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Nutrition in Pulmonary Rehabilitation

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Textbook of Pulmonary Rehabilitation

Abstract

Nutrition and metabolism have been the topic of extensive scientific research in COPD, but clinical awareness of the impact dietary habits, nutritional status and nutritional interventions may have in the COPD rehabilitation trajectory is limited. It is well established that nutritional status, and in particular low fat-free mass, is an important independent determinant of physical functioning and mortality in COPD. Relative to muscle loss, the effects of obesity on physical performance in patients eligible for rehabilitation seem limited, but abdominal obesity adversely affects cardiometabolic risk profile even in normal-weight patients with COPD. A multidisciplinary taskforce installed by the ERS in 2011 (Schols et al. European Respiratory Journal, 44(6):1504–1520, 2014) identified different metabolic phenotypes of COPD as a basis for nutritional risk profile assessment that is useful in clinical trial design, patient counselling and nutritional therapy. Based on a systematic review of the literature, protein energy supplementation likely is effective in undernourished COPD patients and probably most when combined with an exercise programme. There is some evidence that specific nutrients may enhance efficacy of pulmonary rehabilitation, but further research is needed in this area. Overall, the evidence indicates that a well-balanced diet is beneficial to all COPD patients, not only for its potential benefits for the respiratory system but also for its proven benefits on metabolic and cardiovascular risk.

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Acknowledgements

ERS task force ‘nutrition and respiratory disease’: Ivonne Ferreira, Frits Franssen, Harry Gosker, Wim Janssens, Mauricio Muscaritoli, Christophe Pison C, Mauren Rutten-van Mölken, Frode Slinde F, Mick Steiner, Ruzena Tkacova R and Sally Singh.

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Authors and Affiliations

  1. Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands

    Annemie Schols

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  1. Annemie Schols
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Correspondence to Annemie Schols .

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Editors and Affiliations

  1. Department of Medical and Surgical Sciences, University of Modena, Azienda Ospedaliero Universitaria di Modena Policlinico, Modena, Italy

    Enrico Clini

  2. Alfred Health and Institute for Breathing and Sleep, La Trobe University, Melbourne, Australia

    Anne E. Holland

  3. State University of Londrina, Londrina, Paraná, Brazil

    Fabio Pitta

  4. Department of Rehabilitation Sciences, KU Leuven, Respiratory Division and Rehabilitation, University Hospital Leuven, Leuven, Belgium

    Thierry Troosters

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Schols, A. (2018). Nutrition in Pulmonary Rehabilitation. In: Clini, E., Holland, A., Pitta, F., Troosters, T. (eds) Textbook of Pulmonary Rehabilitation. Springer, Cham. https://doi.org/10.1007/978-3-319-65888-9_11

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