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Nutritional support and functional capacity in chronic obstructive pulmonary disease: a systematic review and meta-analysis.
Respirology 2013; 18(4):616-29R

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 randomized, controlled trials (RCT) aimed to clarify the effectiveness of nutritional support in improving functional outcomes in COPD. A systematic review identified 12 RCT (n = 448) in stable COPD patients investigating the effects of nutritional support (dietary advice (1 RCT), oral nutritional supplements (10 RCT), enteral tube feeding (1 RCT)) versus control on functional outcomes. Meta-analysis of the changes induced by intervention found that while respiratory function (forced expiratory volume in 1 s, lung capacity, blood gases) was unresponsive to nutritional support, both inspiratory and expiratory muscle strength (maximal inspiratory mouth pressure +3.86 standard error (SE) 1.89 cm H2 O, P = 0.041; maximal expiratory mouth pressure +11.85 SE 5.54 cm H2 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.

Authors+Show Affiliations

Faculty of Medicine, Institute of Human Nutrition, Southampton General Hospital, University of Southampton, Southampton, UK.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

23432923

Citation

Collins, Peter F., et al. "Nutritional Support and Functional Capacity in Chronic Obstructive Pulmonary Disease: a Systematic Review and Meta-analysis." Respirology (Carlton, Vic.), vol. 18, no. 4, 2013, pp. 616-29.
Collins PF, Elia M, Stratton RJ. Nutritional support and functional capacity in chronic obstructive pulmonary disease: a systematic review and meta-analysis. Respirology. 2013;18(4):616-29.
Collins, P. F., Elia, M., & Stratton, R. J. (2013). Nutritional support and functional capacity in chronic obstructive pulmonary disease: a systematic review and meta-analysis. Respirology (Carlton, Vic.), 18(4), pp. 616-29. doi:10.1111/resp.12070.
Collins PF, Elia M, Stratton RJ. Nutritional Support and Functional Capacity in Chronic Obstructive Pulmonary Disease: a Systematic Review and Meta-analysis. Respirology. 2013;18(4):616-29. PubMed PMID: 23432923.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nutritional support and functional capacity in chronic obstructive pulmonary disease: a systematic review and meta-analysis. AU - Collins,Peter F, AU - Elia,Marinos, AU - Stratton,Rebecca J, PY - 2012/11/15/received PY - 2013/01/09/revised PY - 2013/02/04/revised PY - 2013/02/07/accepted PY - 2013/2/26/entrez PY - 2013/2/26/pubmed PY - 2013/12/16/medline SP - 616 EP - 29 JF - Respirology (Carlton, Vic.) JO - Respirology VL - 18 IS - 4 N2 - 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 randomized, controlled trials (RCT) aimed to clarify the effectiveness of nutritional support in improving functional outcomes in COPD. A systematic review identified 12 RCT (n = 448) in stable COPD patients investigating the effects of nutritional support (dietary advice (1 RCT), oral nutritional supplements (10 RCT), enteral tube feeding (1 RCT)) versus control on functional outcomes. Meta-analysis of the changes induced by intervention found that while respiratory function (forced expiratory volume in 1 s, lung capacity, blood gases) was unresponsive to nutritional support, both inspiratory and expiratory muscle strength (maximal inspiratory mouth pressure +3.86 standard error (SE) 1.89 cm H2 O, P = 0.041; maximal expiratory mouth pressure +11.85 SE 5.54 cm H2 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. SN - 1440-1843 UR - https://www.unboundmedicine.com/medline/citation/23432923/full_citation L2 - https://doi.org/10.1111/resp.12070 DB - PRIME DP - Unbound Medicine ER -