Nutrition in COPD
Discuss nutrition in Chronic obstructive pulmonary disease (COPD) ?
- Significant weight loss (5% of actual weight within three months or 10% within 6 months) is found in 25–40% of all cases when lung function is severely impaired (FEV1<50%).
- A pronounced loss of appetite (anorexia) and decreased food intake are of central importance in the weight loss which accompanies COPD.
- Weight loss and a low BMI predict a poor survival in COPD patients. However, there is limited evidence that COPD patients benefit from EN.
- The main aim of treatment is to meet calculated nutritional requirements and prevent weight loss.
- In patients with stable COPD there is no advantage of disease specific low carbohydrate, high fat ONS over standard or high protein or high energy ONS.
- It was suggested that standard formulae, which are usually rich in carbohydrates (50–60 energy %) would induce greater ventilatory demand due to a higher respiratory quotient)
Discuss parenteral nutrition in COPD?
In patients with stable COPD, glucose-based PN causes an increase in the respiratory
CO2 load. PN composition should accordingly be orientated towards lipids as the
energy source. The proportion of lipid-derived non-protein calories should probably be at least 35% (but probably not more than 65%).
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