Managing malnutrition in COPD: A review

Respir Med. 2021 Jan;176:106248. doi: 10.1016/j.rmed.2020.106248. Epub 2020 Nov 21.


In the UK approximately 1.2 million people have COPD with around 25-40% being underweight and 35% have a severely low fat-free mass index. Measuring their body mass index is recommended and Health care professionals should endeavour to ensure that COPD patients are achieving their nutritional requirements. A narrative review summarizes evidence from 28 original articles identified through a systematic searches of databases, grey literature and hand searches covering 15 years, focusing on two themes, on the impact of malnutrition on COPD, and the management of malnutrition in COPD. Malnutrition causes negative effects on exercise and muscle function and lung function as well as increasing exacerbations, mortality and cost. Management options include nutritional supplementation which may increase weight and muscle function. Nutritional education has short-term improvements. Malnutrition affects multiple aspects of COPD, but treatment is of benefit. Clinical practice should include nutrition management.

Keywords: BMI; Chronic obstructive pulmonary disease; Cost; Exacerbation; FFMI; Malnutrition; Management; Mortality; Nutritional support.

Publication types

  • Systematic Review

MeSH terms

  • Body Mass Index
  • Disease Progression
  • Humans
  • Malnutrition / etiology
  • Malnutrition / therapy*
  • Nutritional Requirements*
  • Nutritional Status
  • Nutritional Support / methods*
  • Patient Care Management / methods*
  • Patient Education as Topic
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / rehabilitation*