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Increased energy and/or protein intake improves anthropometry and muscle strength in chronic obstructive pulmonary disease patients: a systematic review with meta-analysis on randomised controlled clinical trials

Published online by Cambridge University Press:  13 April 2022

Simone Bernardes Open the ORCID record for Simone Bernardes [Opens in a new window] ,
Igor da Conceição Eckert Open the ORCID record for Igor da Conceição Eckert [Opens in a new window] ,
Camila Ferri Burgel ,
Paulo José Zimermann Teixeira  and
Flávia Moraes Silva
Simone Bernardes*
Affiliation:
Post-Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
Igor da Conceição Eckert
Affiliation:
Undergraduate Nutrition Program, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
Camila Ferri Burgel
Affiliation:
Nutrition Service, Santa Casa de Misericordia of Porto Alegre Hospital Complex, Porto Alegre, Rio Grande do Sul, Brazil
Paulo José Zimermann Teixeira
Affiliation:
Post-Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil Undergraduate Medicine Program, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil Pulmologist at Pulmonary Rehabilitation Program, Hospital Pavilhão Pereira Filho, Santa Casa de Misericordia of Porto Alegre Hospital Complex, Porto Alegre, Rio Grande do Sul, Brazil
Flávia Moraes Silva
Affiliation:
Nutrition Department and Postgraduate Program in Nutrition Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Rio Grande do Sul, Brazil
*
* Corresponding author: Simone Bernardes, email simone.bernardes@gmail.com
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Abstract

Compromised nutritional status is associated with a poor prognosis in chronic obstructive pulmonary disease (COPD) patients. However, the impact of nutritional support in this group of patients is controversial. The present study systematically reviewed the effect of energy and or protein supplements or food fortification on anthropometry and muscle strength of COPD patients. We searched MEDLINE (PubMed), EMBASE, Cochrane Library and Scopus for all published randomised clinical trials without language restriction up to May 2021. Three reviewers performed study selection and data extraction independently. We judged the risk of bias by RoB 2 and the certainty of evidence by the GRADE approach. We included thirty-two randomised controlled trials and compiled thirty-one of them (1414 participants) in the random-effects model meta-analyses. Interventions were energy and/or protein oral nutritional supplements or food fortification added to the diet for at least one week. Pooled analysis revealed that nutritional interventions increased body weight (muscle circumference (MD) = 1·44 kg, 95 % CI 0·81, 2·08, I2 = 73 %), lean body mass (standardised mean difference (SMD) = 0·37; 95 % CI 0·15, 0·59, I2 = 46 %), midarm muscle circumference (MD = 0·29 mm2, 95 % CI 0·02, 0·57, I2 = 0 %), triceps skinfold (MD = 1·09 mm, 95 % CI 0·01, 2·16, I2 = 0 %) and handgrip strength (SMD = 0·39, 95 % CI 0·07, 0·71, I2 = 62 %) compared with control diets. Certainty of evidence ranged from very low to low, and most studies were judged with some concerns or at high risk of bias. This meta-analysis revealed, with limited evidence, that increased protein and/or energy intake positively impacts anthropometric measures and handgrip strength of COPD patients.

Keywords

COPDNutritionOral Nutrition TherapyNutritional StatusOral Nutrition SupplementsFood Fortification
Type
Systematic Review and Meta-Analysis
Information
British Journal of Nutrition , Volume 129 , Issue 8 , 28 April 2023 , pp. 1332 - 1349
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Nutrition Society

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