In general, adults with DMD should strive to have a healthy diet balanced in energy, protein, fluid, calcium, vitamin D, and other nutrients. Adults should aim to include a variety of foods from the five main food groups: fruit; vegetables; meat, poultry and alternatives; dairy and breads and cereals.
Adults are at risk of low bone mineral density as a result of not walking or standing, and sometimes due to the use of steroids. Recommended care guidelines are to take a daily multivitamin supplement with vitamin D and minerals if calorie intake is low. Additional vitamin D supplements may be required in the case of vitamin D deficiency (DMD Care Considerations Working Group, 2018). Regular monitoring of vitamin D levels is recommended.
A dietary allowance of 0.95 g/kg bodyweight per day is recommended for those aged 4–13 years; 0.85 g/kg per day for those aged 14–18 years; and 0.80 g/kg per day for those aged 19 years or older.
Recommended fluid intake in the care guidelines is based on weight, with 1500 mL + 20 mL for each kg over 20 kg (DMD Care Considerations Working Group, 2018)
Adults with chewing and swallowing difficulties may start eating softer foods to ensure they are still eating enough. For those not supplementing their eating with a feeding tube, it is important to ensure modified diets remain well balanced. A dietitian can help with this.
Although there is no evidence to suggest specific dietary intolerances of people with DMD (e.g. to dairy or gluten), individuals with DMD may have their own specific dietary intolerances. Any changes in diet should be closely monitored to identify any specific problem issues.