title: Nutrition impact symptoms and body composition in patients with COPD.
abstract: OBJECTIVE
  Anorexia or lack of appetite is common in chronic obstructive pulmonary disease (COPD) and may be caused or augmented by several symptoms affecting appetite and eating. We aimed to investigate and quantify the extent of nutrition impact symptoms (NIS) in patients with COPD and to explore relationships between NIS and fat-free mass depletion.
  
  
  METHODS
  The results in this cross-sectional study are based on 169 COPD patients (62% female subjects). Body composition was assessed using bioelectrical impedance spectroscopy and the patients reported NIS by two newly developed questionnaires: the Eating Symptoms Questionnaire (ESQ) and the Disease-Related Appetite Questionnaire (DRAQ).
  
  
  RESULTS
  Symptoms with the highest prevalence were dry mouth (71%), stomach ache (39%), pain or aches affecting appetite (36%) and constipation (35%). Problems with diarrhoea and feeling affected by smells were more severe among women compared with men (P<0.05). Thirty-six percent of the patients were depleted (fat-free mass index (FFMI) <15 kg/m2 for women and FFMI<16 kg/m2 for men). Depleted patients had more NIS (P<0.05) and also rated appetite and taste of food as worse compared with non-depleted patients (P<0.05).
  
  
  CONCLUSIONS
  NIS are common in patients with COPD, and depleted patients have more severe symptoms. To investigate how these symptoms are best prevented and/or managed and whether NIS prevention/treatment can affect development of malnutrition in patients with COPD is a challenge for the future.
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Nordén
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: A M
authors.initials: AM
authors.lastname: Grönberg
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: I
authors.initials: I
authors.lastname: Bosaeus
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: H Bertéus
authors.initials: HB
authors.lastname: Forslund
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Hulthén
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Rothenberg
authors.affiliation: 1] Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden [2] Department of Medicine, Örebro University Hospital, Örebro, Sweden [3] School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Karlsson
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: O
authors.initials: O
authors.lastname: Wallengren
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: F
authors.initials: F
authors.lastname: Slinde
mesh_terms: D000368:Aged; D001066:Appetite; D001823:Body Composition; D001825:Body Fluid Compartments / Q000378:metabolism*; D015992:Body Mass Index; D001835:Body Weight; D003430:Cross-Sectional Studies; D004435:Eating; D017097:Electric Impedance; D001068:Feeding and Eating Disorders / Q000209:etiology*; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000209:etiology; D008875:Middle Aged; D009752:Nutritional Status; D010146:Pain / Q000209:etiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000378:metabolism; D012737:Sex Factors; D012903:Smell; D011795:Surveys and Questionnaires; D013649:Taste