Evidence map›Paper›PMID 41177667›Full record

ArticleNutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition2026

Medical nutrition therapy for ALS: Dietitians' approaches to diagnosing malnutrition, facilitating feeding tube discussions, and mitigating refeeding syndrome risk.

Stephanie Dobak, Keith Pearson, Rebekah McGuire, Amy C Ellis

Abstract read
In one paragraph

Article in Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Stephanie DobakJefferson Weinberg ALS Center, Philadelphia, Pennsylvania, USA.
Keith PearsonDepartment of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
Rebekah McGuireDepartment of Human Nutrition, The University of Alabama, Tuscaloosa, Alabama, USA.
Amy C EllisDepartment of Human Nutrition, The University of Alabama, Tuscaloosa, Alabama, USA.

Funding

This research was supported by a quality of care research award from the ALS Association.
6 · The paper itself

Abstract

backgroundPersons living with amyotrophic lateral sclerosis (PALS) are at high risk for malnutrition because of disease-related factors such as dysphagia, self-feeding difficulty, and hypermetabolism. Nutrition interventions, including enteral nutrition (EN) initiation after gastrostomy tube (G-tube) placement, are integral to care but can introduce challenges, such as refeeding syndrome. This qualitative analysis explores how registered dietitians (RDs) at US-based outpatient amyotrophic lateral sclerosis (ALS) clinics assess malnutrition, facilitate discussions around G-tube placement, and mitigate refeeding syndrome risk.

methodsSix focus groups were conducted with 22 RDs from US ALS clinics. Audio files were transcribed verbatim, and data analyzed by deductive thematic analysis.

resultsRDs reported widespread use of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition indicators for diagnosing malnutrition, with some using the Global Leadership Initiative on Malnutrition criteria. However, RDs described limitations in using these tools for PALS, particularly in differentiating disease-related from malnutrition-related muscle loss. When discussing G-tube placement, RDs described themselves as key informants in multidisciplinary teams, with timing of counseling typically based on symptoms and clinical progression. For refeeding syndrome, most clinics lacked formal protocols, although RDs used preventative practices, including slow initiation and advancement of EN and proactive communication with the care team.

conclusionsALS RDs play a critical and multifaceted role in managing nutrition-related ALS care. There is a need for ALS-specific malnutrition criteria and standard protocols to manage refeeding syndrome in the outpatient setting. RDs' involvement in G-tube discussions underscores their role in supporting patients in medical decision-making.

Indexed as

Amyotrophic Lateral SclerosisEnteral NutritionMalnutritionNutritionistsNutrition TherapyRefeeding SyndromeFemaleFocus GroupsGastrostomyHumansMaleMiddle AgedNutrition AssessmentQualitative ResearchUnited Statesenteral nutritionnutrition assessmentoutcomes research/quality

Identifiers

PMID41177667
PMCPMC12982618

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.