Elsevier

Respiratory Medicine

Volume 104, Issue 12, December 2010, Pages 1883-1889
Respiratory Medicine

Effects of nutritional supplementation combined with low-intensity exercise in malnourished patients with COPD

https://doi.org/10.1016/j.rmed.2010.05.008Get rights and content
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Summary

Study objectives

The first aim of this study was to investigate the effects of nutritional supplementation combined with low-intensity exercise on body components, exercise tolerance, and health-related quality of life (HRQOL) in malnourished patients with COPD. The second aim of this study was to examine the degree of systemic inflammation and the actual changes in levels of systemic CRP, TNFα, IL-6 and IL-8 actual changes after a combination of nutritional supplementation and low-intensity exercise in these patients.

Design

A prospective randomized trial.

Patients

Thirty-two moderate to severe, clinically stable malnourished COPD patients.

Methods

Patients were randomly divided into a nutritional supplementation with low-intensity exercise group and a control group. Lung function, maximum inspiratory and expiratory muscle force, the Chronic Respiratory Disease Questionnaire (CRQ), the 6-min walking distance (6MWD), and the Borg scale were measured at baseline and were re-assessed at 3 months after intervention. The degree of systemic inflammation and the changes in levels of systemic CRP, TNFα, IL-6 and IL-8 were assessed before and after a combination nutritional supplementation with low-intensity exercise.

Results

Body weight and FFM increased significantly after 12 weeks of nutritional supplementation therapy in patients with COPD. The dietary intake energy increased and the REE:REEpred ratio decreased significantly in the nutrition with low-intensity exercise group. PImax, Quadriceps muscle force and the 6-min walking distance (6MWD) increased significantly from baseline through week 12. Health status, as assessed by CRQ, improved in the domains of dyspnea and total sores significantly in the nutrition with low-intensity exercise group after intervention. In this group, hsCRP, IL-6, IL-8, and TNFα, decreased significantly after intervention compared with the control group.

Conclusions

The combination of nutritional supplementation with low-intensity exercise training was successful in increasing weight and energy intake as well as exercise capacity and health-related QOL in our patients. Moreover, REE and major inflammatory cytokines decreased significantly after nutritional supplementation with low-intensity exercise training. The present study results suggest a potential role for the combination of nutritional supplementation and low-intensity exercise in the management of malnourished patients with COPD.

Keywords

COPD
Nutritional support
Omega-3 PUFA-rich diet
Low-intensity exercise training
Pulmonary rehabilitation

Abbreviations

ANOVA
analysis of variance
CRQ
Chronic Respiratory Disease Questionnaire
GOLD
global initiative for chronic obstructive lung disease
HRQOL
health-related quality of life
6MWD
6-min walking distance
MRC
Medical Research Council
PR
pulmonary rehabilitation

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