Chest
Clinical InvestigationsCOPD/AsthmaNutritional Intervention in COPD: A Systematic Overview
Section snippets
Search Strategy
The following strategies were used to uncover relevantpublications from the English-language medical literature. RCTs wereidentified with assistance from the Cochrane Airways Group registry of, RCTs in COPD. We also searched MEDLINE (National Library of Medicinefrom 1966 to 1999), EMBASE, and CINAHL (Cumulated Index to Nursing and, Allied Health from 1982 to 1999) for original articles published in alllanguages. The following terms were used to uncover trials related tonutritional support in
Results
A total of 272 abstracts were identified. After the two primaryreviewers assessed the abstracts, the number was reduced to 55 reports(κ, 0.89; 95% confidence interval, 0.82 to 0.96) on nutrition and, COPD. When reviewed in detail, 21 reports were included. Both reviewersagreed on all except four reports (κ, 0.94; 95% confidence interval, 0.85 to 1.0), which were therefore sent to a third reviewer (Y.L.) forarbitration. Reasons for excluding studies included the following: uncontrolled study,815
Discussion
How nutrients influence ventilation and metabolism at rest andduring low levels of activity among patients with COPD could assist inour understanding of how to minimize dyspnea on exertion and maximizeenergy reserves. Underweight patients with COPD are more dyspneic thannormal-weight patients, and although the origins of dyspnea in COPD aremultifactorial, changes in diffusing capacity as well as in respiratorymuscle strength may contribute to its intensity.69Patients with COPD clearly have a
Conclusion
Nutritional depletion in COPD is common and has a negative impacton respiratory as well as skeletal muscle function, contributing to themorbidity and mortality of this condition.123456789 It istherefore valuable to include management strategies that increaseenergy balance in order to increase weight and FFM. Although mostpatients tolerate CHO loads, diet content and volume per meal may haveto be modified for patients with severe dyspnea or hypercapnia. Although short-term studies of nutritional
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Rehabilitation of the Patient with Respiratory Dysfunction
2018, Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and RehabilitationNutritional Status in Aging and Lung Disease
2016, Molecular Basis of Nutrition and Aging: A Volume in the Molecular Nutrition SeriesEffect of hospital use of oral nutritional supplementation on length of stay, hospital cost, and 30-day readmissions among medicare patients with COPD
2015, ChestCitation Excerpt :Nevertheless, existing evidence for the benefits of ONS in COPD is mixed. Until recently, meta-analyses and systematic reviews of the literature on nutritional supplementation found little evidence of benefit to patients with COPD.50,51 A systematic review of randomized control trials of nutrition supplementation in COPD by Ferreira et al,28 however, suggests increasing evidence that ONS use is associated with improved outcomes in patients with COPD, although their findings are mixed.
Pulmonary Rehabilitation
2015, Murray and Nadel's Textbook of Respiratory Medicine: Volume 1,2, Sixth EditionTo whom and how to prescribe oral nutritional supplements in hospital and in community?
2013, Nutrition Clinique et MetabolismeDietary habits of firstly admitted Spanish COPD patients
2009, Respiratory MedicineCitation Excerpt :Since stratification according to severity stages did not reveal any difference in dietary habits, it is conceivable that the degree of non-response bias, if present, was very low such that the study provided a valid description of COPD patients' dietary habits. In conclusion, this is the first comprehensive study so far describing in detail dietary habits in Spanish COPD patients and reports mostly adequate dietary habits and adequate daily intake of the main food groups and macro- and micro-nutrients according to local recommendations, with the key exception of vitamin D. Its relevance relies mainly on the unknown but potentially relevant role of specific nutrients (i.e., antioxidants and omega-3 fatty acid) in the prognosis of COPD,4–7 and the accepted strong and independent association between nutritional status and COPD progression.12 Research in other geographic areas, with longitudinal follow up to assess changes in dietary intakes and disease progression, could be useful to provide a more global scenario of dietary habits of COPD patients, and provide insights relevant for the design of specific interventions in these patients.
This study was made possible due funding from FAPESP–Fundacao de, Amparo a pesquisa do Estado de Sao Paulo, Brazil (IMF), Canadian Lung Association/MRC/Glaxo Welcome Postdoctoral fellowship (DB), and West Park Hospital Foundation.