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. 2020 Jan-Dec:17:1479973120904953.
doi: 10.1177/1479973120904953.

Nutritional supplementation during pulmonary rehabilitation in COPD: A systematic review

Abdulelah M Aldhahir  1   2 , Ahmed M Al Rajeh  3 , Yousef S Aldabayan  3 , Salifu Drammeh  1 , Vanitha Subbu  4 , Jaber S Alqahtani  1   5 , John R Hurst  1 , Swapna Mandal  4
Affiliations

Nutritional supplementation during pulmonary rehabilitation in COPD: A systematic review

Abdulelah M Aldhahir et al. Chron Respir Dis. 2020 Jan-Dec.

Abstract

Uptake of nutritional supplementation during pulmonary rehabilitation (PR) for people with chronic obstructive pulmonary disease (COPD) has been limited by an absence of rigorous evidence-based studies supporting use. The objective was to report and summarise the current evidence supporting the use of nutritional supplementation to improve outcomes during PR in stable COPD patients. A systematic search was conducted up to 7 August 2019 (registration number CRD42018089142). The preferred reporting items for systematic reviews and meta-analyses guidelines were used. Six databases were included: Medical Literature Analysis and Retrieval System Online or MEDLARS Online, Allied and Complementary Medicine Database, the Cochrane Database of Systematic Reviews, Excerpta Medica dataBASE, Cumulative Index of Nursing and Allied Health Literature and Web of Science. This systematic search generated 580 initial matches, of which 22 studies (917 COPD participants) met the pre-specified criteria and were included. Sixteen of 19 studies that used nutritional supplements in addition to PR did not show additional benefit compared to PR alone when measuring exercise capacity. Nutritional supplements significantly increased body weight in 7 of 11 studies. Body mass index increased significantly in two of six studies. Handgrip strength did not improve, while quadriceps muscle strength significantly improved in 3 of 11 studies. Four of eight studies showed a significant improvement in inspiratory muscle function. Only 2 of 14 studies demonstrated a significant improvement in quality of life with supplementation in addition to PR. There remains insufficient evidence on the effect of nutritional supplementation on improving outcomes during PR in patients with COPD due to heterogeneity in supplements, outcome measures and PR programmes. Therefore, controversy remains and further research is needed.

Keywords: Chronic obstructive pulmonary disease; nutrition; nutritional supplementation; pulmonary rehabilitation.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Preferred reporting items for systematic reviews and meta-analyses flow diagram.
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References

    1. Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD Executive Summary. Am J Respir Crit Care Med 2017; 195: 557–582. Review. - PubMed
    1. Janson C, Marks G, Buist S, et al. The impact of COPD on health status: findings from the BOLD study. Eur Resp J 2013; 42: 1472–1483. - PMC - PubMed
    1. Van Remoortel H, Hornikx M, Demeyer H, et al. Daily physical activity in subjects with newly diagnosed COPD. Thorax 2013; 68: 962–963. - PMC - PubMed
    1. Zoumot Z, Jordan S, Hopkinson NS. Emphysema: time to say farewell to therapeutic nihilism. Thorax 2014; 69: 973–975. - PMC - PubMed
    1. Wust RCI, Degens H. Factors contributing to muscle wasting and dysfunction in COPD patients. Int J Chronic Obstr Pulm Dis 2007; 2: 289–300. Review. - PMC - PubMed

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