omy .   Add itionally , ▁met abol ic ▁ab normal ities ▁resulting ▁from ▁S MA ▁imp air ▁ β - ox id ation ▁of ▁fat ty ▁ac ids ▁in ▁mus cles ▁and ▁can ▁lead ▁to ▁organ ic ▁a ci dem ia ▁and ▁consequ ent ▁mus cle ▁damage , ▁especially ▁when ▁fast ing . ▁It ▁is ▁suggested ▁that ▁people ▁with ▁S MA , ▁especially ▁those ▁with ▁more ▁severe ▁forms ▁of ▁the ▁disease , ▁reduce ▁int ake ▁of ▁fat ▁and ▁avoid ▁prolong ed ▁fast ing ▁( i . e ., ▁eat ▁more ▁frequently ▁than ▁health y ▁people ) ▁as ▁well ▁as ▁choosing ▁so fter ▁food s ▁to ▁avoid ▁asp iration . ▁During ▁an ▁ac ute ▁ill ness , ▁especially ▁in ▁children , ▁nut r itional ▁problems ▁may ▁first ▁present ▁or ▁can ▁ex ac erb ate ▁an ▁existing ▁problem ▁( example : ▁asp iration ) ▁as ▁well ▁as ▁cause ▁other ▁health ▁issues ▁such ▁as ▁electro ly te ▁and ▁blood ▁sugar ▁dist urban ces . ▁ ▁Orth op a ed ics ▁ ▁S ke let al ▁problems ▁associated ▁with ▁weak ▁mus cles ▁in ▁S MA ▁include ▁tight ▁joint s ▁with ▁limited ▁range ▁of ▁movement , ▁hip ▁dis loc ations , ▁sp inal ▁de form ity , ▁o ste open ia , ▁an ▁increase ▁risk ▁of ▁f ract ures ▁and ▁pain . ▁We ak ▁mus cles ▁that ▁normally ▁stabil ize ▁joint s ▁such ▁as ▁the ▁verte br al ▁column ▁lead ▁to ▁development ▁of ▁k y ph osis ▁and / or ▁sc ol ios is ▁and ▁joint ▁contract