Abstract
Chronic obstructive pulmonary disease (COPD) is a progressive, chronic disease in which the patient’s nutritional status is critical for optimizing outcomes. Pulmonary system abnormalities certainly limit exercise in patients with COPD. The aim of the present study was to assess the fitness and exercise tolerance of COPD patients in correlation with their lifestyle as regards their nutrition and daily activities. This study involved 50 patients diagnosed with COPD who attended the pulmonary outpatient clinic of the Chest Department at Ain Shams University Hospital, as well as COPD inpatients at the time of discharge. All participants were interviewed using a face-to-face questionnaire to assess their nutrition, and their lifestyle as regards daily activities. The BMI, obstruction of the airway (FEV1% predicted), degree of dyspnea [modified Medical Research Council (mMRC)], and exercise capacity cardiopulmonary exercise test (CPET) were also assessed. The mean age of the participants was 51.4 ± 8.2 years and all were men. There were significant positive correlations between mMRC and duration after diagnosis of COPD, age of the participants, and GOLD score. There were significant positive correlations between VO2 max and VO2/kg and spirometric parameters, calorie intake, estimated energy requirement percentage, carbohydrate intake, protein intake, and serum total plasma protein. Ex-smokers had significantly higher spirometric parameters, protein intake, total calorie intake, estimated energy requirement percentage, serum total plasma protein, and CPET parameters; however, they had significantly lower BMI, duration of COPD, and mMRC score. Participants with average nutrition had significantly higher total calorie intake, serum total plasma protein, CPET parameters, and spirometric parameters; however, they had significantly lower duration after diagnosis of COPD, mMRC score, and BMI. The lifestyle among COPD patients, as regards physical activity, balanced diet, and caloric intake, is highly related to the severity of the disease and their quality of life.
Highlights
Chronic obstructive pulmonary disease (COPD), a common preventable and treatable disease, is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases
Nutritional state is an important determinant of symptoms, disability, and prognosis in COPD; Grading the participants according to their BMI provided the following: 10% of the participants were overweight, 28% of the participants were underweight, Comparison between participants with daily activity and participants with nondaily activity in relation to their cardiopulmonary exercise test (CPET) parameters
The current study showed the effect of the nutritional intake on disease severity through the significant negative correlations between modified Medical Research Council (mMRC) scale and calorie intake, energy requirement (EER)%, carbohydrate intake, protein intake, and serum total plasma protein; this is supported by a study by Lee et al (2013) [10], which revealed that total calorie, carbohydrate intake, and protein intake were significantly related to mMRC scale; these findings are consistent with those of a study by Ahmadi et al (2012) [12], in which the severe group had lower mean intake of energy and all other nutrients that were analyzed
Summary
Chronic obstructive pulmonary disease (COPD), a common preventable and treatable disease, is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. Weight loss is recognized as a poor prognostic feature in COPD, and underweight individuals have considerably increased mortality [2]. The nutritional status of patients with COPD has been considered an important factor that influences the experiencing symptoms and prognosis of the disease [3]. 20–40% of COPD patients have been reported as being underweight or malnourished [4]. Chronic obstructive pulmonary disease (COPD) is a progressive, chronic disease in which the patient’s nutritional status is critical for optimizing outcomes. Pulmonary system abnormalities certainly limit exercise in patients with COPD
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