Nutritional support and functional capacity in chronic obstructive pulmonary disease: A systematic review and meta-analysis

Collins, Peter F., Elia, Marinos, & Stratton, Rebecca J. (2013) Nutritional support and functional capacity in chronic obstructive pulmonary disease: A systematic review and meta-analysis. Respirology, 18(4), pp. 616-629.

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Abstract

Currently there is confusion about the value of using nutritional support to treat malnutrition and improve functional outcomes in chronic obstructive pulmonary disease (COPD). This systematic review and meta-analysis of randomised controlled trials (RCTs) aimed to clarify the effectiveness of nutritional support in improving functional outcomes in COPD. A systematic review identified 12 RCTs (n = 448) in stable COPD patients investigating the effects of nutritional support [dietary advice (1 RCT), oral nutritional supplements (ONS; 10 RCTs), enteral tube feeding (1 RCT)] versus control on functional outcomes. Meta-analysis of the changes induced by intervention found that whilst respiratory function (FEV(1,) lung capacity, blood gases) was unresponsive to nutritional support, both inspiratory and expiratory muscle strength (PI max +3.86 SE 1.89 cm H(2) O, P = 0.041; PE max +11.85 SE 5.54 cm H(2) O, P = 0.032) and handgrip strength (+1.35 SE 0.69 kg, P = 0.05) were significantly improved, and associated with weight gains of ≥ 2 kg. Nutritional support produced significant improvements in quality of life in some trials, although meta-analysis was not possible. It also led to improved exercise performance and enhancement of exercise rehabilitation programmes. This systematic review and meta-analysis demonstrates that nutritional support in COPD results in significant improvements in a number of clinically relevant functional outcomes, complementing a previous review showing improvements in nutritional intake and weight.

Impact and interest:

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ID Code: 58275
Item Type: Journal Article
Refereed: Yes
Keywords: Nutrition support, COPD, Meta-analysis, Functional Capacity, Respiratory
DOI: 10.1111/resp.12070
ISSN: 1323-7799
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) > CARDIOVASCULAR MEDICINE AND HAEMATOLOGY (110200) > Respiratory Diseases (110203)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NUTRITION AND DIETETICS (111100)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Exercise & Nutrition Sciences
Copyright Owner: Copyright 2013 The Authors. Respirology copyright 2013 Asian Pacific Society of Respirology
Deposited On: 18 Mar 2013 03:07
Last Modified: 26 Oct 2015 03:03

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