Abstract：
Introduction Nutritional interventions targeting weight loss are useful for the treatment of amyotrophic lateral sclerosis (ALS). However, the changes in body composition after nutritional intervention remain unclear. We herein present a patient with ALS who experienced an increased weight and muscle mass owing to nutritional therapy and physical exercise. Case Presentation An 86-year-old man presented with dysphagia and dysarthria. The patient was diagnosed with bulbar-type ALS. As weight loss progressed, a gastrostomy was performed. After 21 months of disease onset, gastrointestinal bleeding due to a bumper ulcer led to further weight loss (from 40.2 kg to 36.8 kg). The patient experienced difficulty walking and ingesting food orally. Although the total daily energy expenditure (TDEE) was estimated to be 1,122 kcal/day, an intake of 1,500 kcal/day beyond the calculated TDEE was administered. The patient continued to perform daily voluntary exercises in addition to his usual rehabilitation. After 5 months, his weight increased from 36.8 kg to 40.4 kg. Muscle mass increased from 25.1 kg to 30.1 kg, as measured using a multifrequency bioelectrical impedance device. Muscle strength improved from 8.5/10.0 kg to 15.0/18.0 kg in grip strength and from 15.2 kPa to 20.4 kPa in tongue pressure. The patient\'s physical and swallowing functions also improved. Conclusion In patients with ALS, a decreased body weight and muscle mass due to acute disease may be improved by appropriate nutritional therapy and physical exercise.
摘要：
引言针对体重减轻的营养干预对于治疗肌萎缩侧索硬化症(ALS)是有用的。然而,营养干预后身体成分的变化仍不清楚.我们在此介绍了患有ALS的患者,其由于营养治疗和体育锻炼而经历了增加的体重和肌肉质量。病例介绍一名86岁的男子出现吞咽困难和构音障碍。患者被诊断为球型ALS。随着减肥的进展，进行了胃造口术。发病21个月后，由于保险杠溃疡引起的消化道出血导致进一步的体重减轻（从40.2kg降至36.8kg）。患者经历了行走困难和口服食物。尽管每天的总能量消耗（TDEE）估计为1,122千卡/天，超过计算的TDEE每天摄入1,500千卡。除了通常的康复外，患者还继续进行日常自愿锻炼。5个月后,他的体重从36.8公斤增加到40.4公斤。肌肉质量从25.1公斤增加到30.1公斤，使用多频生物电阻抗装置测量。肌肉力量从8.5/10.0kg提高到15.0/18.0kg，舌压从15.2kPa提高到20.4kPa。患者的身体和吞咽功能也得到改善。结论在ALS患者中,适当的营养治疗和体育锻炼可以改善因急性疾病引起的体重和肌肉质量下降。
