Nutritional status and quality of life in interstitial lung disease: a prospective cohort study

Kanjrawi, Alisar A.; Mathers, Lara; Webster, Susanne; Corte, Tamera J.; Carey, Sharon

doi:10.1186/s12890-021-01418-5

Cited by 18 publications

(25 citation statements)

References 47 publications

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“…Furthermore, when considering anthropometric measurements such as waist circumference, 8.4% and 46.2% of patients in the normal weight and overweight classes showed an increase in cardiovascular risk. Our results overlap with prior observations that report a high prevalence of obesity and cardiovascular comorbidities in IPF patients [ 27 , 29 , 30 ].…”

Section: Discussionsupporting

confidence: 73%

“…However, recent studies showed that not only overt malnutrition is a negative prognostic factor for patients with IPF, [22] but also body weight loss, sarcopenia and reduced gait speed or hand grip strength are associated with poor clinical outcomes [23][24][25][26] or reduced quality of life. [27] These conditions were observed in a considerable percentage of our normally nourished patients. Furthermore, despite our study recruited patients at the time of diagnosis, only about one third of them was classified as GAP stage 1 at enrollment, and up to 43% already reported an inactive lifestyle.…”

Section: Discussionmentioning

confidence: 87%

“…Our results overlap with prior observations that report a high prevalence of obesity and cardiovascular comorbidities in IPF patients. [27,[29][30] Low vitamin D values were observed in the great majority of cases, but only a minority of them were receiving supplementation. Since low serum vitamin D concentration was recently found to be a negative prognostic factor in patients with IPF, greater attention should be paid to investigating this deficit early in patient history.…”

Section: Discussionmentioning

confidence: 99%

“…This discrepancy may be due to the differences in study design, as previous studies included patients in advanced stages of the disease and without exclusion of severe comorbidities. However, recent studies showed that not only overt malnutrition is a negative prognostic factor for patients with IPF [ 22 ], but also body weight loss, sarcopenia and reduced gait speed or hand grip strength are associated with poor clinical outcomes [ 23 – 26 ] or reduced quality of life [ 27 ]. These conditions were observed in a considerable percentage of our normally nourished patients.…”

Section: Discussionmentioning

confidence: 99%

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Nutritional assessment in idiopathic pulmonary fibrosis: a prospective multicentre study

Faverio

Fumagalli²,

Conti

et al. 2021

ERJ Open Res

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BackgroundNutritional status (NS) impacts on quality of life and prognosis of patients with respiratory diseases including idiopathic pulmonary fibrosis (IPF). However, there is a lack of studies performing an extensive nutritional assessment of IPF patients. This study aims to investigate the NS and to identify nutritional phenotypes in a cohort of IPF patients at diagnosis.MethodsPatients underwent a thorough pulmonary and nutritional evaluation including questionnaires on NS and physical activity, anthropometry, body impedence, dynamometry, 4-meter gait speed and blood tests.Results90 IPF patients (78.9% males, mean age 72.7 years) were enrolled. The majority of patients were classified as Gender-Age-Physiology Index stage 2 (47, 52.2%) with an inactive lifestyle according to International Physical Activity Questionnaire score (39, 43.3%) and had mean forced vital capacity and diffusing capacity for carbon monoxide 86.5% and 54.2%, respectively. In regards to nutritional phenotypes, the majority of patients were normally nourished (67.8%, 95% Confidence Interval (CI):58.6–77.7), followed by non-sarcopenic obese (25.3%, 95%CI:16.1–35.2), sarcopenic (4.6%, 95%CI:0.0–14.5) and sarcopenic obese (2.3%, 95%CI:0.0–12.2). Among normally nourished, 49.2% showed early signs of nutritional and physical performance alterations, including body mass index≥ 30 in 4.3%, history of weight loss≥ 5% in 11.9%, reduction of gait speed and hand grip strength in 11.9% and 35.6%, respectively. Low vitamin D values were observed in 56.3% of cases.ConclusionsIPF patients at diagnosis are mainly normally nourished and obese, but early signs of nutritional and physical performance impairment can already be identified at this stage.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Nutritional assessment in idiopathic pulmonary fibrosis: a prospective multicentre study

Faverio

Fumagalli²,

Conti

et al. 2021

ERJ Open Res

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“…Any inhalation of recreational drugs such as tobacco, marijuana, vaping, and other products should be discontinued. Recent studies have highlighted the importance of fostering a good nutritional status to maintain respiratory function in chronic respiratory disorders, especially in patients with gastrointestinal symptoms (77)(78)(79). Annual screening for immunosuppressant-induced nonmelanoma skin cancers is also recommended.…”

Section: A Proposed Strategy For the Management Of Ssc-ildmentioning

confidence: 99%

Systemic Sclerosis–Associated Interstitial Lung Disease: How to Incorporate Two Food and Drug Administration–Approved Therapies in Clinical Practice

Khanna

Lescoat

Roofeh

et al. 2021

Arthritis & Rheumatology

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Systemic sclerosis (SSc; scleroderma) has the highest individual mortality of all rheumatic diseases, and interstitial lung disease (ILD) is among the leading causes of SSc-related death. Two drugs are now approved by the US Food and Drug Administration (FDA) and indicated for slowing the rate of decline in pulmonary function in patients with SSc-associated ILD (SSc-ILD): nintedanib (a tyrosine kinase inhibitor) and tocilizumab (the first biologic agent targeting the interleukin-6 pathway in SSc). In addition, 2 generic drugs with cytotoxic and immunoregulatory activity, mycophenolate mofetil and cyclophosphamide, have shown comparable efficacy in a phase II trial but are not FDA-approved for SSc-ILD. In light of the heterogeneity of the disease, the optimal therapeutic strategy for the management of SSc-ILD is still to be determined. The objectives of this review are 2-fold: 1) review the body of research focused on the diagnosis and treatment of SSc-ILD; and 2) propose a practical approach for diagnosis, stratification, management, and therapeutic decision-making in this clinical context. This review presents a practical classification of SSc patients in terms of disease severity (subclinical versus clinical ILD) and associated risk of progression (low versus high risk). The pharmacologic and nonpharmacologic options for first-and second-line therapy, as well as potential combination approaches, are discussed in light of the recent approval of tocilizumab for SSc-ILD.

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Nutrition implications of intrinsic restrictive lung disease

et al. 2022

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Restrictive lung disease is defined as a reduction in lung volume that may be due to intraparenchymal or extraparenchymal causes. Intraparenchymal causes falls under the umbrella term of interstitial lung disease (ILD) and includes idiopathic pulmonary fibrosis. This manuscript provides an overview of ILD and can be beneficial for all clinicians working with patients with ILD. Although not well documented, the prevalence of malnutrition in patients with ILD has been reported to be between ~9% and 55%. Body mass index has been shown to predict survival; but more recently, research has suggested that fat‐free mass has a larger influence on survival. There is insufficient evidence to support the use of antioxidant or vitamin supplementation to help diminish the chronic inflammatory process that is seen in this patient population. There are data from studies examining the vitamin D status in this patient population, but research on vitamin D supplementation appears to be lacking. Registered dietitian nutritionists should continue to advocate and play a more prominent role in the nutrition management of patients with ILD as part of standard of care.

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Nutritional status and quality of life in interstitial lung disease: a prospective cohort study

Cited by 18 publications

References 47 publications

Nutritional assessment in idiopathic pulmonary fibrosis: a prospective multicentre study

Nutritional assessment in idiopathic pulmonary fibrosis: a prospective multicentre study

Systemic Sclerosis–Associated Interstitial Lung Disease: How to Incorporate Two Food and Drug Administration–Approved Therapies in Clinical Practice

Nutrition implications of intrinsic restrictive lung disease

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