Total free living energy expenditure in patients with severe chronic obstructive pulmonary disease.

Abstract

Resting energy expenditure (REE) is often elevated in patients with chronic obstructive pulmonary disease (COPD), but no data are available regarding total energy expenditure in free living conditions. We compared total daily energy expenditure (TDE) in eight COPD patients (FEV1 36 +/- 13%) admitted to a pulmonary rehabilitation center and eight independently living healthy subjects, matched for sex, age, and body mass index (BMI). TDE was measured over a 2-wk interval using doubly labeled water in combination with measurement of REE and body composition. The COPD patients had a significantly higher TDE than the healthy subjects (2,499 +/- 320 kcal/d and 2,107 +/- 88 kcal/d, respectively, p < 0.01). The nonresting component of TDE (TDE-REE: physical activity and diet-induced thermogenesis [DIT]) was significantly higher in the COPD patients than in the healthy subjects, resulting in a ratio between TDE and REE of 1.7 +/- 0.2 and 1.4 +/- 0.1, respectively (p < 0.01). The results indicate that COPD patients exhibit an increased TDE in comparison with healthy subjects. The difference could by attributed to an increase in the nonresting component of TDE, since REE was comparable between the groups.

Fat-Free Mass Depletion Is Associated With Poor Exercise Capacity Irrespective of Dynamic Hyperinflation in COPD Patients

“…30 It is not yet clear whether malnutrition in people with COPD is the cause of their deterioration or just part of the progress of the disease 31 ; in any case it may be only partially reversed by nutritional supplementation. 32 The results of this study are in line with those of previous reports showing that body weight depletion is related to a decreased exercise performance in COPD patients. [8][9][10][11][12] Our patients with low FFM showed a significant reduction in aerobic capacity both at peak of exercise and at AT.…”

Nutritional assessment and therapy in COPD: a European Respiratory Society statement

“…Moreover, while the normal response to semi-starvation is a reduced metabolic rate and depressed whole-body protein turnover, weight-losing COPD patients may display elevated resting energy expenditure and increased whole-body protein turnover [27]. Furthermore, in addition to an increased cost of ventilation due to abnormal pulmonary mechanics, a higher ATP cost of muscular contraction [28] may contribute to decreased mechanical efficiency of lower limb exercise [29] and elevated daily energy requirements in some COPD patients [30]. In support of this, weight gain after lung volume reduction surgery was associated with improved lung function and reduced work of breathing [31].…”

Energy expenditure in chronic obstructive pulmonary disease—evaluation of simple measures

“…Two different, in the clinic often used, calculations were performed; body weight (kg) multiplied by 125 kJ (30 kcal) and predicted RMR multiplied by 1.7, as shown to be characteristic for patients with COPD by Baarends et al (Baarends et al 1997). …”