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
Objectives To examine the outcomes of the Elderly Persons in the Risk Zone study, which was designed to evaluate whether it is possible to delay deterioration if a health‐promoting intervention is made when an older adult (≥80) is at risk of becoming frail and whether a multiprofessional group intervention is more effective in delaying deterioration than a single preventive home visit with regard to frailty, self‐rated health, and activities of daily living (ADLs) at 3‐month follow‐up. Design Randomized, three‐armed, single‐blind, controlled trial performed between November 2007 and May 2011. Setting Two urban districts of Gothenburg, Sweden. Participants Four hundred fifty‐nine community‐living adults aged 80 and older not dependent on the municipal home help service. Intervention A preventive home visit or four weekly multiprofessional senior group meetings with one follow‐up home visit. Measurements Change in frailty, self‐rated health, and ADLs between baseline and 3‐month follow‐up. Results Both interventions delayed deterioration of self‐rated health (odds ratio (OR) = 1.99, 95% confidence interval (CI) = 1.12–3.54). Senior meetings were the most beneficial intervention for postponing dependence in ADLs (OR = 1.95, 95% CI = 1.14–3.33). No effect on frailty could be demonstrated. Conclusion Health‐promoting interventions made when older adults are at risk of becoming frail can delay deterioration in self‐rated health and ADLs in the short term. A multiprofessional group intervention such as the senior meetings described seems to have a greater effect on delaying deterioration in ADLs than a single preventive home visit. Further research is needed to examine the outcome in the long term and in different contexts.
In studies of physical performance comprising muscle strength and power, a vertical jump is a test method that frequently is used. It is important to have access to accurate measuring tools providing data with high reproducibility. Studies have shown that body composition also may play an important part in physical performance. The purpose of this study was to determine test-retest reliability for 3 different kinds of vertical jumps and to correlate jump height with body composition. Thirty-four normally trained subjects (women n = 17) between 18 and 25 years participated. Test-retest, on 3 kinds of vertical jumps, was performed with a median of 7 days between jumps. Methods used were a countermovement jump (CMJ) on a contact mat, with and without arm swing, and an Abalakow jump (AJ) using measuring tape, with arm swing. Body composition was assessed with the use of bioelectric impedance analysis. The results showed that high intraclass correlation coefficients (ICCs) were observed between testing occasions for all 3 vertical jumps (ICC between 0.48 and 0.88). The AJ in women presented the lowest ICC. Also the correlation between CMJ and AJ was high (rs = 0.88). Moderate-to-high correlations could be shown between body composition and CMJ in women (rs = -0.57-0.76). In conclusion, very high test-retest reliability for CMJ on a contact mat was found. For the AJ using a measuring tape, ICC were overall high, but a moderate nonsignificant ICC were found in women, indicating poor reproducibility. The data from the CMJ and AJ may be compared if approximately 25% of the AJ value is subtracted. In practice, this means that vertical jump tests have high reproducibility and can be used as measures of power development.
SenseWear Pro2 Armband underestimated energy cost of most activities in this study, an underestimation that increased with increased physical activity intensity. A table of energy costs (MET values) of physical activities in children measured by indirect calorimetry is presented as an initiation of the creation of a compendium of physical activities in children.
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