Dietary support to underweight patients with end-stage pulmonary disease assessed for lung transplantation.
BACKGROUND
Undernutrition in hospitalized patients is often not recognized and nutritional support neglected. Chronic obstructive pulmonary disease is frequently characterized by weight loss. No data exist on the effects of nutritional supplementation in underweight lung transplantation candidates during hospitalization.


OBJECTIVE
To evaluate the effects on energy intake and body weight of an intensified nutritional support compared to the regular support during hospitalization.


METHODS
The participants were underweight (n = 42) and normal-weight (n = 29) patients with end-stage pulmonary disease assessed for lung transplantation. The underweight patients were randomized to receive either an energy-rich diet planned for 10 MJ/day and 45-50 energy percentage fat and offered supplements (group 1), or the normal hospital diet planned for 8.5-9 MJ/day and 30-35 energy percentage fat and regular support (group 2, control group). The normal-weight control patients (group 3) received the normal diet. Food intake was recorded for 3 days.


RESULTS
During a mean hospital stay of 12 days, the energy intake was significantly greater for the patients on intensified nutritional support (median 11.2 MJ) than for the underweight patients on the regular support (8.4 MJ; p < 0.02) and the normal-weight patients (7.0 MJ; p < 0.001). The increase in energy intake in group 1 resulted in a significant weight gain (median 1.2 kg) compared with group 2 (p < 0.01) and group 3 (p < 0.001).


CONCLUSIONS
In a group of underweight patients with lung disease assessed for lung transplantation, it was possible to increase energy intake by an intensified nutritional support which was associated with a significant weight gain, compared to the regular nutritional support during a short hospital stay.
Department of Thoracic Medicine, Rikshospitalet, Oslo, Norway. liv.forli@rikshospitalet.no
L
L
Førli
J I
JI
Pedersen
O
O
Bjørtuft
M
M
Vatn
J
J
Boe
D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D016001:Confidence Intervals; D004032:Diet; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000150:complications* / Q000601:surgery*; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009664:Norway; D009748:Nutrition Disorders / Q000150:complications* / Q000178:diet therapy*; D009751:Nutritional Requirements; D018529:Nutritional Support; D011300:Preoperative Care; D011446:Prospective Studies; D012016:Reference Values; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D015430:Weight Gain; D015431:Weight Loss