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Nutritional modulation as part of the integrated management of chronic obstructive pulmonary disease.

Abstract

Weight loss is a frequent complication in patients with chronic obstructive pulmonary disease (COPD) and is a determining factor for functional capacity, health status and mortality. Weight loss in COPD is a consequence of an inbalance between increased energy requirements and dietary intake. Both metabolic and mechanical inefficiency may contribute to elevated energy expenditure during physical activity, while systemic inflammation has been associated with hypermetabolism at rest. Disease-specific symptoms and systemic inflammation may impair appetite and dietary intake. Altered intermediary metabolism may cause disproportionate wasting of fat-free mass in some patients. A combination of nutritional support and exercise as an anabolic stimulus appears to be the best approach to obtaining marked functional improvement. Patients responding to this treatment even demonstrated a decreased mortality. The effectiveness of anti-catabolic modulation requires further investigation.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Department of Respiratory Medicine, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands. a.schols@pul.unimaas.nl

    Source

    MeSH

    Anabolic Agents
    Body Composition
    Cachexia
    Dietary Supplements
    Eating
    Energy Metabolism
    Exercise
    Humans
    Inflammation
    Nutrition Assessment
    Nutritional Support
    Pulmonary Disease, Chronic Obstructive
    Weight Loss

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    15018476

    Citation

    Schols, Annemie. "Nutritional Modulation as Part of the Integrated Management of Chronic Obstructive Pulmonary Disease." The Proceedings of the Nutrition Society, vol. 62, no. 4, 2003, pp. 783-91.
    Schols A. Nutritional modulation as part of the integrated management of chronic obstructive pulmonary disease. Proc Nutr Soc. 2003;62(4):783-91.
    Schols, A. (2003). Nutritional modulation as part of the integrated management of chronic obstructive pulmonary disease. The Proceedings of the Nutrition Society, 62(4), pp. 783-91.
    Schols A. Nutritional Modulation as Part of the Integrated Management of Chronic Obstructive Pulmonary Disease. Proc Nutr Soc. 2003;62(4):783-91. PubMed PMID: 15018476.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Nutritional modulation as part of the integrated management of chronic obstructive pulmonary disease. A1 - Schols,Annemie, PY - 2004/3/17/pubmed PY - 2004/7/23/medline PY - 2004/3/17/entrez SP - 783 EP - 91 JF - The Proceedings of the Nutrition Society JO - Proc Nutr Soc VL - 62 IS - 4 N2 - Weight loss is a frequent complication in patients with chronic obstructive pulmonary disease (COPD) and is a determining factor for functional capacity, health status and mortality. Weight loss in COPD is a consequence of an inbalance between increased energy requirements and dietary intake. Both metabolic and mechanical inefficiency may contribute to elevated energy expenditure during physical activity, while systemic inflammation has been associated with hypermetabolism at rest. Disease-specific symptoms and systemic inflammation may impair appetite and dietary intake. Altered intermediary metabolism may cause disproportionate wasting of fat-free mass in some patients. A combination of nutritional support and exercise as an anabolic stimulus appears to be the best approach to obtaining marked functional improvement. Patients responding to this treatment even demonstrated a decreased mortality. The effectiveness of anti-catabolic modulation requires further investigation. SN - 0029-6651 UR - https://www.unboundmedicine.com/medline/citation/15018476/full_citation L2 - https://www.cambridge.org/core/product/identifier/S0029665103001034/type/journal_article DB - PRIME DP - Unbound Medicine ER -