Systematic review of tailored dietary advice and dietitian involvement in the treatment of chronic obstructive pulmonary disease (COPD).

Erika Penz, Kylie Bell, Josh Lawson, Allison Cammer

Journal: Respiratory medicine 2024;225():107584

PMID: 38467310

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Abstract

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a leading public health concern globally. Interdisciplinary pulmonary rehabilitation programs exist and should ideally consider nutritional health impacts since the nutritional status of COPD patients is often compromised. However, little is known about the role of dietary counseling in COPD management.

RESEARCH QUESTION

Does providing tailored dietary advice to adult patients with COPD improve outcomes?

STUDY DESIGN AND METHODS

We conducted a systematic review. The following electronic databases and registrars were used: MEDLINE, EMBASE, Web of Science, CINAHL, Cochrane Library, and ClinicalTrials.gov. The original search was conducted in June 2021 with an updated search conducted on February 21, 2024. Validity and bias assessments were completed.

RESULTS

We selected 14 articles for inclusion. Multiple outcomes were considered including functional, body composition, nutritional intake, cost analyses, quality of life, and others. The most common measured outcomes were quality of life and the 6 min walk test. A number of interventions were used with most interventions being interdisciplinary pulmonary rehabilitation packages where nutrition counseling was one component. A number of interventions showed positive results but there tended to be inconsistency.

INTERPRETATION

Evidence shows that various interventions appear to improve outcomes, but it is difficult to determine if improvements are due to nutritional intervention specifically or a rehabilitation program as a whole. More specific randomized controlled trials should be completed regarding tailored nutritional counseling and therapy in adults with COPD to determine the benefits attributable to nutritional interventions.

Address: College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Respiratory Research Centre (RRC), University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Electronic address: [email protected].; Respiratory Research Centre (RRC), University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Canadian Centre for Rural and Agricultural Health (CCRAH), University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Electronic address: [email protected].; Respiratory Research Centre (RRC), University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Electronic address: [email protected].; College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Respiratory Research Centre (RRC), University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Electronic address: [email protected].

DOI: 10.1016/j.rmed.2024.107584

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MeSH Terms: Pulmonary Disease, Chronic Obstructive, Humans, Quality of Life, Nutritionists, Nutritional Status, Counseling, Walk Test, Male, Female, Adult