Two components of the new ESPEN diagnostic criteria for malnutrition are independent predictors of lung function in hospitalized patients with chronic obstructive pulmonary disease (COPD)

Ingadottir, Arora Ros; Beck, Anne Marie; Baldwin, Christine; Weekes, C. Elizabeth; Geirsdóttir, Ólöf Guðný; Ramel, Alfons; Gíslason, Þórarinn; Gunnarsdóttir, Ingibjörg

doi:10.1016/j.clnu.2017.05.031

Cited by 41 publications

(31 citation statements)

References 29 publications

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“…Enright et al [29] found a significant association between low FFM in patients with CF and the severity of pulmonary disease, which was related to a loss of diaphragm muscle mass. Recent criteria by the European Society of Clinical Nutrition and Metabolism for patients with chronic obstructive pulmonary disease advocate for a more integrated diagnostic approach that combines weight loss with either ageadjusted BMI or FFM index [60]. Specifically, adults with a normal BMI and low FFM have a lower predicted FEV1% than adults with both normal BMI and FFM [36].…”

Section: Lean Body or Fat-free Massmentioning

confidence: 99%

Cystic fibrosis, body composition, and health outcomes: a systematic review

et al. 2018

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Section: Lean Body or Fat-free Massmentioning

confidence: 99%

Cystic fibrosis, body composition, and health outcomes: a systematic review

et al. 2018

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“…Our participants might have continued to gain weight if the intervention had been provided for a longer duration. Although weight remained stable despite no further weight gain being achieved, it is important to highlight that in the majority of our patients, weight loss, which is associated with a higher mortality, was prevented 15 34…”

Section: Discussionmentioning

confidence: 81%

“…Patients with a clinical diagnosis of COPD who had been recently admitted to the Department of Respiratory Medicine at Landspitali University Hospital were screened for possible nutritional risk (score ≥4) by a trained researcher using a validated nutritional screening tool 3 15. The Icelandic Simple Screening (ISS) used is recommended by the clinical guidelines for hospital nutrition at Landspitali,16 and has been validated against a full nutritional assessment in patients with COPD3 and predicts mortality in patients with COPD 15. ISS gathers information on body mass index (BMI), unintentional weight loss, age, comorbidities, recent hospitalisation and a range of symptoms that impact nutritional intake during the last weeks or months (vomiting, diarrhoea, loss of appetite or nausea, difficulties in chewing or swallowing).…”

Section: Methodsmentioning

confidence: 99%

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Oral nutrition supplements and between-meal snacks for nutrition therapy in patients with COPD identified as at nutritional risk: a randomised feasibility trial

et al. 2019

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IntroductionIntervention studies have mainly used oral nutritional supplements (ONS) for the management of patients with chronic obstructive pulmonary disease (COPD) identified as at nutritional risk. In this 12-month randomised feasibility trial, we assessed the (1) feasibility of the recruitment, retention and provision of two interventions: ONS and between-meal snacks (snacks) and (2) the potential impact of the provision of snacks and ONS on body weight and quality of life in patients with COPD.Methods Hospitalised patients with COPD, at nutritional risk, were randomised to ONS (n=19) or snacks (n=15) providing 600 kcal and 22 g protein a day in addition to regular daily diet. The intervention started in hospital and was continued for 12 months after discharge from the hospital.Results Study recruitment rate was n=34 (45%) and retention rate at 12 months was similar for both groups: n=13 (68%) in the ONS group and n=10 (67%) in the Snacks group. Both groups gained weight from baseline to 12 months (2.3±4.6 kg (p=0.060) in the ONS group and 4.4±6.4 kg (p=0.030) in the Snacks group). The St George’s Respiratory Questionnaire total score improved from baseline to 12 months in both groups (score 3.9±11.0 (p=0.176) in the ONS group and score 8.9±14.1 (p=0.041) in the Snacks group).Discussion In patients with COPD who are at nutritional risk snacks are at least as feasible and effective as ONS, however, adequately powered trials that take account of the difficulties in recruiting this patient group are required to confirm this effect.

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“…Surrogate measures, such as the use of body mass index (BMI), gives no indication of body composition, muscle mass, the proportion of fat to muscle, or the patient nutritional status. Recently, several studies have shown that parameters of body composition, including the use of the fat-free mass index (FFMI), have been shown to be associated with exercise capacity, disease severity, mortality, and quality of life in patients with COPD [4–9].…”

Section: Introductionmentioning

confidence: 99%

A Low Lean-to-Fat Ratio Reduces the Risk of Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Patients with a Normal or Low Body Mass Index

et al. 2019

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Background Increased risk of acute exacerbation of chronic obstructive pulmonary disease (COPD) has been reported in patients who are overweight and obese. However, the effects of body fat in patients with normal or low body mass index (BMI) and COPD remain unknown. This study aimed to examine the association between acute exacerbations of COPD and the lean-to-fat (LTF) ratio in patients with a normal or low BMI. Material/Methods Patients with COPD (n=68) underwent assessment of body composition, in whom 43 cases had a normal BMI (18.5 to 25 kg/m 2 ) and 14 cases were underweight (<18.5 kg/m 2 ). Patients with COPD were treated according to current clinical guidelines and underwent regular follow-up for one year. Acute exacerbations of COPD were recorded. Results BMI, the fat-free mass index (FFMI), skeletal muscle mass index (SMMI), and LTF ratio had no significant effect of the risk of acute exacerbations of COPD in the whole study cohort, but a low LTF ratio was significantly associated with reduced risk of acute exacerbations of COPD in the subgroup with a BMI<25 kg/m 2 (OR=4.528; P<0.05). The Fat Mass Index (FMI) had a protective effect in the whole cohort (OR=0.292; P=0.024) and in the subgroup with BMI <25 kg/m 2 (OR=0.253, P=0.049). The cumulative incidence of acute exacerbations of COPD was significantly increased in the patients with a high LTF ratio in the whole cohort (P=0.047) and in the subgroup with BMI <25 kg/m 2 (P=0.014). Conclusions In patients with BMI <25 kg/m 2 , the LTF ratio was positively correlated with the risk of occurrence of acute exacerbations of COPD.

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Two components of the new ESPEN diagnostic criteria for malnutrition are independent predictors of lung function in hospitalized patients with chronic obstructive pulmonary disease (COPD)

Cited by 41 publications

References 29 publications

Cystic fibrosis, body composition, and health outcomes: a systematic review

Cystic fibrosis, body composition, and health outcomes: a systematic review

Oral nutrition supplements and between-meal snacks for nutrition therapy in patients with COPD identified as at nutritional risk: a randomised feasibility trial

A Low Lean-to-Fat Ratio Reduces the Risk of Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Patients with a Normal or Low Body Mass Index

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