Document Detail


Nutritional intervention in COPD: a systematic overview.
MedLine Citation:
PMID:  11171709     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We conducted a systematic overview of randomized controlled trials (RCTs) to clarify the contribution of nutritional supplementation for patients with stable COPD. METHODS: RCTs were identified from several sources, including the Cochrane Airways Group register of RCTs, a hand search of abstracts presented at international meetings, and consultation with experts. Two reviewers independently selected trials for inclusion, assessed quality, and extracted the data. RESULTS: Twenty-one reports were classified according to the type, duration of supplementation, and the presence of anabolic substances. High carbohydrate meals were associated with an increase in carbon dioxide production and a decrease in exercise capacity. Short-term crossover studies in which diets of various compositions were administered supported the notion that high carbohydrate loads increase the stress on the ventilatory system. The influence of longer-term supplementation (> 2 weeks) on weight, anthropometry, and exercise capacity varied, without there being a consistent effect. Lean body weight was only occasionally reported and health-related quality of life too rarely to be included as an outcome. The influence of recombinant human growth hormone was disappointing. Anabolic steroids increased body weight and lean body mass, but had little influence on exercise capacity. CONCLUSION: This systematic overview in patients with COPD supports the notion that those with marginal ventilatory reserve might benefit from a dietary regimen in which a high percentage of calories are supplied by fat. Although there are reports of the benefits of nutritional repletion, trials of > 2 weeks failed to show consistent benefit on body weight. Evaluating nutritional repletion is hampered by the absence of information regarding body composition, exercise, and health-related quality of life. Growth hormone has not been shown to be useful. Further studies are needed to refine the beneficial effects of anabolic steroids as adjunctive agents together with nutritional support and exercise.
Authors:
I Ferreira; D Brooks; Y Lacasse; R Goldstein
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chest     Volume:  119     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-04-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  353-63     Citation Subset:  AIM; IM    
Affiliation:
Departments of Medicine, the University of Toronto and Respiratory Medicine, West Park Hospital, Toronto, Ontario, Canada. ivoneferreira@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Anabolic Agents / therapeutic use
Body Composition
Dietary Carbohydrates / administration & dosage
Dietary Fats / administration & dosage
Exercise
Humans
Lung Diseases, Obstructive / diet therapy*
Nutritional Support*
Quality of Life
Randomized Controlled Trials as Topic
Chemical
Reg. No./Substance:
0/Anabolic Agents; 0/Dietary Carbohydrates; 0/Dietary Fats

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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