Effect of supplementing a high-fat, low-carbohydrate enteral formula in COPD patients

Nutrition. 2003 Mar;19(3):229-32. doi: 10.1016/s0899-9007(02)01064-x.


Objective: One of the goals in treating patients with chronic obstructive pulmonary disease (COPD) who suffer from hypoxemia, hypercapnia, and malnutrition is to correct the malnutrition without increasing the respiratory quotient and minimize the production of carbon dioxide. This 3-wk study evaluated the efficacy of feeding a high-fat, low-carbohydrate (CHO) nutritional supplement as opposed to a high-carbohydrate diet in COPD patients on parameters of pulmonary function.S METHODS: Sixty COPD patients with low body weight (<90% ideal body weight) were randomized to the control group, which received dietary counseling for a high-CHO diet (15% protein, 20% to 30% fat, and 60% to 70% CHO), or the experimental group, which received two to three cans (237 mL/can) of a high-fat, low-CHO oral supplement (16.7% protein, 55.1% fat, and 28.2% CHO) in the evening as part of the diet. Measurements of lung function (forced expiratory volume in 1 s or volume of air exhaled in 1 s of maximal expiration, minute ventilation, oxygen consumption per unit time, carbon dioxide production in unit time, and respiratory quotient) and blood gases (pH, arterial carbon dioxide tension, and arterial oxygen tension) were taken at baseline and after 3 wk.

Results: Lung function measurements decreased significantly and forced expiratory volume increased significantly in the experimental group.

Conclusion: This study demonstrates that pulmonary function in COPD patients can be significantly improved with a high-fat, low-CHO oral supplement as compared with the traditional high-CHO diet.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Blood Gas Analysis
  • Carbon Dioxide / metabolism
  • Dietary Carbohydrates / administration & dosage*
  • Dietary Carbohydrates / adverse effects
  • Dietary Carbohydrates / metabolism
  • Dietary Fats / administration & dosage*
  • Dietary Fats / metabolism
  • Dietary Supplements*
  • Energy Metabolism
  • Female
  • Forced Expiratory Volume / physiology
  • Humans
  • Hypercapnia / prevention & control
  • Hypoxia / prevention & control
  • Male
  • Middle Aged
  • Nutrition Disorders / prevention & control*
  • Oxygen Consumption / physiology
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / diet therapy*
  • Pulmonary Disease, Chronic Obstructive / metabolism
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Gas Exchange / physiology
  • Respiration


  • Dietary Carbohydrates
  • Dietary Fats
  • Carbon Dioxide