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Optimizing oral nutritional drink supplementation in patients with chronic obstructive pulmonary disease

Published online by Cambridge University Press:  08 March 2007

Roelinka Broekhuizen ,
Eva C. Creutzberg ,
Clarie A. P. M. Weling-Scheepers ,
Emiel F. M. Wouters  and
Annemie M. W. J. Schols
Roelinka Broekhuizen*
Affiliation:
Department of Respiratory Medicine, University Hospital Maastricht, Maastricht, The Netherlands
Eva C. Creutzberg
Affiliation:
Department of Respiratory Medicine, University Hospital Maastricht, Maastricht, The Netherlands Asthma Centre Hornerheide, Horn, The Netherlands
Clarie A. P. M. Weling-Scheepers
Affiliation:
Asthma Centre Hornerheide, Horn, The Netherlands
Emiel F. M. Wouters
Affiliation:
Department of Respiratory Medicine, University Hospital Maastricht, Maastricht, The Netherlands
Annemie M. W. J. Schols
Affiliation:
Department of Respiratory Medicine, University Hospital Maastricht, Maastricht, The Netherlands
*
*Corresponding author: Dr Roelinka Broekhuizen, fax +31 43 3875051, email r.broekhuizen@pul.unimaas.nl
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Abstract

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Nutritional support is indicated in some patients with chronic obstructive pulmonary disease to restore nutritional status and improve functional capacity. However, the efficacy of nutritional supplements is sometimes disappointing, partly owing to a compensatory drop in habitual food intake. We retrospectively studied the effect of nutritional drink supplements, differing in portion size and energy content, on weight gain and body composition. Thirty-nine patients with stable chronic obstructive pulmonary disease, participating in an 8-week pulmonary rehabilitation programme and eligible for nutritional support, were studied. Group A (n 19) received three portions of 125 ml (2380 kJ), whereas group B (n 20) received three portions of 200 ml (3350 kJ) daily. The macronutrient composition of the regimens was similar (20 % protein, 60 % carbohydrates and 20 % fat). Lung function, body weight, body composition (by bio-electrical impedance analysis), habitual dietary intake (by dietary history) and resting energy expenditure (by ventilated hood) were determined. Weight gain was compared with expected weight as predicted by a computer simulation model. Although patients in both groups significantly increased in weight, this increase was higher in group A (A, 3·3 (sd 1·9) kg; B, 2·0 (sd 1·2) kg; P=0·019), while receiving less energy. The observed weight gain in group A was similar to that expected, but in group B it was lower than expected (P<0·001). In both groups, fat-free mass and fat mass were gained in a ratio of 2:1, fat-free mass increasing primarily during the first 4 weeks. This study illustrates that there might be an optimum for the portion size of nutritional drink supplements in chronic obstructive pulmonary disease and that more is not always better.

Keywords

Chronic obstructive pulmonary diseaseNutritionBody compositionTherapyRehabilitation
Type
Research Article
Information
British Journal of Nutrition , Volume 93 , Issue 6 , June 2005 , pp. 965 - 971
Copyright
Copyright © The Nutrition Society 2005

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