Palabras clave
Desnutrición
Disfagia
Nutrición
Cómo citar
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Resumen
Objetivo: Revisar la literatura sobre el manejo nutricional en pacientes con Esclerosis Lateral Amiotrófica (ELA), con énfasis en estrategias para prevenir y tratar la desnutrición, además de discutir su relación con la supervivencia de estos pacientes. Revisión bibliográfica: Los hallazgos indican que la desnutrición en pacientes con ELA es multifactorial, estando principalmente asociada con la disfagia, el hipermetabolismo y la reducción de la ingesta alimentaria. Estos factores interactúan entre sí, resultando en un balance energético negativo, pérdida de peso progresiva y deterioro del estado nutricional. Estrategias como dietas hipercalóricas, modificación de la consistencia de los alimentos y el uso de nutrición enteral son fundamentales para garantizar un aporte adecuado y la seguridad alimentaria. Consideraciones finales: La ELA compromete significativamente la calidad de vida de los pacientes, siendo la desnutrición y la disfagia las complicaciones más prevalentes. La intervención nutricional temprana, junto con el seguimiento multidisciplinario, es esencial para mejorar el pronóstico y promover el bienestar. Asimismo, se destaca la necesidad de directrices más estandarizadas para optimizar el manejo nutricional de estos pacientes.
Referencias
ABRELA. Associação Brasileira de Esclerose Lateral Amiotrófica (ELA). Protocolo clínico para o tratamento do paciente com Esclerose Lateral Amiotrófica/Doença do Neurônio Motor: guia terapêutico. Organização de Cristina Salvioni e Adriana Leico Oda. São José dos Campos, SP: Pulso Editorial, 2021. Disponível em: https://www.arela-rs.org.br/arquivos/390.pdf. Accessed on: oct. 10, 2023.
ALMEIDA CS., et al. Assessment and nutrition education in patients with amyotrophic lateral sclerosis. Jornal Archives of Neuro-Psychiatry, 2016; 74(11): 902-908.
BENTO DCP, et al. Clinical and epidemiological characteristics of patients with Amyotrophic Lateral Sclerosis (ALS) in central Brazil. Jornal Medicina (Ribeirão Preto), 2022; 55(3): e192620.
BRASIL. MINISTÉRIO DA SAÚDE. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Gestão e Incorporação de Tecnologias e Inovação em Saúde. Protocolo clínico e diretrizes terapêuticas da esclerose lateral amiotrófica [recurso eletrônico]. Brasília: Ministério da Saúde, 2021. 36 p. Disponível em: https://www.gov.br/conitec/pt-br/midias/protocolos/publicacoes_ms/20210713_publicacao_ela.pdf. Accessed on: nov. 24, 2024.
DODD GT. et al. The Thermogenic Effect of Leptin Is Dependent on a Distinct Population of Prolactin-Releasing Peptide Neurons in the Dorsomedial Hypothalamus. Jornal Cell Metabolism, 2014; 20(4): 639-49.
EPPS D. et al. Evaluation and Management of Dysphagia in Amyotrophic Lateral Sclerosis: A Survey of Speech-Language Pathologists’ Clinical Practice. Journal of Clinical Neuromuscular Disease, 2020; 21(3): 135-143.
FERRI A, COCCURELLO R. What is “Hyper” in the ALS Hypermetabolism? Jornal Mediators of Inflammation, 2017; 2017: 7821672.
GENTON L. et al. Nutritional state, energy intakes and energy expenditure of amyotrophic lateral sclerosis (ALS) patients. Jornal Clinical Nutrition, 2011; 30(5): 0261-5614.
HIRAYAMA T. et al. Investigation of non-motor symptoms in patients with amyotrophic lateral sclerosis. Jornal Acta Neurologica Belgica, 2023; 123(5): 1797-1804.
KUBAT GB, PICONE P. Skeletal muscle dysfunction in amyotrophic lateral sclerosis: a mitochondrial perspective and therapeutic approaches. Jornal Neurological Sciences, 2024; 45(9): 4121-4131.
KURIHARA M. et al. Factors Affecting Energy Metabolism and Prognosis in Patients with Amyotrophic Lateral Sclerosis. Jornal Annals of Nutrition and Metabolism, 2021; 77(4): 236-243.
LIMA NS. et al. One‐carbon metabolism pathway genes and their non‐association with the development of amyotrophic lateral sclerosis. Journal of Cellular Biochemistry, 2022; 123(3): 620-627.
LÓPEZ-GÓMEZ JJ. et al. Impact of Percutaneous Endoscopic Gastrostomy (PEG) on the Evolution of Disease in Patients with Amyotrophic Lateral Sclerosis (ALS). Jornal Nutrients, 2021; 13(8):2765.
MACHADO ENS. et al. Manual Clínico: Nutrição Personalizada Para os Pacientes Com ELA (Esclerose Lateral Amiotrófica). Belém: RFB Editora, 2026; 62p.
MAKSIMOVIC K. et al. Evidence of Metabolic Dysfunction in Amyotrophic Lateral Sclerosis (ALS) Patients and Animal Models. Jornal Biomolecules, 2023; 13(5): 863.
MARCHI L. et al. Manual Therapy of Dysphagia in a Patient with Amyotrophic Lateral Sclerosis: A Case Report. Jornal Medicina, 2024; 60(6): 845.
MARIANI L. et al. Progression of Oropharyngeal Dysphagia in Amyotrophic Lateral Sclerosis: A Retrospective Cohort Study. Jornal Dysphagia, 2022; 37(4): 868–878.
MOTTA S, QUAREMBA G, ARUTA L, et al. The Dysphagia Outcome and Severity Scale (DOSS) and non-instrumental swallowing measures in amyotrophic lateral sclerosis. Jornal Neurological Sciences, 2026; 47(6): 476.
OLIVEIRA MMG. et al. Terapia Nutricional em Disfagia: A Importância do Acompanhamento Nutricional. Revista Brasileira de Ciências da Saúde, 2008; 16.
PANEBIANCO M. et al. Dysphagia in neurological diseases: a literature review. Jornal Neurological Sciences, 2020; 41(11): 3067–3073.
PAPE JA, GROSE JH. The effects of diet and sex in amyotrophic lateral sclerosis. Jornal Revue Neurologique, 2020; 176(5):301–315.
PENMAN JP, THOMSON M. A review of the textured diets developed for the management of dysphagia. Journal of Human Nutrition and Dietetics, 1998; 11: 51-60.
PERRY BJ. et al. Predicting dysphagia onset in patients with ALS: the ALS dysphagia risk score. Jornal Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2022; 23(3–4): 271–278.
PROAÑO B. et al. Paraoxonase I Activity and Its Relationship with Nutrition in Amyotrophic Lateral Sclerosis. Jornal Antioxidants, 2024; 13(8): 1021.
RUGAITIENĖ M. et al. Oropharyngeal Dysphagia as the Main Expression of Amyotrophic Lateral Sclerosis. Jornal Medicina, 2022; 58(5): 647.
SCHULZ S, SCHOLZ V, LEHNERT B. Geschmacksneutrale Andickungsmittel? – Ein kompetitiver Vergleich. Jornal HNO, 2022; 70(8): 588–594.
STEELE C M. et al. The Influence of Food Texture and Liquid Consistency Modification on Swallowing Physiology and Function: A Systematic Review. Jornal Dysphagia, 2015; 30(1): 2–26.
SULISTYO A. et al. Enteral tube feeding for amyotrophic lateral sclerosis/motor neuron disease. Jornal Cochrane Database of Systematic Reviews, 2023; 8(8): CD004030.
TABOR L. et al. Defining Swallowing-Related Quality of Life Profiles in Individuals with Amyotrophic Lateral Sclerosis. Jornal Dysphagia, 2016; 31(3): 376-82.
TODA C. et al. Extracellular Signal–Regulated Kinase in the Ventromedial Hypothalamus Mediates Leptin-Induced Glucose Uptake in Red-Type Skeletal Muscle. Jornal Diabetes, 2013; 62(7): 2295-307.
VAN DP. et al. European Academy of Neurology (Guideline on the management of amyotrophic lateral sclerosis in collaboration with European Reference Network for Neuromuscular Diseases. Jornal European Journal of Neurology, 2024; 31(6): e16264
VILAR MDC. et al. Nutritional therapy in amyotrophic lateral sclerosis: protocol for a systematic review and meta-analysis. Jornal BMJ Open, 2022; 12(8): e064086.
WANG S. et al. Original Article Effect of complete high-caloric nutrition on the nutritional status and survival rate of amyotrophic lateral sclerosis patients after gastrostomy. Jornal In Am J Transl Res, 2022; 14(11):7842-7851
WANG TH. et al. Fisetin Exerts Antioxidant and Neuroprotective Effects in Multiple Mutant hSOD1 Models of Amyotrophic Lateral Sclerosis by Activating ERK. Jornal Neuroscience, 2018; 379: 152–166.
WANG Y. et al. Loss of appetite in patients with amyotrophic lateral sclerosis is associated with weight loss and anxiety/depression. Jornal Scientific Reports, 2021; 11(1): 9119.
WILLS AM. et al. Hypercaloric enteral nutrition in patients with amyotrophic lateral sclerosis: A randomised, double-blind, placebo-controlled phase 2 trial. Jornal The Lancet, 2014; 383(9934): 2065–2072.
WU XS. et al. Texture-Modified Diets, Nutritional Status and Mealtime Satisfaction: A Systematic Review. Jornal Healthcare, 2021; 9(6): 624.
XU RS, YUAN M. Considerations on the concept, definition, and diagnosis of amyotrophic lateral sclerosis. Jornal Neural Regeneration Research, 2021; 16(9): 1723, 2021.
YANG J. Genetically Tailored Sports and Nutrition Actions to Improve Health. Jornal Health Information Scienc, 2019; 1183: 279–286.
ZHU Q. et al. The safety and effectiveness of high-calorie therapy for treating amyotrophic lateral sclerosis: a systematic review and meta-analysis. Journal of Neurology, 2023; 270(10): 4729–4743.