Nutritional support in chronic obstructive pulmonary disease (COPD): A randomised trial

Effective nutrition support for patients with chronic obstructive pulmonary disease: managing malnutrition in primary care

“… 4 , 5 Systematic reviews and meta-analyses investigating the effectiveness of nutrition support in COPD have found that malnutrition is amenable to nutrition intervention, which leads to significant improvements in nutritional intake and nutritional status, 6 as well as improved functional capacity, respiratory muscle strength, and quality of life. 7 The majority of evidence for nutrition support in the treatment of COPD-related malnutrition is based on ready-to-drink (RTD) ONS in stable outpatients, 6 , 7 and is currently lacking for other forms of nutrition support such as powdered ONS and enteral tube feeding.…”

“…Based on this evidence, several important considerations should be highlighted: if the goal is to treat malnutrition, low-volume RTD ONS for up to 12 weeks, in combination with dietary advice, should be commenced and monitored 1 in consultation with a dietitian where available; as patients respond to nutrition support and their intake and nutritional status improves, they should be transitioned to a powdered ONS and a high-energy, high-protein diet; powdered ONS in combination with individualised dietary counselling can be effective at treating malnutrition in stable (non-exacerbating) patients with COPD; 8 however, as consumption appears to be considerably lower than RTD ONS, 6 patients should be reviewed regularly to monitor adherence and response to treatment; where patients are not responding to nutrition intervention strategies (for example, poor compliance and/or worsening malnutrition), referral to a dietitian is recommended; 1 and among those who are malnourished, a 2 kg increase is suggested as a threshold at which functional improvements are seen. 7 Timelines to achieve weight gain will depend on the individual’s condition and a resolution of malnutrition can take months rather than weeks. …”

“…among those who are malnourished, a 2 kg increase is suggested as a threshold at which functional improvements are seen. 7 Timelines to achieve weight gain will depend on the individual’s condition and a resolution of malnutrition can take months rather than weeks.…”