There are many nutritional challenges in Duchenne Muscular Dystrophy particularly related maintaining a healthy weight, muscle strength and mobility in the early stages and dealing with the physical complications and the risks of increasing disability in the later stages.
It is important to consider the negative effects of over nutrition (obesity) on glucose metabolism, mobility and respiratory and cardiac function. Hyponutrition (emaciation) impacts on muscle and ventilatory function, gastrointestinal function and bone density. As the disease progresses there is an increased risk of chewing and swallowing difficulties with aspiration of food and fluid. This predisposes Duchenne children to respiratory complications and chest infections. Poor nutrition, dehydration and reduced gut motility contribute to bowel and bladder dysfunction. This increases the risk of urinary tract infections, severe constipation and faecal and urinary incontinence.
In Europe and America/Canada the Professional bodies for Dietetics and Nutrition collaborate with Healthcare providers and Specialists to ensure training and policies are in place to guide those involved in the nutritional support of Duchenne children. If a nutritional strategy is not put in place and monitored throughout all stages of the condition,Duchenne children will be at risk of a reduced quality of life, increased suffering and an earlier death.
In Iran there is great variability with the provision of training and information for Health Professional and families to optimise nutritional support. In the main cities, the children of wealthier families experience better overall nutritional health with access to professional guidance. In rural areas, socially disadvantaged Duchenne children are more likely to suffer the consequences of poor nutrition and inadequate access to health care resulting in earlier physical deterioration, family breakdown and the tragedy of ending their lives in institutional care.