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22-04-2013 | Physical rehabilitation | Article

Nutritional supplementation boosts COPD rehabilitation


Free abstract

medwireNews: Combining high-carbohydrate nutritional supplementation with pulmonary rehabilitation may help reverse weight loss and muscle wasting in patients with chronic obstructive pulmonary disease (COPD), research suggests.

In particular, the researchers found that lean body mass and mid-thigh cross-sectional area improved in nutritionally depleted COPD patients, as reported in Respirology.

"In COPD patients, muscle mass can be increased by strength training and additional [nutritional supplementation] that can overcome negative energy balance caused by exercise training," say study authors Alev Gurgun (Ege University School of Medicine, Turkey) and colleagues.

"[Nutritional supplementation] with exercise training may therefore be advantageous to improve body composition and muscle mass."

The study included 46 patients with COPD who had nutritional depletion, as evidenced by low body mass index (BMI; ≤21 kg/m2, fat-free mass index ≤ 15 kg/m2 in women, ≤ 16 kg/m2 in men) or recent weight loss (BMI ≤25 kg/m2 plus weight loss ≥ 5% in previous month or ≥ 10% in previous 6 months), who were randomly assigned to receive pulmonary rehabilitation and/or nutritional supplementation, or usual care (control group).

Following 8 weeks of treatment, the authors observed significant improvement in dyspnea and exercise capacity in both treatment groups compared with the control group.

Additionally, while significant increases in body weight were observed in both groups, BMI improved in the combined intervention group only, and there were significantly greater increases in body weight, BMI, and fat-free mass in this group compared with in the pulmonary rehabilitation alone group.

There was also a significant increase in mid-thigh cross-sectional area in the combined intervention group of 2.5 cm2, on average, while no significant increase was found in the pulmonary rehabilitation alone group.

The authors also note that health-related quality of life and anxiety improved in the intervention groups compared with the control group.

Gurgun and colleagues say that while a previous study showed that anabolic steroids could increase body mass, primarily by expansion of fat mass, their study demonstrates that high-carbohydrate nutritional supplementation may also contribute to improved muscle function and exercise capacity.

"The wasting effects of weight loss on morbidity and mortality provide a strong rationale for nutritional repletion therapy," say the authors.

"Thus, future studies including larger groups of patients in comparison with the control groups receiving non-nutritive placebo are needed to show long-term effects," they conclude.

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Kirsty Oswald, medwireNews Reporter