Combined Exercise Training and Nutritional Interventions or Pharmacological Treatments to Improve Exercise Capacity and Body Composition in Chronic Obstructive Pulmonary Disease: A Narrative Review

Abstract

Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that is associated with significant morbidity, mortality, and healthcare costs. The burden of respiratory symptoms and airflow limitation can translate to reduced physical activity, in turn contributing to poor exercise capacity, muscle dysfunction, and body composition abnormalities. These extrapulmonary features of the disease are targeted during pulmonary rehabilitation, which provides patients with tailored therapies to improve the physical and emotional status. Patients with COPD can be divided into metabolic phenotypes, including cachectic, sarcopenic, normal weight, obese, and sarcopenic with hidden obesity. To date, there have been many studies performed investigating the individual effects of exercise training programs as well as nutritional and pharmacological treatments to improve exercise capacity and body composition in patients with COPD. However, little research is available investigating the combined effect of exercise training with nutritional or pharmacological treatments on these outcomes. Therefore, this review focuses on exploring the potential additional beneficial effects of combinations of exercise training and nutritional or pharmacological treatments to target exercise capacity and body composition in patients with COPD with different metabolic phenotypes.

Effects of different exercise intensities based on body weight change on nutritional status, body composition, and energy balance in patients with COPD: A randomized controlled trial

“…Thus, it is necessary to consider adding interventions to correct energy imbalance in patients who lose body weight during pulmonary rehabilitation with high-intensity exercise. Several studies have shown the positive effects of nutritional supplements on increasing energy intake during pulmonary rehabilitation in patients with COPD [8]. However, no studies have focused on reducing energy expenditure by adjusting exercise intensity (i.e., mitigating exercise intensity) during pulmonary rehabilitation to regulate energy imbalance.…”