Nutritional status is linked to muscle strength and perceived function in adults with muscular dystrophy: evidence for targeted nutritional interventions

Muscular dystrophy (MD) encompasses inherited myopathies characterised by progressive skeletal and cardiac muscle degeneration, chronic inflammation and metabolic dysfunction. While emerging therapies show pre-clinical promise, few reach clinical translation, highlighting the need for supportive interventions to improve function and quality of life (QoL). Nutritional strategies may offer such benefits; however, limited data exist characterising diet in MD or associations with functional outcomes. This study assessed diet, nutritional status and associations with muscle strength, function and QoL in MD adults. Adults with MD (<i>n</i> 39; FSHD = 8, LGMD = 9 and Other = 22) and matched Controls (<i>n</i> 17) completed two 3-d food records, strength/function assessments and QoL questionnaires. Between-group differences were analysed using <i>t</i> tests or Mann-Whitney <i>U</i> and associations using Pearson's r or Spearman's Rho (<i>P</i> < 0·05). Compared with controls, individuals with MD consumed more energy (89 % <i>v</i>. 35 % exceeded RDI, <i>P</i> = 0·023), but less carbohydrate (-21 %, <i>P</i> = 0·013), sugar (-31 %, <i>P</i> = 0·004), protein (-15 %), BCAA (-31 %, <i>P</i> = 0·049) and vitamin C (-43 %, <i>P</i> = 0·009). MD participants demonstrated reduced muscle thickness, strength, function and reported lower QoL and physical capacity (all <i>P</i> < 0·05). Protein intake positively correlated with strength and function (<i>P</i> < 0·05); branched-chain amino acids intake was associated with lean mass (<i>r</i> = 0·442, <i>P</i> = 0·02) and strength (<i>r</i> = 0·372, <i>P</i> = 0·036). Findings indicate adults with MD consume excess energy but insufficient protein and micronutrients, supporting the need for adult MD-specific dietary guidance to optimise musculoskeletal health and QoL.