Up date nutritional support for patients with COPD

Chronic Obstructive Pulmonary disease (COPD) is associated with multiple comorbid conditions including ischemic heart disease, peripheral muscular dysfunction, osteoporosis, osteopenia, glaucoma, anemia, anxiety , depression, caquexia and malnutrition. A number of individuals with COPD experience involuntary weight loss as the condition progresses and weight loss, muscle wasting and tissue depletion are commonly seen.Malnutrition has a negative impact on the clinical course of COPD. The negative impact of malnutrition has led to interest in nutritional assessment and supplementation, alone or in combination with anabolic substances or appetite stimulants, in an effort to improve disease outcome. The effects of nutritional supplementation on weigh gain and anthropometric parameters were small suggesting that oral supplementation alone is of limited efficacy. The studies with anabolic steroids or growth hormone showed improvement in nutritional parameters but no improvement in exercise capacity.Large randomized trials that include measure of lean body mass, exercise capacity and quality of life should be stimulated.