title: Medical Nutrition Therapy for Patients With Advanced Systemic Sclerosis (MNT PASS): A Pilot Intervention Study.
abstract: The objective of this study was to demonstrate the feasibility and associations with short-term outcomes of a medical nutrition therapy (MNT) intervention in patients with systemic scleroderma (SSc).
  
  
  
  Eighteen patients with SSc, gastrointestinal (GI) involvement, and unintentional weight loss were consented and recruited for a 6-week MNT intervention, in addition to their usual medical management. MNT emphasized increased calorie and protein intake, modified textures, and lifestyle modifications. Symptoms, anthropometrics, diet (24-hour recall), and body composition (dual-energy x-ray absorptiometry) were assessed pre- and postintervention. Sarcopenia was defined as appendicular lean height (ALH) for women <5.45 kg/m2and for men <7.26 kg/m2. Descriptive, parametric, and nonparametric statistics were conducted.
  
  
  
  Participants (n = 18) were predominantly white (78%), female (89%), malnourished (83%), and 51.3 ± 11.0 years of age with a body mass index of 22.6 ± 6.7 kg/m2. Significant decreases in nutrition symptom scores (12.8 vs 7.6, P < .05) and improvements in ALH (5.6 ± 0.8 vs 5.8 ± 0.8 kg/m2, respectively; P = .05) occurred pre- vs postintervention, respectively (n = 14). Sarcopenia was observed in 54% of participants at baseline and 39% at follow-up ( P = .02). Caloric intake (1400 vs 1577 kcal/d, P = .12) and macronutrient distribution (ie, % fat, protein, carbohydrate) did not change significantly pre- vs postintervention, respectively.
  
  
  
  Individually tailored MNT can improve symptom burden and potentially ALH in patients with SSc involving the GI tract. This study underscores the clinical potential of multidisciplinary patient management and the need for larger nutrition intervention trials of longer duration in these patients.
authors.affiliation: 1 Digestive Health Center, Division of Gastroenterology and Hepatology, Northwestern Medicine, Chicago, Illinois.
authors.forename: Bethany
authors.initials: B
authors.lastname: Doerfler
authors.affiliation: 2 Advocate South Suburban Hospital, Hazel Crest, Illinois.
authors.forename: Tara S
authors.initials: TS
authors.lastname: Allen
authors.affiliation: 3 Advocate Children's Hospital, Oak Lawn, Illinois.
authors.forename: Courtney
authors.initials: C
authors.lastname: Southwood
authors.affiliation: 1 Digestive Health Center, Division of Gastroenterology and Hepatology, Northwestern Medicine, Chicago, Illinois.
authors.forename: Darren
authors.initials: D
authors.lastname: Brenner
authors.affiliation: 1 Digestive Health Center, Division of Gastroenterology and Hepatology, Northwestern Medicine, Chicago, Illinois.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Hirano
authors.affiliation: 4 University of Illinois at Chicago, Institute for Health Policy and Research, Chicago, Illinois.
authors.forename: Patricia
authors.initials: P
authors.lastname: Sheean
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D001823:Body Composition; D015992:Body Mass Index; D004032:Diet; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000178:diet therapy / Q000453:epidemiology*; D008875:Middle Aged; D015596:Nutrition Assessment; D044623:Nutrition Therapy; D009752:Nutritional Status; D010865:Pilot Projects; D015995:Prevalence; D055948:Sarcopenia / Q000175:diagnosis / Q000178:diet therapy / Q000453:epidemiology*; D012595:Scleroderma, Systemic / Q000178:diet therapy* / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D015431:Weight Loss
keywords: malnutrition; medical nutrition therapy; nutrition status; sarcopenia; scleroderma