Effects of nutritional supplementation combined with low-intensity exercise in malnourished patients with COPD
Open accessAbstract
Study objectives The first aim of this study was to investigate the effects of nutritional supplementation combined with low-intensity exercise on body components, exercise tolerance, and health-related quality of life (HRQOL) in malnourished patients with COPD. The second aim of this study was to examine the degree of systemic inflammation and the actual changes in levels of systemic CRP, TNFα, IL-6 and IL-8 actual changes after a combination of nutritional supplementation and low-intensity exercise in these patients. Design A prospective randomized trial. Patients Thirty-two moderate to severe, clinically stable malnourished COPD patients. Methods Patients were randomly divided into a nutritional supplementation with low-intensity exercise group and a control group. Lung function, maximum inspiratory and expiratory muscle force, the Chronic Respiratory Disease Questionnaire (CRQ), the 6-min walking distance (6MWD), and the Borg scale were measured at baseline and were re-assessed at 3 months after intervention. The degree of systemic inflammation and the changes in levels of systemic CRP, TNFα, IL-6 and IL-8 were assessed before and after a combination nutritional supplementation with low-intensity exercise. Results Body weight and FFM increased significantly after 12 weeks of nutritional supplementation therapy in patients with COPD. The dietary intake energy increased and the REE:REEpred ratio decreased significantly in the nutrition with low-intensity exercise group. PI(max), Quadriceps muscle force and the 6-min walking distance (6MWD) increased significantly from baseline through week 12. Health status, as assessed by CRQ, improved in the domains of dyspnea and total sores significantly in the nutrition with low-intensity exercise group after intervention. In this group, hsCRP, IL-6, IL-8, and TNFα, decreased significantly after intervention compared with the control group. Conclusions The combination of nutritional supplementation with low-intensity exercise training was successful in increasing weight and energy intake as well as exercise capacity and health-related QOL in our patients. Moreover, REE and major inflammatory cytokines decreased significantly after nutritional supplementation with low-intensity exercise training. The present study results suggest a potential role for the combination of nutritional supplementation and low-intensity exercise in the management of malnourished patients with COPD.
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For patients with COPD, results of 2 studies clearly showed benefits from exercise training along with protein supplementation; whey protein served as an effective protein source.
“For patients with COPD, results of 2 studies clearly showed benefits from exercise training along with protein supplementation 162,164 ; whey protein served as an effective protein source.”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [164]
Cites
1 retracted
RETRACTED: Effects of Omega-3 Polyunsaturated Fatty Acids on Inflammatory Markers in COPD
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RetractedThe anti-inflammatory effect of exercise
Petersen, A. M. W., & Pedersen, B. K. (2005) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00164.2004 · Cited by 3,100 · cited 1× · see citing works
“Human skeletal muscle has been shown to be one of the main sources of IL-6, and muscle-derived IL-6 stimulates CRP production in the liver.(35,36) It has recently been shown that exercise-induced muscle-derived IL-6 is reduced after lowintensity endurance training.”
BackgroundA measure of quality of life for clinical trials in chronic lung disease
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Undernutrition in Patients with COPD and Its Treatment
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- Authors
- Sugawara, K., Takahashi, H., Kasai, C., Kiyokawa, N., Watanabe, T., Fujii, S., Kashiwagura, T., Honma, M., Satake, M., & Shioya, T.
- Affiliations
- Akita City Hospital (JP)
- Akita University (JP)
- Corresponding author
- Shioya, Takanobu
- Venue
- Respiratory Medicine
- Publisher
- Elsevier BV
- Published
- 2010-12
- Volume
- 104
- Issue
- 12
- Pages
- 1883-1889
- ISSN
- 0954-6111 (ISSN-L)
- OpenAlex
- W2082336326
- Cited by
- 131
- References
- 4
- Citations by year
- 2026: 3 · 2025: 12 · 2024: 6 · 2023: 14 · 2022: 7 · 2021: 6 · 2020: 7 · 2019: 12 · 2018: 8 · 2017: 4 · 2016: 4 · 2015: 9 · 2014: 10 · 2013: 11 · 2012: 7
- FWCI
- 7.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Respiratory Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Keywords
- chronic obstructive pulmonary disease, malnutrition, dietary supplementation, low-intensity exercise, exercise training, systemic inflammation, inflammatory cytokines, C-reactive protein, TNF-α, interleukin-6, interleukin-8, body composition, fat-free mass, energy intake, exercise capacity, 6-minute walk distance, health-related quality of life, muscle strength
- MeSH terms
- Aged, Body Weight, Female, Humans, Japan, Male, Quality of Life, Surveys and Questionnaires, Respiratory Function Tests, Tumor Necrosis Factor-alpha, Interleukin-6, Interleukin-8, Exercise Tolerance, Dietary Supplements, Pulmonary Disease, Chronic Obstructive, Malnutrition
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