title: Nutritional modulation as part of the integrated management of chronic obstructive pulmonary disease.
abstract: Weight loss is a frequent complication in patients with chronic obstructive pulmonary disease (COPD) and is a determining factor for functional capacity, health status and mortality. Weight loss in COPD is a consequence of an inbalance between increased energy requirements and dietary intake. Both metabolic and mechanical inefficiency may contribute to elevated energy expenditure during physical activity, while systemic inflammation has been associated with hypermetabolism at rest. Disease-specific symptoms and systemic inflammation may impair appetite and dietary intake. Altered intermediary metabolism may cause disproportionate wasting of fat-free mass in some patients. A combination of nutritional support and exercise as an anabolic stimulus appears to be the best approach to obtaining marked functional improvement. Patients responding to this treatment even demonstrated a decreased mortality. The effectiveness of anti-catabolic modulation requires further investigation.
authors.affiliation: Department of Respiratory Medicine, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands. a.schols@pul.unimaas.nl
authors.forename: Annemie
authors.initials: A
authors.lastname: Schols
mesh_terms: D045930:Anabolic Agents / Q000627:therapeutic use; D001823:Body Composition; D002100:Cachexia / Q000178:diet therapy / Q000209:etiology; D019587:Dietary Supplements; D004435:Eating / Q000502:physiology; D004734:Energy Metabolism / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D015596:Nutrition Assessment; D018529:Nutritional Support; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000178:diet therapy* / Q000378:metabolism; D015431:Weight Loss
chemical_list: D045930:Anabolic Agents