Supplementary Material for: Nutritional Status and Changes in Body Weight in Patients with Multiple System Atrophy

Introduction: The importance of nutritional management in neurodegenerative diseases is increasingly recognized in the clinical setting. However, few reports have examined the nutritional intake in patients with multiple system atrophy (MSA). Here, we investigated changes in daily caloric intake, body mass index (BMI) and nutritional status during the disease course of MSA. Methods: We performed a single-hospital study of 82 consecutive patients with probable MSA according to the consensus criteria. We determined daily caloric intake, the level of activities of daily living (ADL; independent, wheelchair-bound or bedridden) and BMI at the time of admission. Nutritional status was also evaluated using biochemical nutritional markers including serum albumin, total cholesterol and lymphocyte count. Results: Although daily caloric intake decreased with ADL level deterioration (p < 0.01), no significant differences were observed in BMI among ADL levels. Serum albumin also decreased with ADL deterioration (p < 0.01); however, no significant differences were observed for serum total cholesterol or lymphocyte count with respect to ADL level. Conclusion: We demonstrated that patients with advanced stage MSA may develop malnutrition in the absence of a decrease in BMI. Moreover, serum albumin level may be useful for evaluating nutritional changes in MSA patients.