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Nutritional intervention in COPD

 

Clinical bottom line

Those with marginal ventilatory capacity might benefit from a diet high in fat.


Reference

IM Ferreira et al. Nutritional intervention in COPD: a systematic overview. Chest 2001 119: 353-363.

Systematic review

The review was done with assistance from the Cochrane Airways group and used three other electronic databases besides. Subjects hat to have been allocated to a nutritional intervention (any route of administration) or placebo, their usual diet, or other treatments such as anabolic substances. Intensive care studies were excluded. The main outcomes were measures such as weight, lean body mass, BMI) and functional exercise capacity (walking tests) and lung function.

Results

There were 21 reports for inclusion, looking at different types of nutritional support, or supplementation, and looking for immediate effects, short term effects (less than two weeks), and long term effects (more than two weeks). Most studies looked at increased calorie provision over the longer term. Most trials appeared to be small: for instance, 11 trials on calorie supplementation had 327 patients.

In four studies of the immediate effects of a meal a high carbohydrate meal decreased walking distance, and did so more than a high fat meal.

Comment

A number of the studies were of high methodological quality, but their small size, and heterogeneous interventions and outcomes meant that few valid conclusions could be drawn. No large effects were seen.