Optimizing oral nutritional drink supplementation in patients with chronic obstructive pulmonary disease

• Published in: British journal of nutrition 2005-06, Vol.93 (6), p.965-971
• Main Authors: Broekhuizen, Roelinka, Creutzberg, Eva C., Weling-Scheepers, Clarie A. P. M., Wouters, Emiel F. M., Schols, Annemie M. W. J.
• Format: Article
• Language: English
• Subjects: Adipose Tissue - physiopathology; Administration, Oral; Beverages; Biological and medical sciences; Body composition; Body Composition - physiology; Body weight; Carbohydrates; chronic diseases; Chronic obstructive pulmonary disease; clinical nutrition; Computer simulation; Diet; Dietary Supplements; Energy; energy intake; Energy Intake - physiology; exercise; exercise capacity; Exercise Test; Feeding. Feeding behavior; Female; Food; functional status; Fundamental and applied biological sciences. Psychology; Health Status; Humans; Lung - physiopathology; lung function; Male; Metabolism; Middle Aged; Mortality; Muscle function; Nutrition; Nutritional status; nutritional support; patients; portion size; Proteins; Pulmonary Disease, Chronic Obstructive - diet therapy; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - rehabilitation; Rehabilitation; rehabilitation (people); Respiratory function; respiratory tract diseases; Retrospective Studies; simulation models; Therapy; Ventilation; Vertebrates: anatomy and physiology, studies on body, several organs or systems; weight gain; Weight Gain - physiology
• ISSN: 0007-1145; 1475-2662
• DOI: 10.1079/BJN20051437

Nutritional support is indicated in some patients with chronic obstructive pulmonary disease to restore nutritional status and improve functional capacity. However, the efficacy of nutritional supplements is sometimes disappointing, partly owing to a compensatory drop in habitual food intake. We retrospectively studied the effect of nutritional drink supplements, differing in portion size and energy content, on weight gain and body composition. Thirty-nine patients with stable chronic obstructive pulmonary disease, participating in an 8-week pulmonary rehabilitation programme and eligible for nutritional support, were studied. Group A (n 19) received three portions of 125 ml (2380 kJ), whereas group B (n 20) received three portions of 200 ml (3350 kJ) daily. The macronutrient composition of the regimens was similar (20 % protein, 60 % carbohydrates and 20 % fat). Lung function, body weight, body composition (by bio-electrical impedance analysis), habitual dietary intake (by dietary history) and resting energy expenditure (by ventilated hood) were determined. Weight gain was compared with expected weight as predicted by a computer simulation model. Although patients in both groups significantly increased in weight, this increase was higher in group A (A, 3·3 (sd 1·9) kg; B, 2·0 (sd 1·2) kg; P=0·019), while receiving less energy. The observed weight gain in group A was similar to that expected, but in group B it was lower than expected (P