Nutritional status, dietary energy intake and the risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD)

Hallin, Runa; Koivisto-Hursti, Ulla-Kaisa; Lindberg, Eva; Janson, Christer

doi:10.1016/j.rmed.2005.05.020

Cited by 93 publications

(81 citation statements)

References 35 publications

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“…Numerous studies, however, reported on the association between nutritional status and healthcare utilisation, focusing on patients hospitalised for a COPD exacerbation or predictors thereof. The studies showed that being undernourished in COPD is likely to be associated with longer in-patient hospital stays [107,108], a higher probability of being readmitted [62,109] and an increase in healthcare utilisation [110] in comparison with normally nourished patients. Three randomised controlled trials in COPD investigated the effects of nutritional supplementation on healthcare utilisation and/or costs [65,76,111].…”

Section: Cost-effectiveness Issuesmentioning

confidence: 99%

Nutritional assessment and therapy in COPD: a European Respiratory Society statement

et al. 2014

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Nutrition and metabolism have been the topic of extensive scientific research in chronic obstructive pulmonary disease (COPD) but clinical awareness of the impact dietary habits, nutritional status and nutritional interventions may have on COPD incidence, progression and outcome is limited. A multidisciplinary Task Force was created by the European Respiratory Society to deliver a summary of the evidence and description of current practice in nutritional assessment and therapy in COPD, and to provide directions for future research. Task Force members conducted focused reviews of the literature on relevant topics, advised by a methodologist. It is well established that nutritional status, and in particular abnormal body composition, is an important independent determinant of COPD outcome. The Task Force identified different metabolic phenotypes of COPD as a basis for nutritional risk profile assessment that is useful in clinical trial design and patient counselling. Nutritional intervention is probably effective in undernourished patients and probably most when combined with an exercise programme. Providing evidence of costeffectiveness of nutritional intervention is required to support reimbursement and thus increase access to nutritional intervention. Overall, the evidence indicates that a well-balanced diet is beneficial to all COPD patients, not only for its potential pulmonary benefits, but also for its proven benefits in metabolic and cardiovascular risk. @ERSpublications Metabolism and nutrition: shifting paradigms in COPD management

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Section: Cost-effectiveness Issuesmentioning

confidence: 99%

Nutritional assessment and therapy in COPD: a European Respiratory Society statement

et al. 2014

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Section: Introductionmentioning

confidence: 99%

“…The impact of dietary habits, nutritional status, and nutritional interventions is increasingly emphasized due to the possible role these may play on COPD outcome and prognosis [3,4]. Several studies have evaluated the impact of nutritional therapy in COPD patients [3–5]. However, it is still unclear how specific dietary components may influence lung function [6] and important clinical outcomes in patients with COPD [7].…”

Section: Introductionmentioning

confidence: 99%

Oxidant status, iron homeostasis, and carotenoid levels of COPD patients with advanced disease and LTOT

Kentson

Leanderson

Jacobson

et al. 2018

European Clinical Respiratory Journal

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Background: The pathogenesis of chronic obstructive pulmonary disease (COPD) is associated with oxidative stress. Both iron (Fe) and oxygen are involved in the chemical reactions that lead to increased formation of reactive oxygen species. Oxidative reactions are prevented by antioxidants such as carotenoids. Objective: To study the differences in Fe status, carotenoid levels, healthy eating habits, and markers of inflammation and oxidative damage on proteins in subjects with severe COPD ± long-term oxygen therapy (LTOT) and lung-healthy control subjects. Methods: Sixty-six Caucasians with advanced COPD (28 with LTOT) and 47 control subjects were included. Questionnaires about general health, lifestyle, and dietary habits were answered. Lung function tests and blood sampling were performed. Results: COPD subjects (±LTOT) did not demonstrate increased oxidative damage, assessed by protein carbonylation (PC), while levels of soluble transferrin receptors (sTfRs) were slightly elevated. Soluble TfRs, which is inversely related to Fe status, was negatively associated with PC. Levels of carotenoids, total and β-cryptoxanthin, α- and β-carotenes, were significantly lower in COPD subjects, and their diet contained significantly less fruits and vegetables. Lutein correlated inversely with IL-6, lycopene correlated inversely with SAT, while β-carotene was positively associated with a Mediterranean-like diet. Conclusions: Fe could favor oxidative stress in COPD patients, suggesting a cautious use of Fe prescription to these patients. COPD subjects ate a less healthy diet than control subjects did and would, therefore, benefit by dietary counseling. COPD patients with hypoxemia are probably in particular need of a lycopene-enriched diet.

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“…7 In addition, factors linked to socioeconomic status, such as respiratory tract infections, housing conditions, air pollution, and diet each contribute to the risk of having exacerbations. [8][9][10] Obviously, sex, age, and socioeconomic differences are important factors that can influence trend changes of COPD and exacerbations. Although these factors are well registered in general practice registration networks, their roles have not been well studied in COPD trend studies in primary care.…”

Section: Introductionmentioning

confidence: 99%

Trends in COPD prevalence and exacerbation rates in Dutch primary care

Bischoff¹,

Schermer²,

Bor³

et al. 2009

Br J Gen Pract

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BackgroundChanges in the burden of chronic obstructive pulmonary disease (COPD) and its exacerbations on primary health care are not well studied. AimTo identify trends in the prevalence of physiciandiagnosed COPD and exacerbation rates by age, sex, and socioeconomic status in a general practice population. Design of studyTrend analysis of COPD data from a 27-year prospective cohort of a dynamic general practice population. SettingData were taken from the Continuous Morbidity Registration Nijmegen. MethodFor the period 1980-2006, COPD and COPD exacerbation data were extracted for patients aged ≥40 years. Data were standardised for the composition of the Continuous Morbidity Registration population in the year 2000. Regression coefficients for trends were estimated by sex, age, and socioeconomic status. Rate ratios were calculated for prevalence differences in different demographic subgroups. ResultsDuring the study period, the overall COPD prevalence decreased from 72.7 to 54.5 per 1000 patients per year. The exacerbation rate decreased from 44.1 to 31.5 per 100 patients, and the percentage of patients with COPD who had exacerbations declined from 27.6% to 21.0%. The prevalence of COPD increased significantly in women, in particular those aged ≥65 years with low socioeconomic status. Decreases in exacerbation rates and percentages of patients with exacerbations were independent of sex, age, and socioeconomic status. ConclusionThe decline in COPD prevalence and exacerbation rates suggests a reduction of the burden on Dutch primary care. The increase of the prevalence in women indicates a need to focus on this particular subgroup in COPD management and research.

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Nutritional status, dietary energy intake and the risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD)

Cited by 93 publications

References 35 publications

Nutritional assessment and therapy in COPD: a European Respiratory Society statement

Nutritional assessment and therapy in COPD: a European Respiratory Society statement

Oxidant status, iron homeostasis, and carotenoid levels of COPD patients with advanced disease and LTOT

Trends in COPD prevalence and exacerbation rates in Dutch primary care

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