Nutritional interventions and dietary supplements in muscle diseases: a systematic review
Authors' conclusion
Evidence for nutritional interventions in muscle diseases remains limited, especially for inflammatory myopathies. The strongest support emerged for mechanistically targeted approaches: creatine with exercise, carbohydrate-rich and ketogenic diets in McArdle disease and sialic acid in GNE myopathy.
Study context
- Population
- Patients with muscle diseases (inflammatory myopathies, Duchenne muscular dystrophy, McArdle disease, GNE myopathy, critical illness myopathy)51 studies included
- Comparison
- Dietary interventions and supplements in muscle diseases
- Outcome
- Safety and efficacy of dietary interventions and supplements on muscle disease outcomes
Methodological detailsPRISMA-guided, registered on PROSPERO, multidisciplinary team
- PRISMA-guided
- Registered on PROSPERO
- Multidisciplinary team
Pooled result
As reported in the abstract
- Creatine (loading 20 g/day, maintenance 3 g/day) with exercise improved high-intensity functional performance in PM and DM over 6 months
- Creatine (2-10 g/day for 8-16 weeks) improved maximal voluntary contraction and fatigue resistance in Duchenne muscular dystrophy
- Carbohydrate-rich diets (65% CHO) reduced exercise-related symptoms in McArdle disease; high-dose creatine (150 mg/kg/day) paradoxically worsened symptoms
- Aceneuramic acid (6 g/day for 48 weeks) in GNE myopathy: dose-dependent strength improvements in 4 trials, leading to regulatory approval in Japan
- High-protein supplementation: positive trends for muscle preservation in critical illness myopathy
- Most interventions used dietary supplements rather than whole dietary approaches
Further pooled results
- Low risk of bias
- 31%
- Some concerns
- 49%
- High risk of bias
- 20%
Original publication
Nutritional interventions and dietary supplements in muscle diseases: a systematic review. Rheumatology (Oxford). Published 21 July 2026. doi:10.
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