Nutritional modulation as part of the integrated management of chronic obstructive pulmonary disease

Proc Nutr Soc. 2003 Nov;62(4):783-91. doi: 10.1079/PNS2003303.


Weight loss is a frequent complication in patients with chronic obstructive pulmonary disease (COPD) and is a determining factor for functional capacity, health status and mortality. Weight loss in COPD is a consequence of an inbalance between increased energy requirements and dietary intake. Both metabolic and mechanical inefficiency may contribute to elevated energy expenditure during physical activity, while systemic inflammation has been associated with hypermetabolism at rest. Disease-specific symptoms and systemic inflammation may impair appetite and dietary intake. Altered intermediary metabolism may cause disproportionate wasting of fat-free mass in some patients. A combination of nutritional support and exercise as an anabolic stimulus appears to be the best approach to obtaining marked functional improvement. Patients responding to this treatment even demonstrated a decreased mortality. The effectiveness of anti-catabolic modulation requires further investigation.

Publication types

  • Review

MeSH terms

  • Anabolic Agents / therapeutic use
  • Body Composition
  • Cachexia / diet therapy
  • Cachexia / etiology
  • Dietary Supplements
  • Eating / physiology
  • Energy Metabolism / physiology*
  • Exercise / physiology*
  • Humans
  • Inflammation / metabolism
  • Nutrition Assessment
  • Nutritional Support
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / diet therapy*
  • Pulmonary Disease, Chronic Obstructive / metabolism
  • Weight Loss*


  • Anabolic Agents