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Nutritional support in chronic obstructive pulmonary disease: a systematic review and meta-analysis

Collins, Peter F., Stratton, Rebecca J., & Elia, Marinos (2012) Nutritional support in chronic obstructive pulmonary disease: a systematic review and meta-analysis. American Journal of Clinical Nutrition, 95(6), pp. 1385-1395.

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Abstract

BACKGROUND: The efficacy of nutritional support in the management of malnutrition in chronic obstructive pulmonary disease (COPD) is controversial. Previous meta-analyses, based on only cross-sectional analysis at the end of intervention trials, found no evidence of improved outcomes.

OBJECTIVE: The objective was to conduct a meta-analysis of randomized controlled trials (RCTs) to clarify the efficacy of nutritional support in improving intake, anthropometric measures, and grip strength in stable COPD.

DESIGN: Literature databases were searched to identify RCTs comparing nutritional support with controls in stable COPD.

RESULTS: Thirteen RCTs (n = 439) of nutritional support [dietary advice (1 RCT), oral nutritional supplements (ONS; 11 RCTs), and enteral tube feeding (1 RCT)] with a control comparison were identified. An analysis of the changes induced by nutritional support and those obtained only at the end of the intervention showed significantly greater increases in mean total protein and energy intakes with nutritional support of 14.8 g and 236 kcal daily. Meta-analyses also showed greater mean (±SE) improvements in favor of nutritional support for body weight (1.94 ± 0.26 kg, P < 0.001; 11 studies, n = 308) and grip strength (5.3%, P < 0.050; 4 studies, n = 156), which was not shown by ANOVA at the end of the intervention, largely because of bias associated with baseline imbalance between groups.

CONCLUSION: This systematic review and meta-analysis showed that nutritional support, mainly in the form of ONS, improves total intake, anthropometric measures, and grip strength in COPD. These results contrast with the results of previous analyses that were based on only cross-sectional measures at the end of intervention trials.

Impact and interest:

18 citations in Scopus
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14 citations in Web of Science®

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ID Code: 51629
Item Type: Journal Article
Keywords: Nutrition support, chronic obstructive pulmonary disease, meta-analysis, COPD, malnutrition
DOI: 10.3945/ajcn.111.023499
ISSN: 1938-3207
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NUTRITION AND DIETETICS (111100)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NUTRITION AND DIETETICS (111100) > Clinical and Sports Nutrition (111101)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Schools > School of Exercise & Nutrition Sciences
Copyright Owner: Copyright 2012 American Society for Nutrition
Deposited On: 17 Jul 2012 08:14
Last Modified: 18 Jul 2012 17:13

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