Nutritional supplementation for stable chronic obstructive pulmonary disease

Ferreira I, Brooks D, Lacasse Y, Goldstein R, White J

Published Online:

October 8, 2008

Low body weight is common in people with chronic obstructive pulmonary disease (COPD). It can impair their heart and lung function and reduce their ability to exercise and recover. Some degree of malnutrition is common in people with COPD but it is unclear whether this is the cause of their deterioration, or just part of the progress of the disease. The review of trials found no evidence that simple nutritional supplementation makes a significant difference to people with COPD. More research is needed.

Abstract (click to read)

Background:

Low body weight in patients with chronic obstructive pulmonary disease (COPD) is associated with an impaired pulmonary status, reduced diaphragmatic mass, lower exercise capacity and higher mortality rate when compared to adequately nourished individuals with this disease. Nutritional support may therefore be a useful part of their comprehensive care.

Objectives:

To conduct a systematic review of randomised controlled trials (RCTs) to clarify whether nutritional supplementation (caloric supplementation for at least 2 weeks) improved anthropometric measures, pulmonary function, respiratory muscle strength and functional exercise capacity in patients with stable COPD.

Search strategy:

Randomized controlled trials (RCTs) were identified from the Cochrane Airways Group register of RCTs, a hand-search of abstracts presented at international meetings and consultation with experts. Searches are current as of June 2006.

Selection criteria:

Two reviewers independently selected trials for inclusion, assessed quality and extracted the data.

Data collection and analysis:

Within each trial and for each outcome, we calculated an effect size. The effect sizes were then pooled by a random-effects model. Homogeneity among the effect sizes was also tested.

Main results:

Fourteen studies recruiting 487 participants met the inclusion criteria. Nine papers were considered as high quality. Two studies were double-blinded. For each of the outcomes studied, the effect of nutritional support was small: the 95% confidence intervals around the pooled effect sizes all included zero. The effect of nutritional support was homogeneous across studies.

Authors' conclusions:

Nutritional support had no significant effect on anthropometric measures, lung function or exercise capacity in patients with stable COPD. Although some quality of life indices gave significant findings, these results were from a single small unblinded study and restricted to certain domains of health status measurements. More work in this particular area is needed to establish whether supplementation can lead to subjective benefits in quality of life.

This record should be cited as:

Ferreira I, Brooks D, Lacasse Y, Goldstein R, White J. Nutritional supplementation for stable chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD000998. DOI: 10.1002/14651858.CD000998.pub2

Assessed as up to date:

June 1, 2006

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Primary Review Group:

Airways Group

Health topics:

Lungs & airways > Chronic obstructive pulmonary disease (stable) > Self-management & education

Complementary & alternative medicine > Lungs & airways > Chronic obstructive pulmonary disease (stable)

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Nutritional supplementation for stable chronic obstructive pulmonary disease

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