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A randomized clinical trial investigating the efficacy of targeted nutrition as adjunct to exercise training in COPD.
J Cachexia Sarcopenia Muscle 2017; 8(5):748-758JC

Abstract

BACKGROUND

Evidence regarding the efficacy of nutritional supplementation to enhance exercise training responses in COPD patients with low muscle mass is limited. The objective was to study if nutritional supplementation targeting muscle derangements enhances outcome of exercise training in COPD patients with low muscle mass.

METHODS

Eighty-one COPD patients with low muscle mass, admitted to out-patient pulmonary rehabilitation, randomly received oral nutritional supplementation, enriched with leucine, vitamin D, and omega-3 fatty acids (NUTRITION) or PLACEBO as adjunct to 4 months supervised high intensity exercise training.

RESULTS

The study population (51% males, aged 43-80) showed moderate airflow limitation, low diffusion capacity, normal protein intake, low plasma vitamin D, and docosahexaenoic acid. Intention-to-treat analysis revealed significant differences after 4 months favouring NUTRITION for body mass (mean difference ± SEM) (+1.5 ± 0.6 kg, P = 0.01), plasma vitamin D (+24%, P = 0.004), eicosapentaenoic acid (+91%,P < 0.001), docosahexaenoic acid (+31%, P < 0.001), and steps/day (+24%, P = 0.048). After 4 months, both groups improved skeletal muscle mass (+0.4 ± 0.1 kg, P < 0.001), quadriceps muscle strength (+12.3 ± 2.3 Nm,P < 0.001), and cycle endurance time (+191.4 ± 34.3 s, P < 0.001). Inspiratory muscle strength only improved in NUTRITION (+0.5 ± 0.1 kPa, P = 0.001) and steps/day declined in PLACEBO (-18%,P = 0.005).

CONCLUSIONS

High intensity exercise training is effective in improving lower limb muscle strength and exercise performance in COPD patients with low muscle mass and moderate airflow obstruction. Specific nutritional supplementation had additional effects on nutritional status, inspiratory muscle strength, and physical activity compared with placebo.

Authors+Show Affiliations

Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.Department of Research and Education, CIRO+ Horn, Haelen, The Netherlands.Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands. Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, The Netherlands.Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands. Department of Research and Education, CIRO+ Horn, Haelen, The Netherlands.Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands. On behalf of the CIRO network.Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28608438

Citation

van de Bool, Coby, et al. "A Randomized Clinical Trial Investigating the Efficacy of Targeted Nutrition as Adjunct to Exercise Training in COPD." Journal of Cachexia, Sarcopenia and Muscle, vol. 8, no. 5, 2017, pp. 748-758.
van de Bool C, Rutten EPA, van Helvoort A, et al. A randomized clinical trial investigating the efficacy of targeted nutrition as adjunct to exercise training in COPD. J Cachexia Sarcopenia Muscle. 2017;8(5):748-758.
van de Bool, C., Rutten, E. P. A., van Helvoort, A., Franssen, F. M. E., Wouters, E. F. M., & Schols, A. M. W. J. (2017). A randomized clinical trial investigating the efficacy of targeted nutrition as adjunct to exercise training in COPD. Journal of Cachexia, Sarcopenia and Muscle, 8(5), pp. 748-758. doi:10.1002/jcsm.12219.
van de Bool C, et al. A Randomized Clinical Trial Investigating the Efficacy of Targeted Nutrition as Adjunct to Exercise Training in COPD. J Cachexia Sarcopenia Muscle. 2017;8(5):748-758. PubMed PMID: 28608438.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized clinical trial investigating the efficacy of targeted nutrition as adjunct to exercise training in COPD. AU - van de Bool,Coby, AU - Rutten,Erica P A, AU - van Helvoort,Ardy, AU - Franssen,Frits M E, AU - Wouters,Emiel F M, AU - Schols,Annemie M W J, Y1 - 2017/06/12/ PY - 2017/02/24/received PY - 2017/04/21/revised PY - 2017/05/04/accepted PY - 2017/6/14/pubmed PY - 2018/6/9/medline PY - 2017/6/14/entrez KW - Emphysema KW - Muscle function KW - Nutrient supplementation KW - Physical activity KW - Pulmonary rehabilitation SP - 748 EP - 758 JF - Journal of cachexia, sarcopenia and muscle JO - J Cachexia Sarcopenia Muscle VL - 8 IS - 5 N2 - BACKGROUND: Evidence regarding the efficacy of nutritional supplementation to enhance exercise training responses in COPD patients with low muscle mass is limited. The objective was to study if nutritional supplementation targeting muscle derangements enhances outcome of exercise training in COPD patients with low muscle mass. METHODS: Eighty-one COPD patients with low muscle mass, admitted to out-patient pulmonary rehabilitation, randomly received oral nutritional supplementation, enriched with leucine, vitamin D, and omega-3 fatty acids (NUTRITION) or PLACEBO as adjunct to 4 months supervised high intensity exercise training. RESULTS: The study population (51% males, aged 43-80) showed moderate airflow limitation, low diffusion capacity, normal protein intake, low plasma vitamin D, and docosahexaenoic acid. Intention-to-treat analysis revealed significant differences after 4 months favouring NUTRITION for body mass (mean difference ± SEM) (+1.5 ± 0.6 kg, P = 0.01), plasma vitamin D (+24%, P = 0.004), eicosapentaenoic acid (+91%,P < 0.001), docosahexaenoic acid (+31%, P < 0.001), and steps/day (+24%, P = 0.048). After 4 months, both groups improved skeletal muscle mass (+0.4 ± 0.1 kg, P < 0.001), quadriceps muscle strength (+12.3 ± 2.3 Nm,P < 0.001), and cycle endurance time (+191.4 ± 34.3 s, P < 0.001). Inspiratory muscle strength only improved in NUTRITION (+0.5 ± 0.1 kPa, P = 0.001) and steps/day declined in PLACEBO (-18%,P = 0.005). CONCLUSIONS: High intensity exercise training is effective in improving lower limb muscle strength and exercise performance in COPD patients with low muscle mass and moderate airflow obstruction. Specific nutritional supplementation had additional effects on nutritional status, inspiratory muscle strength, and physical activity compared with placebo. SN - 2190-6009 UR - https://www.unboundmedicine.com/medline/citation/28608438/A_randomized_clinical_trial_investigating_the_efficacy_of_targeted_nutrition_as_adjunct_to_exercise_training_in_COPD_ L2 - https://dx.doi.org/10.1002/jcsm.12219 DB - PRIME DP - Unbound Medicine ER -