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

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.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Faculty of Medicine, Institute of Human Nutrition, Southampton General Hospital, University of Southampton, Southampton, UK.

    ,

    Source

    Respirology (Carlton, Vic.) 18:4 2013 May pg 616-29

    MeSH

    Humans
    Lung
    Malnutrition
    Nutritional Support
    Pulmonary Disease, Chronic Obstructive
    Quality of Life
    Randomized Controlled Trials as Topic
    Respiratory Function Tests
    Treatment Outcome

    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 -