Smart food: Diet and Duchenne MD

Last updated June 5, 2024, by Marisa Wexler, MS
Fact-checked by José Lopes, PhD

A well-balanced diet can help people with Duchenne muscular dystrophy (DMD) improve muscle health and quality of life while slowing down disease progression.

DMD is a genetic disorder that’s characterized by progressive muscle wasting. Most people with DMD start to experience muscle weakness in childhood, but following the right diet might help ease symptoms.

Creating a balanced diet plan

Although there isn’t a specialized DMD diet, there are a few important considerations to keep in mind when creating a diet plan for someone with DMD.

• The nutritional and dietary needs of people with DMD will change over time and should be assessed routinely. It’s generally recommended that people with DMD regularly consult with a dietitian.
• As strength is lost and people with DMD become less mobile, they generally burn fewer calories. As a result, the total amount of calories needed daily may have to be adjusted.
• Most people with DMD are treated with steroids to help slow disease progression. Long-term use can lead to side effects such as weight gain, changes in how the body processes sugar, and bone fragility. Managing the side effects of long-term corticosteroid use is a major goal of nutrition for muscular dystrophy.
• Many people with DMD experience gastrointestinal issues such as gastroesophageal reflux (also called acid reflux) and constipation. Changes in diet can be a key part of managing these problems.
• In later stages of the disease, muscle weakness in the jaw and throat can make chewing and swallowing harder. This may prevent people with DMD from getting enough nutrients and require dietary modifications such as changing the textures of foods (softer or pureed foods). Less commonly, medical interventions such as feeding tubes also may be needed.

Nutritional needs for people with DMD

The overall goal of a DMD diet is to provide the body with all the energy and nutrients it needs to function properly. There aren’t any hard-and-fast rules for what to eat when living with DMD, but there are a few general guidelines to consider:

• Muscles require protein to maintain their health and heal. While there aren’t DMD-specific guidelines, it’s typically suggested people with DMD ensure they are eating enough protein.
• DMD also can affect muscles of the heart. To minimize the risk of heart issues, it’s recommended to limit foods that have been linked with a higher risk of cardiac problems, such as saturated fats or high amounts of salt.
• Drinking enough water for hydration and eating plenty of fiber-rich foods can help reduce the likelihood of having digestive issues like constipation.
• Bone health may be an issue for people with DMD, especially when taking corticosteroids for long periods of time. So it’s important to get enough calcium and vitamin D, which are essential nutrients for bone health.

Nutritional assessment

Every person’s nutritional needs are a little different and change over time. To help people with DMD and their families maintain a healthy eating plan, it’s recommended they should consult with a nutritionist once every six months.

During these consultations, the nutritionist can provide guidance for a personalized nutrition plan based on what the person likes to eat and suggest any dietary changes that might be beneficial.

A nutritionist also usually tracks a person’s weight and height, so that any unintentional weight gain or loss can be addressed. Supplements may sometimes be recommended if the nutritionist believes there may be an issue with getting enough of certain nutrients.

Nutritionists can give advice about the process of eating and any digestive complaints that may make it more complicated. If there are any issues with chewing or swallowing, nutritionists can be a great source of advice for how to address them.

Foods to eat

Although there aren’t any special foods for muscular dystrophy, a healthy diet for someone with DMD will typically prioritize foods that are dense with fiber, protein, and minerals, without too much excess sugar, fat, or salt. Some examples of foods to prioritize include:

• whole grains, such as whole-grain bread or brown rice
• low-fat protein sources, such as lean meats (e.g., chicken, turkey), fish, and tofu
• sources of healthy fats, such as olive oil, nuts, or avocado
• lots of fruits and vegetables, such as oranges, strawberries, carrots, and tomatoes
• good sources of calcium, such as low-fat dairy products and leafy greens like spinach and kale.

Foods to avoid

It’s generally recommended that people with DMD try to avoid eating foods that have excess calories and fats, which can increase the risk of metabolic problems and heart issues.

General recommendations for foods people with muscular dystrophy should avoid include:

• processed, fried, or fast foods
• sugary foods such as sweets and candies
• sugary drinks such as soda and certain fruit drinks
• foods with a high salt content, such as chips and fries.

As people with DMD frequently have a slow-moving digestive system, certain types of carbohydrates can be harder to process. These foods can cause issues such as flatulence, nausea, discomfort, abdominal pain, bloating, or feeling unusually full after eating.

You may want to try to avoid or eat less of certain foods such as:

• dairy-based milk, soft cheese, yogurt, and ice cream
• wheat-based products such as bread, pasta, and cereals
• certain legumes such as beans, chickpeas, and lentils
• certain vegetables including artichokes, asparagus, onions, and garlic
• some fruits including apples, cherries, pears, peaches, mangoes, and watermelon
• certain sweeteners such as honey, corn syrup, molasses, and agave syrup.

Other tips

There are other ways to help with eating when living with DMD. These include:

• scheduling meal and snack times, which can make it easier to not over- or under-eat
• making physical adaptations that facilitate eating, such as using an extra-long straw to reach drinks or eating at a counter-height table for resting elbows on it
• eating small amounts frequently, rather than just a few large meals, to help make mealtimes more manageable and reduce acid reflux
• eating softer foods (mashed, pureed, or cut up into small pieces) or swallowing a sip of water with each bite of food, which may particularly help with difficulty chewing and swallowing
• drinking a glass of water after every meal, which can help rinse the throat and ensure that all food reaches the stomach.

Muscular Dystrophy News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.