Department of Physiology, College of Medicine, University of the Philippines Manila, Manila, Philippines; Department of Epidemiology and Biostatistics, College of Public Health, University of the Philippines Manila, Manila, Philippines.
Department of Neurosurgery, McGill University, Montreal, Quebec, Canada.
Rev Neurol (Paris). 2023 Nov;179(9):1008-1019. doi: 10.1016/j.neurol.2023.01.731. Epub 2023 Aug 7.
Several randomized clinical trials were done to determine whether supplementation with a high caloric diet, either through carbohydrate or lipid supplementation, is safe, tolerable and improves survival. However, most of these trials are small and the results are conflicting.
Randomized prospective trials utilizing high caloric supplementation among patients with amyotrophic lateral sclerosis (ALS) were searched using the terms [("amyotrophic lateral sclerosis" or "motor neuron disease" or "ALS" or "MND") and ("high calorie" or "high fat" or "high protein" or "high carbohydrate" or "supplementation")] in Medline, Cochrane, Embase, Scopus, Prospero and Herdin by two independent neurologists. Journal articles deemed relevant were assessed for eligibility.
There were 57 articles obtained from databases, 49 of which were excluded. Four articles were further excluded since all of them had different interventions. Overall, there were 311 ALS patients included in the study, 176 of them were from the intervention group while 135 were used as controls. Overall, high caloric supplementation in ALS was deemed safe and tolerable, and also when adverse events, tolerability and mortality are combined using meta-analysis. Although in most publications the efficacy of giving high caloric supplementation has been generally beneficial, some of the outcome parameters are not statistically different from controls when studies are combined using meta-analysis.
Current evidence suggests that high calorie supplementation is generally safe and tolerable for patients with ALS. However, it has not been shown to be efficacious in improving weight and functional disability.
有几项随机临床试验旨在确定通过碳水化合物或脂质补充高卡路里饮食是否安全、耐受并能提高生存率。然而，这些试验大多规模较小，结果相互矛盾。
通过两位独立的神经科医生在 Medline、Cochrane、Embase、Scopus、Prospero 和 Herdin 中使用术语 [（“肌萎缩侧索硬化症（ALS）”或“运动神经元病”或“ALS”或“MND”）和（“高热量”或“高脂肪”或“高蛋白”或“高碳水化合物”或“补充”）] 搜索接受 ALS 患者高卡路里补充的随机前瞻性试验。认为相关的期刊文章将进行评估以确定其是否符合入选标准。
从数据库中获得了 57 篇文章，其中 49 篇被排除。由于所有文章都有不同的干预措施，又有 4 篇文章被进一步排除。总的来说，有 311 名 ALS 患者纳入研究，其中 176 名来自干预组，135 名作为对照组。总的来说，高卡路里补充在 ALS 中被认为是安全且耐受的，而且当使用荟萃分析综合不良事件、耐受性和死亡率时也是如此。尽管在大多数出版物中，给予高卡路里补充的疗效通常是有益的，但当使用荟萃分析综合研究时，一些结果参数与对照组没有统计学差异。
目前的证据表明，高卡路里补充对于 ALS 患者通常是安全且耐受的。然而，它并没有显示出在改善体重和功能障碍方面的疗效。
