PURPOSE: Association between severe nutritional depletion and COPD has long been recognized. In managing COPD, clinicians give emphasis on drug treatment alone, giving least or no importance on nutritional supplementation. One of the goals in treating stable COPD patients with malnutrition is to correct the malnutrition without increasing the respiratory quotient and production of CO2. This study evaluated efficacy of high vegetable fat and low carbohydrate diet in malnourished patients with stable COPD on some aspects of anthropometry and pulmonary functions.
METHODS: 54 male COPD patients with low body weight (<90% ideal body weight), attending out patient department, were randomized to the ‘control’ group (26), who received ad lib diet with concomitant drug regimen and the ‘experimental’ group (28), which received modified diet (carbohydrate 25%, protein 30% and vegetable fat 45%) with concomitant drug regimen. Measurement on anthropometry (body weight, mid arm circumference), respiratory rate and pulmonary functions (FVC, FEV1, FEV1/FVC ratio, PEFR) were taken as baseline and after 30, 60 and 90 days.
RESULTS: In the trial group, the mean percentage of predicted body weight significantly increased at the end of day-90 (90.10 + 7.05 vs. 84.40 + 5.17; P<0.001). This improvement is also significant in comparison to the findings of control group at day-90 (90.10 + 7.05 vs. 84.46 + 5.83; P<0.05). At the end of day-90, significant improvement in respiratory rate was noted in the trial group in comparison to control group (P<0.001). All measurements of pulmonary functions and mid arm circumference also showed trend of improvement.
CONCLUSION: Provision of high vegetable fat and low carbohydrate diet may cause clinical improvement in malnourished stable COPD patients. However, the intervention is time-intensive and costly. More detailed work of alternative out patient strategies of controlled supervision combined with larger sample size is indicated to delineate the full therapeutic potential of nutritional support for this clinical population.
CLINICAL IMPLICATIONS: Clinician should offer high vegetable fat and low carbohydrate diet to COPD patients for better outcomes.
DISCLOSURE: Taskina Ali, No Financial Disclosure Information; No Product/Research Disclosure Information