS
  Thirty three ALS patients and 33 age- and gender-matched healthy controls participated. REE was measured by an open-circuit indirect calorimeter, body composition by dual energy X-ray absorptiometry, and estimated caloric intake by 7-day food records.
  
  
  RESULTS
  Patients had lower body mass indices and lower lean body mass (LBM) than healthy controls. REE values (as a percentage of predicted) was similar but increased when normalized by LBM (P<0.001). LBM and REE decreased while REE/LBM increased in ten patients who were reassessed 6 months later. A model for predicting measured REE was constructed based on the different components, with 86% prediction of its variability.
  
  
  CONCLUSIONS
  ALS is associated with increased REE. Various factors, such as poor caloric intake and mechanical ventilation, may mask this tendency. All the above parameters need to be considered during nutritional intervention to prevent additional muscle loss.
authors.affiliation: Clinical Nutrition Unit, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. vaisman@tasmc.health.gov.il
authors.forename: Nachum
authors.initials: N
authors.lastname: Vaisman
authors.forename: Michal
authors.initials: M
authors.lastname: Lusaus
authors.forename: Beatrice
authors.initials: B
authors.lastname: Nefussy
authors.forename: Eva
authors.initials: E
authors.lastname: Niv
authors.forename: Doron
authors.initials: D
authors.lastname: Comaneshter
authors.forename: Ron
authors.initials: R
authors.lastname: Hallack
authors.forename: Vivian E
authors.initials: VE
authors.lastname: Drory
mesh_terms: D015502:Absorptiometry, Photon; D000690:Amyotrophic Lateral Sclerosis / Q000378:metabolism*; D001823:Body Composition; D015992:Body Mass Index; D002153:Calorimetry, Indirect; D002149:Energy Intake; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged