title: Nutritional assessment and therapy in COPD: a European Respiratory Society statement.
abstract: Nutrition and metabolism have been the topic of extensive scientific research in chronic obstructive pulmonary disease (COPD) but clinical awareness of the impact dietary habits, nutritional status and nutritional interventions may have on COPD incidence, progression and outcome is limited. A multidisciplinary Task Force was created by the European Respiratory Society to deliver a summary of the evidence and description of current practice in nutritional assessment and therapy in COPD, and to provide directions for future research. Task Force members conducted focused reviews of the literature on relevant topics, advised by a methodologist. It is well established that nutritional status, and in particular abnormal body composition, is an important independent determinant of COPD outcome. The Task Force identified different metabolic phenotypes of COPD as a basis for nutritional risk profile assessment that is useful in clinical trial design and patient counselling. Nutritional intervention is probably effective in undernourished patients and probably most when combined with an exercise programme. Providing evidence of cost-effectiveness of nutritional intervention is required to support reimbursement and thus increase access to nutritional intervention. Overall, the evidence indicates that a well-balanced diet is beneficial to all COPD patients, not only for its potential pulmonary benefits, but also for its proven benefits in metabolic and cardiovascular risk.
authors.affiliation: NUTRIM School for Nutrition, Toxicology and Metabolism, Dept of Respiratory Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands a.schols@maastrichtuniversity.nl.
authors.forename: Annemie M
authors.initials: AM
authors.lastname: Schols
authors.affiliation: Asthma and Airways Centre, Toronto Western Hospital, Toronto, Canada Dept of Respiratory Medicine, McMaster University, Hamilton, Canada.
authors.forename: Ivone M
authors.initials: IM
authors.lastname: Ferreira
authors.affiliation: Program Development Centre, CIRO+ (Centre of Expertise for Chronic Organ Failure), Horn, The Netherlands.
authors.forename: Frits M
authors.initials: FM
authors.lastname: Franssen
authors.affiliation: NUTRIM School for Nutrition, Toxicology and Metabolism, Dept of Respiratory Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Harry R
authors.initials: HR
authors.lastname: Gosker
authors.affiliation: Laboratory of Respiratory Medicine, Katholieke Universiteit, Leuven, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: Janssens
authors.affiliation: Dept of Clinical Medicine, Sapienza University of Rome, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Muscaritoli
authors.affiliation: Clinique Universitaire de Pneumologie, Institut du Thorax, CHU Grenoble, Grenoble, France Inserm U1055, Grenoble, France Université Joseph Fourier, Grenoble, France European Institute for Systems Biology and Medicine, Lyon, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Pison
authors.affiliation: Erasmus University Rotterdam, Institute of Health Policy and Management, Rotterdam The Netherlands Erasmus University Rotterdam, Institute of Medical Technology Assessment, Rotterdam, The Netherlands.
authors.forename: Maureen
authors.initials: M
authors.lastname: Rutten-van Mölken
authors.affiliation: Dept of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: Frode
authors.initials: F
authors.lastname: Slinde
authors.affiliation: Centre for Exercise and Rehabilitation Science, Leicester Respiratory Biomedical Research Unit, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Steiner
authors.affiliation: Dept of Respiratory Medicine, Faculty of Medicine, P.J. Safarik University, Kosice, Slovakia L. Pasteur University Hospital, Kosice, Slovakia.
authors.forename: Ruzena
authors.initials: R
authors.lastname: Tkacova
authors.affiliation: Centre for Exercise and Rehabilitation Science, Leicester Respiratory Biomedical Research Unit, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK.
authors.forename: Sally J
authors.initials: SJ
authors.lastname: Singh
mesh_terms: D026683:Advisory Committees; D001823:Body Composition; D002100:Cachexia / Q000150:complications / Q000175:diagnosis* / Q000178:diet therapy; D005060:Europe; D015444:Exercise; D006801:Humans; D015596:Nutrition Assessment; D009748:Nutrition Disorders / Q000150:complications / Q000175:diagnosis / Q000178:diet therapy; D009752:Nutritional Status; D009765:Obesity / Q000150:complications / Q000175:diagnosis* / Q000178:diet therapy; D010641:Phenotype; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis*; D012307:Risk Factors; D055948:Sarcopenia / Q000150:complications / Q000175:diagnosis* / Q000178:diet therapy; D012955:Societies, Medical