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Liljeberg E, Payne L, Skinnars Josefsson M, Söderström L, Einarsson S. Understanding the complexity of barriers and facilitators to adherence to oral nutritional supplements among patients with malnutrition: a systematic mixed-studies review. Nutr Res Rev 2024:1-21. [PMID: 39380303 DOI: 10.1017/s0954422424000192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2024]
Abstract
The aim of this systematic mixed-studies review is to summarise barriers/facilitators to adherence to and/or consumption of oral nutritional supplements (ONS) among patients with disease-related malnutrition. In March 2022, the Cochrane CENTRAL, PUBMED, PsycINFO (Ovid) and CINAHL were searched for articles with various study designs, published since 2000. Articles were identified on the basis of 'population' (patients ≥18 years with malnutrition/at nutritional risk), 'intervention' (ONS with ≥2 macronutrients and micronutrients), 'comparison' (any comparator/no comparator) and 'outcome' (factors affecting adherence or consumption) criteria. A sequential exploratory synthesis was conducted: first, a thematic synthesis was performed identifying barriers/facilitators; and second, the randomised controlled trials (RCTs) were used to support these findings. The five WHO dimensions of adherence guided the analysis. Study inclusion, data extraction, analysis and risk-of-bias assessment (MMAT 2018) were carried out independently by two researchers. From 21 835 screened articles, 171 were included with 42% RCTs and 20% qualitative studies. The two major populations were patients with malignancies (34%) and older adults (35%). In total, fifty-nine barriers/facilitators were identified. Patients' health status, motivation, product tolerance and satisfaction as well as well-functioning healthcare routines and support were factors impacting ONS consumption. Few barriers/facilitators (n = 13) were investigated in RCTs. Two of those were serving a small ONS volume and integrating ONS into ward routines. Given the complexity of ONS adherence, non-adherence to ONS should be addressed using a holistic approach. More studies are needed to investigate the effect of different approaches to increase adherence to ONS.
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Affiliation(s)
- Evelina Liljeberg
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Geriatrics, Rehabilitation Medicine and Pain Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Liz Payne
- School of Psychology, University of Southampton, Southampton, UK
| | | | - Lisa Söderström
- Centre for Clinical Research Västerås, Uppsala University, Västerås, Sweden
| | - Sandra Einarsson
- Department of Food, Nutrition and Culinary Science, Umeå University, Umeå, Sweden
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Justel Enríquez A, Rabat-Restrepo JM, Vilchez-López FJ, Tenorio-Jiménez C, García-Almeida JM, Irles Rocamora JA, Pereira-Cunill JL, Martínez Ramírez MJ, Molina-Puerta MJ, Molina Soria JB, Rebollo-Pérez MI, Olveira G, García-Luna PP. Practical Guidelines by the Andalusian Group for Nutrition Reflection and Investigation (GARIN) on Nutritional Management of Patients with Chronic Obstructive Pulmonary Disease: A Review. Nutrients 2024; 16:3105. [PMID: 39339705 PMCID: PMC11434837 DOI: 10.3390/nu16183105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Revised: 09/06/2024] [Accepted: 09/10/2024] [Indexed: 09/30/2024] Open
Abstract
Malnutrition is common in chronic obstructive pulmonary disease (COPD) patients and is associated with worse lung function and greater severity. This review by the Andalusian Group for Nutrition Reflection and Investigation (GARIN) addresses the nutritional management of adult COPD patients, focusing on Morphofunctional Nutritional Assessment and intervention in clinical practice. A systematic literature search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, followed by critical appraisal based on Scottish Intercollegiate Guidelines Network (SIGN) guidelines. Recommendations were graded according to the European Society for Clinical Nutrition and Metabolism (ESPEN) system. The results were discussed among GARIN members, with consensus determined using a Likert scale. A total of 24 recommendations were made: 2(A), 6(B), 2(O), and 14(GPP). Consensus exceeded 90% for 17 recommendations and was 75-90% for 7. The care of COPD patients is approached from a nutritional perspective, emphasizing nutritional screening, morphofunctional assessment, and food intake in early disease stages. Nutritional interventions include dietary advice, recommendations on food group intake, and the impact of specialized nutritional treatment, particularly oral nutritional supplements. Other critical aspects, such as physical activity and quality of life, are also analyzed. These recommendations provide practical guidance for managing COPD patients nutritionally in clinical practice.
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Affiliation(s)
- Alicia Justel Enríquez
- Servicio de Endocrinología y Nutrición, Hospital Universitario de la Princesa, 28006 Madrid, Spain
| | - Juana M. Rabat-Restrepo
- Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen Macarena, 41009 Sevilla, Spain
- Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, 41009 Sevilla, Spain; (J.-A.I.R.); (P.P.G.-L.)
| | | | - Carmen Tenorio-Jiménez
- Endocrinology and Nutrition Clinical Management Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain
| | - José M. García-Almeida
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga/Plataforma Bionand, 29010 Málaga, Spain
| | - José-Antonio Irles Rocamora
- Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, 41009 Sevilla, Spain; (J.-A.I.R.); (P.P.G.-L.)
- UGC Endocrinología y Nutrición, Hospital Universitario Valme, 41014 Sevilla, Spain
| | - José L. Pereira-Cunill
- Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, 41009 Sevilla, Spain; (J.-A.I.R.); (P.P.G.-L.)
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain
- Endocrine Diseases Research Group, Institute of Biomedicine of Seville (IBIS), 41007 Sevilla, Spain
| | - María J. Martínez Ramírez
- Servicio de Endocrinología y Nutrición, Complejo Hospitalario de Jaén, 23007 Jaén, Spain
- Facultad de Medicina, Universidad de Jaén, 23071 Jaén, Spain
| | - María J. Molina-Puerta
- UGC Endocrinología y Nutrición, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain
| | | | - María I. Rebollo-Pérez
- Servicio de Endocrinología y Nutrición, Hospital Juan Ramón Jiménez, 21005 Huelva, Spain
| | - Gabriel Olveira
- Instituto de Investigación Biomédica de Málaga/Plataforma Bionand, 29010 Málaga, Spain
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Departamento de Medicina y Dermatología, Facultad de Medicina, Universidad de Málaga, 29010 Málaga, Spain
| | - Pedro P. García-Luna
- Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, 41009 Sevilla, Spain; (J.-A.I.R.); (P.P.G.-L.)
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain
- Endocrine Diseases Research Group, Institute of Biomedicine of Seville (IBIS), 41007 Sevilla, Spain
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Engelen MPKJ, Simbo SY, Ruebush LE, Thaden JJ, Ten Have GAM, Harrykissoon RI, Zachria AJ, Calder PC, Pereira SL, Deutz NEP. Functional and metabolic effects of omega-3 polyunsaturated fatty acid supplementation and the role of β-hydroxy-β-methylbutyrate addition in chronic obstructive pulmonary disease: A randomized clinical trial. Clin Nutr 2024; 43:2263-2278. [PMID: 39181037 DOI: 10.1016/j.clnu.2024.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 07/31/2024] [Accepted: 08/07/2024] [Indexed: 08/27/2024]
Abstract
INTRODUCTION Short-term (4 weeks) supplementation with n-3 polyunsaturated fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) has recently been shown to improve protein metabolism in a dose dependent way in normal weight patients with Chronic Obstructive Pulmonary Disease (COPD). Furthermore, EPA/DHA supplementation was able to increase extremity lean soft tissue but not muscle function. No studies are available combining n-3 PUFAs and the leucine metabolite β-hydroxy-β-methylbutyrate (HMB) supplementation in chronic clinical conditions. Whether adding HMB to daily EPA/DHA supplementation for 10 weeks enhances muscle and brain health, daily functional performance, and quality of life of patients with COPD by further improving their protein and amino acid homeostasis remains unknown. METHODS Patients with COPD (GOLD: II-IV, n = 46) received daily for 10 weeks, according to a randomized double-blind placebo-controlled three-group design, EPA/DHA (n = 16), EPA/DHA to which HMB was added (n = 14), or placebo (n = 16). The daily dose of 2.0 g of EPA/DHA or soy + corn oil as the placebo was provided via gel capsules, and 3.0 g of Ca-HMB or maltodextrin as placebo as powders. At pre- and post-intervention, a pulse mixture of multiple amino acids was administered to measure postabsorptive net protein breakdown (netPB as primary endpoint) and whole body production (WBP) and conversion rates of the amino acids. As secondary endpoints, lean soft tissue and fat mass were assessed by dual-energy X-ray absorptiometry, upper and lower muscle function by handgrip and single leg isokinetic dynamometry, brain (cognitive, wellbeing) health by assessments, daily functional performance by measuring 6-min walk distance, 4-m gait speed, and postural balance, and quality of life by questionnaire. Plasma enrichments and concentrations were analyzed by LC-MS/MS, and systemic inflammatory profile and metabolic hormones by Luminex. RESULTS HMB + EPA/DHA but not EPA/DHA supplementation increased postabsorptive netPB (p = 0.028), and WBPs of glutamine (p = 0.024), taurine (p = 0.039), and tyrosine (p = 0.036). Both EPA/DHA and HMB + EPA/DHA supplementation resulted in increased WBP of phenylalanine (p < 0.05). EPA/DHA but not HMB + EPA/DHA was able to increase WBP of arginine (p = 0.030), citrulline (p = 0.008), valine (p = 0.038), and conversion of citrulline to arginine (p = 0.009). Whole body and extremity fat mass were reduced after HMB + EPA/DHA supplementation only, whereas lean soft tissue was increased after EPA/DHA (p = 0.049) and HMB + EPA/DHA (p = 0.073). No other significant findings were observed. Reductions in several proinflammatory cytokines were observed in the HMB + EPA/DHA group including IL-2, IL-17, IL-6, IL-12P40, and TNF-β (p < 0.05). CONCLUSIONS Ten weeks of supplementation with 2 g of EPA/DHA daily is sufficient to induce muscle gain in COPD but HMB is needed to induce fat loss. Whether HMB is solely responsible for the fat mass loss or has a synergistic effect with EPA/DHA remains unclear. The increase in net protein breakdown observed with HMB + EPA/DHA supplementation may indicate a beneficial enhanced protein turnover cycling associated with increased lean soft tissue. CLINICAL TRIAL REGISTRY ClinicalTrials.gov; NCT03796455.
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Affiliation(s)
- Mariëlle P K J Engelen
- Center for Translational Research in Aging and Longevity, Dept. Kinesiology and Sport Management, Texas A&M University, College Station, USA; Primary Care & Rural Medicine, Texas A&M University, College Station, TX, USA.
| | - Sunday Y Simbo
- Center for Translational Research in Aging and Longevity, Dept. Kinesiology and Sport Management, Texas A&M University, College Station, USA
| | - Laura E Ruebush
- Center for Translational Research in Aging and Longevity, Dept. Kinesiology and Sport Management, Texas A&M University, College Station, USA
| | - John J Thaden
- Center for Translational Research in Aging and Longevity, Dept. Kinesiology and Sport Management, Texas A&M University, College Station, USA
| | - Gabriella A M Ten Have
- Center for Translational Research in Aging and Longevity, Dept. Kinesiology and Sport Management, Texas A&M University, College Station, USA
| | - Rajesh I Harrykissoon
- Pulmonary, Critical Care and Sleep Medicine, Scott and White Medical Center, College Station, TX, USA
| | - Anthony J Zachria
- Pulmonary, Critical Care and Sleep Medicine, Scott and White Medical Center, College Station, TX, USA
| | - Philip C Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | | | - Nicolaas E P Deutz
- Primary Care & Rural Medicine, Texas A&M University, College Station, TX, USA
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Holst M, Geisler L, Mikkelsen S, Rasmussen HH, Jørgensen BG, Beck AM. Pulmonary rehabilitation: A cohort study assessing the effectiveness of a multi-professional nutrition intervention. Clin Nutr ESPEN 2024; 62:33-42. [PMID: 38901947 DOI: 10.1016/j.clnesp.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 04/15/2024] [Accepted: 04/23/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Limited benefit of pulmonary exercise rehabilitation has been associated with fulfilment of energy and protein requirements. OBJECTIVES The aim was to enhance dietary intake towards requirements and to maintain changes after a pulmonary rehabilitation program. METHODS This single arm intervention study included multidisciplinary focus on nutrition and three sessions of individual dietary counselling during a 10-week pulmonary exercise rehabilitation in five municipalities centers. Data were collected at baseline (P0), at the end of intervention (P1) and for two municipalities at three months post intervention (P2). RESULTS Of the 111 included participants, (mean age 70.8 (±9)) 99 (89%) completed the rehabilitation including the three individual dietary counselling's. A very large variation in body composition including body mass index and exercise abilities was found. Protein intake improved from 64 (±22 g) (P0) to 88 (±25 g) (P1) (p < 0.001) and energy intake from 1676 (±505 kcal) (P0) to 1941 (±553 kcal) (p < 0.001) (P1) and Muscle Mass Index increased from 10.6 (±3.2) (P0) to 10.9 (±3.2) (P1) (p = 0.007); number of 30 s chair stand test improved from 10.9 (±2.8) repetitions (P0) to 14.1 (±4.3) repetitions (P1) (p < 0.001), distance in six-minut walking test improved from 377.2 (±131.2 m) (P0) to 404.1 (±128.6 m) (P1) (p < 0.001). Two municipalities completed the three months follow-up. For those, dietary improvements remained stable, including protein intake. CONCLUSION Including three sessions of dietary counselling in a multi-professional effort was associated with improved individualized dietary intake, as well as physical function. Benefits remained almost unchanged after three months. Improvements in function could not be fully explained by improved intakes.
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Affiliation(s)
- Mette Holst
- Center of Nutrition and Intestinal Failure, Aalborg University Hospital, Søndre Skovvej 5, DK-9000 Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Lea Geisler
- Center of Nutrition and Intestinal Failure, Aalborg University Hospital, Søndre Skovvej 5, DK-9000 Aalborg, Denmark.
| | - Sabina Mikkelsen
- Center of Nutrition and Intestinal Failure, Department of Gastroenterology, Aalborg University Hospital, Søndre Skovvej 5, DK-9000 Aalborg, Denmark.
| | - Henrik H Rasmussen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Center of Nutrition and Intestinal Failure, Department of Gastroenterology, Aalborg University Hospital, Søndre Skovvej 5, DK-9000 Aalborg, Denmark.
| | - Birte G Jørgensen
- Department of Health Promotion, Frederikshavn Municipality, Nytorv 1, DK-9900 Frederikshavn, Denmark.
| | - Anne Marie Beck
- "EATEN" Research Unit for Dieticians and Nutrition Research, "Herlev Hospital, Borgmester Ib Juuls Vej 1, 20th Floor, DK-2730 Herlev, Denmark.
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Lattanzi G, Lelli D, Antonelli Incalzi R, Pedone C. Effect of Macronutrients or Micronutrients Supplementation on Nutritional Status, Physical Functional Capacity and Quality of Life in Patients with COPD: A Systematic Review and Meta-Analysis. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024; 43:473-487. [PMID: 38329722 DOI: 10.1080/27697061.2024.2312852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/25/2024] [Indexed: 02/09/2024]
Abstract
Given the importance that a correct and balanced nutrition has on patients with chronic obstructive pulmonary disease (COPD), supplementation of macro and micronutrients has been proposed, but the results of previous meta-analyses are contrasting. We performed an update of the latest evidence through a systematic review and meta-analysis of studies to assess the role of nutritional supplements in improving nutritional status, pulmonary function, physical performance, and quality of life of these patients.We included randomized controlled trials (RCTs) published between 01-01-2010 and 11-01-2023 evaluating the effectiveness of nutritional support in patients affected by stable COPD with an intervention of at least 2 weeks. Primary outcomes were changes in body mass index (BMI) and fat free mass index (FFMI). Secondary outcomes were exercise tolerance (6-min walking test, 6MWT), quality of life (St George's Respiratory Questionnaire, SGRQ) and respiratory function (FEV1). According with supplements type (macronutrients or micronutrients), we calculated the pooled adjusted mean difference (MD) and 95% confidence intervals (95%CIs) of the selected outcomes, using random-effects models in presence of high heterogeneity (I2>50%) or fixed-effects models otherwise. The risk of publication bias was evaluated with the trim and fill method.From 967 articles, 20 RCTs were included. Macronutrients supplementation improved BMI (MD 1.0 kg/m2, 95%CI 0.21-1.79), FFMI (MD 0.77 Kg/m2, 95%CI 0.48-1.06), 6MQT (MD 68.39 m, 95%CI 40.07-96.71), and SGRQ (MD -5.14, 95% CI -7.31-2.97), while it does not ameliorate respiratory function (MD 0.26% 95%CI -1.87-2.40). Micronutrients supplementation alone did not improve any of the considered outcomes.
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Affiliation(s)
- Greta Lattanzi
- Unit of Food Science and Human Nutrition, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Diana Lelli
- Operative Research Unit of Geriatrics, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Raffaele Antonelli Incalzi
- Operative Research Unit of Internal Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Research Unit of Internal Medicine, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Claudio Pedone
- Operative Research Unit of Geriatrics, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Research Unit of Geriatrics, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
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Iwanami Y, Ebihara K, Nakao K, Kubo R, Miyagi M, Nakamura Y, Sakamoto S, Kishi K, Okuni I, Ebihara S. Impact of Controlling Nutritional Status Score on Mortality in Elderly Patients with Idiopathic Pulmonary Fibrosis. J Clin Med 2024; 13:2825. [PMID: 38792367 PMCID: PMC11122391 DOI: 10.3390/jcm13102825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/01/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Background: There are only a few reports on the nutritional status and mortality of patients with idiopathic pulmonary fibrosis (IPF). As such, this study aims to investigate the relationship between controlling nutritional status (CONUT) and the mortality of elderly patients with IPF. Methods: A total of 170 IPF patients aged ≥65 years old who visited the rehabilitation department of our hospital between July 2014 and July 2021 (mean age: 75.7 ± 6.3 years, sex (male/female): 138/32, %FVC: 78.3 ± 18.3%) were retrospectively analyzed. The Kaplan-Meier method and log-rank test were applied. Furthermore, using a Cox proportional hazards model with multivariate analysis, we analyzed the relationship between all-cause mortality and baseline characteristics including CONUT. Results: Based on the CONUT score, the normal group included 101 cases, the mild group included 58 cases, the moderate group included 11 cases, and the severe group had 0 cases. There were 49 cases of all-cause mortality events, suggesting that the mortality of the moderate group was significantly poorer than that of the normal and mild groups (p < 0.05). Furthermore, multivariate analysis identified GAP stage (HR: 5.972, 95%CI: 2.901~12.291, p < 0.0001), mMRC scale (HR: 0.615, 95%CI: 0.389~0.971, p = 0.009), and CONUT (HR: 2.012, 95%CI: 1.192~3.395, p = 0.037) as factors significantly influencing mortality. Conclusions: Severe malnutrition was not observed in elderly patients with IPF. Moderate malnutrition was associated with a significantly higher risk of all-cause mortality, suggesting that CONUT is an important indicator for predicting mortality.
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Affiliation(s)
- Yuji Iwanami
- Department of Rehabilitation Medicine, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; (Y.I.); (K.E.); (K.N.); (R.K.); (I.O.)
| | - Kento Ebihara
- Department of Rehabilitation Medicine, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; (Y.I.); (K.E.); (K.N.); (R.K.); (I.O.)
| | - Keiko Nakao
- Department of Rehabilitation Medicine, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; (Y.I.); (K.E.); (K.N.); (R.K.); (I.O.)
| | - Ryuki Kubo
- Department of Rehabilitation Medicine, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; (Y.I.); (K.E.); (K.N.); (R.K.); (I.O.)
| | - Midori Miyagi
- Department of Rehabilitation Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan;
| | - Yasuhiko Nakamura
- Department of Respiratory Medicine, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; (Y.N.); (S.S.); (K.K.)
| | - Susumu Sakamoto
- Department of Respiratory Medicine, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; (Y.N.); (S.S.); (K.K.)
| | - Kazuma Kishi
- Department of Respiratory Medicine, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; (Y.N.); (S.S.); (K.K.)
| | - Ikuko Okuni
- Department of Rehabilitation Medicine, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; (Y.I.); (K.E.); (K.N.); (R.K.); (I.O.)
| | - Satoru Ebihara
- Department of Rehabilitation Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan;
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Heefner A, Simovic T, Mize K, Rodriguez-Miguelez P. The Role of Nutrition in the Development and Management of Chronic Obstructive Pulmonary Disease. Nutrients 2024; 16:1136. [PMID: 38674827 PMCID: PMC11053888 DOI: 10.3390/nu16081136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a prevalent lung condition associated with significant morbidity and mortality. The management of COPD classically involves pulmonary rehabilitation, bronchodilators, and corticosteroids. An aspect of COPD management that is currently lacking in the literature is nutritional management, despite the prevalence of inadequate nutritional status in patients with COPD. In addition, certain nutritional imbalances have been reported to increase the risk of COPD development. This review summarizes the current literature on the role diet and nutrients may play in the risk and management of COPD development.
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Affiliation(s)
- Allison Heefner
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284, USA
- School of Medicine, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Tijana Simovic
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Kasey Mize
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Paula Rodriguez-Miguelez
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284, USA
- Division of Pulmonary and Critical Care, Virginia Commonwealth University, Richmond, VA 23284, USA
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8
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Huang WJ, Ko CY. Systematic review and meta-analysis of nutrient supplements for treating sarcopenia in people with chronic obstructive pulmonary disease. Aging Clin Exp Res 2024; 36:69. [PMID: 38483650 PMCID: PMC10940388 DOI: 10.1007/s40520-024-02722-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/09/2024] [Indexed: 03/17/2024]
Abstract
Individuals with chronic obstructive pulmonary disease (COPD) are prone to malnutrition and sarcopenia as a result of nutritional deficiencies and increased energy metabolism. However, the effects of nutrient supplements (NS) on treating sarcopenia in patients with COPD are not well established from systematic evidence. This meta-analysis examined the effect of NS on sarcopenia in patients with COPD. A systematic search of multiple databases was conducted, and 29 randomized controlled trials involving 1625 participants (age, mean [SD] = 67.9 [7.8] years) were analyzed. NS demonstrated significant improvements in body weight (MD,1.33 kg; 95% CI, 0.60, 2.05 kg; P = 0.0003; I2 = 87%), fat-free mass index (MD, 0.74 kg/m2; 95% CI, 0.21, 1.27 kg/m2; P = 0.007; I2 = 75%), and 6-min walk test (MD, 19.43 m; 95% CI, 4.91, 33.94 m; P = 0.009; I2 = 81%) compared with control. However, NS had nonsignificant effects on handgrip strength (SMD, 0.36; 95% CI, - 0.15, 0.88; P = 0.16; I2 = 87%) and quadriceps muscle strength (SMD, 0.11; 95% CI, - 0.06, 0.27; P = 0.20; I2 = 25%) compared with the control. In conclusion, NS may be an effective treatment for improving body composition and physical performance in COPD. Future studies should explore the effects of intervention durations, specific NS types, or combined training in patients with COPD and sarcopenia.
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Affiliation(s)
- Wen-Jian Huang
- Department of Clinical Nutrition, the Second Affiliated Hospital of Fujian Medical University, No. 34, Zhongshanbei Rd, Licheng District, Quanzhou, 362000, Fujian, China
- Huidong Center for Chronic Disease Control, Huizhou, 516300, Guangdong, China
| | - Chih-Yuan Ko
- Department of Clinical Nutrition, the Second Affiliated Hospital of Fujian Medical University, No. 34, Zhongshanbei Rd, Licheng District, Quanzhou, 362000, Fujian, China.
- School of Public Health, Fujian Medical University, Fuzhou, Fujian, China.
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Sasanfar B, Toorang F, Salehi-Abarghouei A. Effects of n-3 polyunsaturated fatty acid supplementation on appetite: a systematic review and meta-analysis of controlled clinical trials. Syst Rev 2024; 13:44. [PMID: 38281014 PMCID: PMC10821539 DOI: 10.1186/s13643-023-02430-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 12/11/2023] [Indexed: 01/29/2024] Open
Abstract
BACKGROUND The current studies explore the effect of omega-3 polyunsaturated fatty acids (PUFAs) on appetite. OBJECTIVE To examine the effect of omega-3 polyunsaturated fatty acids (n-3 PUFAs) on appetite using a systematic review and meta-analysis of controlled clinical trials (CTs). PATIENTS AND METHODS Online databases including PubMed, Scopus, ISI Web of Science, and Google Scholar were searched up to January 2022. A random-effects model was used to compare the overall standardized mean difference in appetite scores between n-3 PUFAs supplemented and control individuals. RESULTS Fifteen eligible CTs with 1504 participants (872 for n-3 PUFA supplementation and 632 for placebo groups) were included in our systematic review. The meta-analysis showed no significant difference in overall appetite score between n-3 PUFAs supplemented and control groups (standardized mean difference [SMD] = 0.458, 95% confidence interval [CI] - 0.327, 1.242, P value = 0.25). However, the n-3 PUFA supplementation significantly increased the desire to eat (SMD = 1.07, 95% CI 0.116, 2.029, P = 0.02) compared to control. CONCLUSION Although we found no effect of omega-3 supplementation on overall appetite score, it modestly increases the desire to eat. Further CTs evaluating the effect of PUFAs on appetite are still needed to confirm these findings.
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Affiliation(s)
- Bahareh Sasanfar
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Faculty of Health, Shahid Sadoughi University of Medical Sciences, P O Box 8915173160, Yazd, Iran
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
- Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fatemeh Toorang
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
- Departments of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Amin Salehi-Abarghouei
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
- Yazd Cardiovascular Research Center, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
- Department of Nutrition, School of Public Health, Faculty of Health, Shahid Sadoughi University of Medical Sciences, P O Box 8915173160, Yazd, Iran.
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10
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Zong M, Shen H, Ren L, Han T, Chen J, Chen Y, Lu J, Zhang Y, Li S, Sun J. Effects of whey protein complex combined with low-intensity exercise in elderly inpatients with COPD at a stable stage. Asia Pac J Clin Nutr 2023; 32:375-382. [PMID: 38135472 PMCID: PMC11090394 DOI: 10.6133/apjcn.202312_32(4).0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
BACKGROUND AND OBJECTIVES Previous literature mostly has demonstrated the efficacy of pulmonary rehabilitation (PR) combined with whole nutrition powder in patients with chronic obstructive pulmonary disease (COPD). However, the benefits of whey protein as an oral nutritional supplement (ONS) during PR are not clear. METHODS AND STUDY DESIGN It took 12 weeks to complete the trial, we divided 90 elderly patients with stable-stage COPD into a low-intensity exercise group (n= 30, PR group), PR plus whey proteins complex group (n= 30, PRWP group), and a control group (n= 30) randomly, and assessed index such as exercise capacity, mental health status, lung function, and body composition. Eventually, 84 people persisted until the end of the trial. RESULTS Compared with the control group, hand grip strength (HGS)(1.4 ± 0.6 kg, and 1.0 ± 0.2 kg respectively, p< 0.05) in the PRWP and PR group, 6 minutes of walking distance (6MWD)(14.1 ± 3.8m, p< 0.05) in PRWP group improved. Furthermore, compared with the PR group, Medical Research Council Dyspnea Scale (MRC)(-0.2 ± 0.1, p< 0.01), anxiety score (-1.2 ± 0.4, p< 0.01), and body weight (2.0 ± 0.8kg, p< 0.05) improved in the PRWP group. There were no inter-group differences in a fat-free mass index or appendicular skeletal muscle mass index. CONCLUSIONS Muscle strength could be enhanced in both intervention models. Adding whey protein complex was additionally successful in rectifying dyspnea, anxiety, and weight loss caused by exercise. This rehabilitation pattern might be valuable in elderly patients with COPD.
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Affiliation(s)
- Min Zong
- Clinical nutrition center, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Honghua Shen
- Department of Respiratory Rehabilitation, Shanghai Fourth Rehabilitation Hospital, China
| | - Lei Ren
- Department of Respiratory Rehabilitation, Shanghai Fourth Rehabilitation Hospital, China
| | - Tao Han
- Department of Laboratory Medicine, Shanghai Fourth Rehabilitation Hospital, China
| | - Jie Chen
- Geriatric Medicine department, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Yanqiu Chen
- Clinical nutrition center, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Jiashuo Lu
- Food hygiene and nutrition department, Shanghai University of Traditional Chinese Medicine, China
| | - Yin Zhang
- Department of Respiratory Rehabilitation, Shanghai Fourth Rehabilitation Hospital, China
| | - Shijie Li
- Clinical nutrition center, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Jianqin Sun
- Clinical nutrition center, Huadong Hospital Affiliated to Fudan University, Shanghai, China.
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11
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Shen Z, Qiu B, Chen L, Zhang Y. Common gastrointestinal diseases and chronic obstructive pulmonary disease risk: a bidirectional Mendelian randomization analysis. Front Genet 2023; 14:1256833. [PMID: 38046045 PMCID: PMC10690629 DOI: 10.3389/fgene.2023.1256833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/26/2023] [Indexed: 12/05/2023] Open
Abstract
Background: Observational studies suggest an association between gastrointestinal diseases and chronic obstructive pulmonary disease (COPD), but the causal relationship remains unclear. Methods: We conducted bidirectional Mendelian randomization (MR) analysis using summary data from genome-wide association study (GWAS) to explore the causal relationship between common gastrointestinal diseases and COPD. Gastrointestinal diseases included gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), irritable bowel syndrome (IBS), Crohn's disease (CD), ulcerative colitis (UC), functional dyspepsia (FD), non-infectious gastroenteritis (NGE), and constipation (CP). Significant MR analysis results were replicated in the COPD validation cohort. Results: Bidirectional MR analysis supported a bidirectional causal relationship between GERD and COPD, and COPD was also found to increase the risk of IBS and CP. Our study also provided evidence for a bidirectional causal relationship between PUD and COPD, although the strength of evidence may be insufficient. Furthermore, we provided evidence that there is no causal association between CD, UC, FD, NGE, and COPD. Conclusion: This study offers some evidence to clarify the causal relationship between common gastrointestinal diseases and COPD. Further research is needed to understand the underlying mechanisms of these associations.
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Affiliation(s)
- Zixiong Shen
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, China
| | - Binxu Qiu
- Department of Gastrointestinal Surgery, The First Hospital of Jilin University, Changchun, China
| | - Lanlan Chen
- Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, China
| | - Yiyuan Zhang
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, China
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12
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Zailani H, Satyanarayanan SK, Liao WC, Hsu YT, Huang SY, Gałecki P, Su KP, Chang JPC. Roles of Omega-3 Polyunsaturated Fatty Acids in Managing Cognitive Impairment in Chronic Obstructive Pulmonary Disease: A Review. Nutrients 2023; 15:4363. [PMID: 37892438 PMCID: PMC10609799 DOI: 10.3390/nu15204363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/08/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) contributes significantly to the death of people worldwide, especially the elderly. An essential feature of COPD is pulmonary inflammation, which results from long-term exposure to noxious substances from cigarette smoking and other environmental pollutants. Pulmonary inflammatory mediators spill over to the blood, leading to systemic inflammation, which is believed to play a significant role in the onset of a host of comorbidities associated with COPD. A substantial comorbidity of concern in COPD patients that is often overlooked in COPD management is cognitive impairment. The exact pathophysiology of cognitive impairment in COPD patients remains a mystery; however, hypoxia, oxidative stress, systemic inflammation, and cerebral manifestations of these conditions are believed to play crucial roles. Furthermore, the use of medications to treat cognitive impairment symptomatology in COPD patients has been reported to be associated with life-threatening adverse effects, hence the need for alternative medications with reduced side effects. In this Review, we aim to discuss the impact of cognitive impairment in COPD management and the potential mechanisms associated with increased risk of cognitive impairment in COPD patients. The promising roles of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) in improving cognitive deficits in COPD patients are also discussed. Interestingly, ω-3 PUFAs can potentially enhance the cognitive impairment symptomatology associated with COPD because they can modulate inflammatory processes, activate the antioxidant defence system, and promote amyloid-beta clearance from the brain. Thus, clinical studies are crucial to assess the efficacy of ω-3 PUFAs in managing cognitive impairment in COPD patients.
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Grants
- MOST 109-2320-B-038-057-MY3, 109-2320-B-039-066, 110-2321-B-006-004, 111-2321-B-006-008, 110-2811-B-039-507, 110-2320-B-039-048-MY2, and 110-2320-B-039-047-MY3, 110-2813-C-039-327-B, 110-2314-B-039-029-MY3, 111-2314-B-039-041-MY3 Ministry of Science and Technology, Taiwan
- ANHRF 109-31, 109-40, 110-13, 110-26, 110-44, 110-45, 111-27, and 111-28 An-Nan Hospital, China Medical University, Tainan, Taiwan
- CMRC-CMA-2 Higher Education Sprout Project by the Ministry of Education (MOE), Taiwan
- CMU 110-AWARD-02, CMU108-SR-106, CMU110-N-17, CMU110-SR-73 China Medical University, Taichung, Taiwan
- CRS-108-048, DMR-105-053, DMR-109-102, DMR-109-244, DMR-HHC-109-11, DMR-HHC-109-12, DMR-HHC-110-10, DMR-110-124, DMR-111-245 and DMR-HHC-111-8 China Medical University Hospital, Taichung, Taiwan
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Affiliation(s)
- Halliru Zailani
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404327, Taiwan; (H.Z.); (S.K.S.)
- Graduate Institute of Nutrition, China Medical University, Taichung 404, Taiwan
- Department of Biochemistry, Ahmadu Bello University, Zaria 810106, Nigeria
| | - Senthil Kumaran Satyanarayanan
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404327, Taiwan; (H.Z.); (S.K.S.)
| | - Wei-Chih Liao
- Division of Pulmonary and Critical Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 404327, Taiwan
| | - Yi-Ting Hsu
- Department of Neurology, China Medical University Hospital, Taichung 404327, Taiwan;
| | - Shih-Yi Huang
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 11031, Taiwan
- Nutrition Research Centre, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Piotr Gałecki
- Department of Adult Psychiatry, Medical University of Lodz, 91-229 Lodz, Poland;
| | - Kuan-Pin Su
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404327, Taiwan; (H.Z.); (S.K.S.)
- College of Medicine, China Medical University, Taichung 404, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404, Taiwan
- An-Nan Hospital, China Medical University, Tainan 717, Taiwan
| | - Jane Pei-Chen Chang
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404327, Taiwan; (H.Z.); (S.K.S.)
- College of Medicine, China Medical University, Taichung 404, Taiwan
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13
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Fekete M, Csípő T, Fazekas-Pongor V, Bálint M, Csizmadia Z, Tarantini S, Varga JT. The Possible Role of Food and Diet in the Quality of Life in Patients with COPD-A State-of-the-Art Review. Nutrients 2023; 15:3902. [PMID: 37764686 PMCID: PMC10536642 DOI: 10.3390/nu15183902] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/25/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Diet has been described as a modifiable risk factor for the development and progression of chronic diseases, and emerging evidence increasingly points to its preventive and therapeutic role in chronic obstructive pulmonary disease (COPD). While the relationship between the underlying disease and diet is natural in conditions such as metabolic disorders, obesity, diabetes, etc., the direct effect is not so evident in chronic obstructive pulmonary disease. Poor diet quality and the development of nutrient deficiencies in respiratory diseases, including COPD, can be associated with disease-specific factors such as the exacerbation of respiratory symptoms. These symptoms can be improved by dietary interventions, leading to positive changes in the pathogenesis of the disease and the quality of life of patients. Therefore, our aim was to review the latest randomized controlled trials (RCTs) of dietary interventions in chronic respiratory patients and describe their effects on respiratory function, physical activity, systemic inflammatory parameters, and quality of life. We conducted a literature search on dietary interventions for COPD patients in the PubMed, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials (CENTRAL) databases, focusing on publications from 1 July 2018 to 1 July 2023. We used specific keywords and MESH terms, focusing on RCTs. A total of 26 articles and 1811 COPD patients were included in this review. On the basis of our findings, dietary interventions, in particular components of the Mediterranean diet such as protein, omega-3 polyunsaturated fatty acids, and vegetables, appear to have beneficial effects in patients with chronic respiratory diseases, and their application is beneficial. However, long-term follow-up studies are still needed to examine the effects of dietary interventions in this patient population.
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Affiliation(s)
- Mónika Fekete
- Department of Public Health, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary; (M.F.); (T.C.); (V.F.-P.); (M.B.)
| | - Tamás Csípő
- Department of Public Health, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary; (M.F.); (T.C.); (V.F.-P.); (M.B.)
| | - Vince Fazekas-Pongor
- Department of Public Health, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary; (M.F.); (T.C.); (V.F.-P.); (M.B.)
| | - Madarász Bálint
- Department of Public Health, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary; (M.F.); (T.C.); (V.F.-P.); (M.B.)
| | - Zoltán Csizmadia
- Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary;
| | - Stefano Tarantini
- Department of Neurosurgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
- Department of Health Promotion Sciences, College of Public Health, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Peggy and Charles Stephenson Oklahoma Cancer Center, Oklahoma City, OK 73104, USA
| | - János Tamás Varga
- Department of Pulmonology, Semmelweis University, 1083 Budapest, Hungary
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14
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Tseng PT, Zeng BY, Zeng BS, Liao YC, Stubbs B, Kuo JS, Sun CK, Cheng YS, Chen YW, Chen TY, Tu YK, Lin PY, Hsu CW, Li DJ, Liang CS, Suen MW, Wu YC, Shiue YL, Su KP. Omega-3 polyunsaturated fatty acids in sarcopenia management: A network meta-analysis of randomized controlled trials. Ageing Res Rev 2023; 90:102014. [PMID: 37442370 DOI: 10.1016/j.arr.2023.102014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 07/15/2023]
Abstract
Sarcopenia frequently occurs with aging and leads to major adverse impacts on activities of daily living and quality of life in elderly individuals. Omega-3 polyunsaturated fatty acid (omega-3 PUFAs) supplements are considered promising therapeutic agents for sarcopenia management; however, the evidence remains inconsistent. We reviewed randomized controlled trials (RCTs) about omega-3 PUFA supplementation in patients with sarcopenia or in those at high risk for sarcopenia. Network meta-analysis (NMA) procedures were conducted using a frequentist model. The primary outcomes were (1) upper-extremity muscle strength and (2) lower-extremity physical function. The NMA of 16 RCTs showed that the high-dose (more than 2.5 g/day omega-3 PUFAs) group yielded the greatest improvement in both upper-extremity muscle strength and lower-extremity physical function [compared to placebo/standard care groups, standardized mean difference (SMD)= 1.68, 95% confidence interval (95%CI)= 0.03-3.33, and SMD= 0.73, 95%CI= 0.16-1.30, respectively], and the effects were reaffirmed in subgroup analyses of placebo-controlled RCTs or those excluding concurrent resistance training programs. None of the investigated omega-3 PUFAs supplementation was associated with significantly increased skeletal muscle mass, fat mass, or overall body weight. Our findings provide a basis for future large-scale RCTs to investigate the dose effects and clinical application of omega-3 PUFA supplementation in sarcopenia management. TRIAL REGISTRATION: The current study was approved by the Institutional Review Board of the Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (TSGHIRB No. B-109-29) and registered in PROSPERO (CRD42022347161).
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Affiliation(s)
- Ping-Tao Tseng
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan; Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan; Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan
| | - Bing-Yan Zeng
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Department of Internal Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Bing-Syuan Zeng
- Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan; Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Yu-Chi Liao
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan; Clinical Psychology Center, Asia University Hospital, Taichung, Taiwan; Center for Prevention and Treatment of Internet Addiction, Asia University, Taichung, Taiwan
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK; Faculty of Health, Social Care Medicine and Education, Anglia Ruskin University, Chelmsford, UK
| | - John S Kuo
- Neuroscience and Brain Disease Center, China Medical University,Taichung, Taiwan; Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Shian Cheng
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan
| | - Tien-Yu Chen
- School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Dian-Jeng Li
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Chih-Sung Liang
- School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Mein-Woei Suen
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan; Gender Equality Education and Research Center, Asia University, Taichung, Taiwan; Department of Medical Research, Asia University Hospital, Asia University, Taichung, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Yi-Cheng Wu
- Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan.
| | - Yow-Ling Shiue
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan.
| | - Kuan-Pin Su
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan; An-Nan Hospital, China Medical University, Tainan, Taiwan.
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15
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Nan Y, Zhou Y, Dai Z, Yan T, Zhong P, Zhang F, Chen Q, Peng L. Role of nutrition in patients with coexisting chronic obstructive pulmonary disease and sarcopenia. Front Nutr 2023; 10:1214684. [PMID: 37614743 PMCID: PMC10442553 DOI: 10.3389/fnut.2023.1214684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 07/24/2023] [Indexed: 08/25/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases in the elderly population and is characterized by persistent respiratory symptoms and airflow obstruction. During COPD progression, a variety of pulmonary and extrapulmonary complications develop, with sarcopenia being one of the most common extrapulmonary complications. Factors that contribute to the pathogenesis of coexisting COPD and sarcopenia include systemic inflammation, hypoxia, hypercapnia, oxidative stress, protein metabolic imbalance, and myocyte mitochondrial dysfunction. These factors, individually or in concert, affect muscle function, resulting in decreased muscle mass and strength. The occurrence of sarcopenia severely affects the quality of life of patients with COPD, resulting in increased readmission rates, longer hospital admission, and higher mortality. In recent years, studies have found that oral supplementation with protein, micronutrients, fat, or a combination of nutritional supplements can improve the muscle strength and physical performance of these patients; some studies have also elucidated the possible underlying mechanisms. This review aimed to elucidate the role of nutrition among patients with coexisting COPD and sarcopenia.
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Affiliation(s)
- Yayun Nan
- Department of Ningxia Geriatrics Medical Center, Ningxia People’s Hospital, Yinchuan, China
| | - Yuting Zhou
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Ziyu Dai
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Ting Yan
- Department of Ningxia Geriatrics Medical Center, Ningxia People’s Hospital, Yinchuan, China
| | - Pingping Zhong
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Fufeng Zhang
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Qiong Chen
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Linlin Peng
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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16
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Therdyothin A, Phiphopthatsanee N, Isanejad M. The Effect of Omega-3 Fatty Acids on Sarcopenia: Mechanism of Action and Potential Efficacy. Mar Drugs 2023; 21:399. [PMID: 37504930 PMCID: PMC10381755 DOI: 10.3390/md21070399] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/29/2023] Open
Abstract
Sarcopenia, a progressive disease characterized by a decline in muscle strength, quality, and mass, affects aging population worldwide, leading to increased morbidity and mortality. Besides resistance exercise, various nutritional strategies, including omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation, have been sought to prevent this condition. This narrative review summarizes the current evidence on the effect and mechanism of n-3 PUFA on musculoskeletal health. Despite conflicting evidence, n-3 PUFA is suggested to benefit muscle mass and volume, with more evident effects with higher supplementation dose (>2 g/day). n-3 PUFA supplementation likely improves handgrip and quadriceps strength in the elderly. Improved muscle functions, measured by walking speed and time-up-to-go test, are also observed, especially with longer duration of supplementation (>6 months), although the changes are small and unlikely to be clinically meaningful. Lastly, n-3 PUFA supplementation may positively affect muscle protein synthesis response to anabolic stimuli, alleviating age-related anabolic resistance. Proposed mechanisms by which n-3 PUFA supplementation improves muscle health include 1. anti-inflammatory properties, 2. augmented expression of mechanistic target of rapamycin complex 1 (mTORC1) pathway, 3. decreased intracellular protein breakdown, 4. improved mitochondrial biogenesis and function, 5. enhanced amino acid transport, and 6. modulation of neuromuscular junction activity. In conclusion, n-3 PUFAs likely improve musculoskeletal health related to sarcopenia, with suggestive effect on muscle mass, strength, physical performance, and muscle protein synthesis. However, the interpretation of the findings is limited by the small number of participants, heterogeneity of supplementation regimens, and different measuring protocols.
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Affiliation(s)
- Atiporn Therdyothin
- Department of Musculoskeletal Ageing and Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK
- Department of Orthopedics, Police General Hospital, Bangkok 10330, Thailand
| | | | - Masoud Isanejad
- Department of Musculoskeletal Ageing and Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK
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17
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Jenkins AR, Gaynor-Sodeifi K, Lewthwaite H, Triandafilou J, Belo LF, de Oliveira MF, Jensen D. Efficacy of interventions to alter measures of fat-free mass in people with COPD: a systematic review and meta-analysis. ERJ Open Res 2023; 9:00102-2023. [PMID: 37529637 PMCID: PMC10388177 DOI: 10.1183/23120541.00102-2023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/08/2023] [Indexed: 08/03/2023] Open
Abstract
Introduction Low fat-free mass (FFM) is linked to poor health outcomes in COPD, including impaired exercise tolerance and premature death. The aim of this systematic review was to synthesise evidence on the effectiveness of interventions for increasing FFM in COPD. Methods Searches of electronic databases (MEDLINE, Cochrane Library, Embase, Web of Science, Scopus) and trial registers (ClinicalTrials.gov) were undertaken from inception to August 2022 for randomised studies of interventions assessing measures of FFM in COPD. The primary outcome was change in FFM (including derivatives). Secondary outcomes were adverse events, compliance and attrition. Results 99 studies (n=5138 people with COPD) of 11 intervention components, used alone or in combination, were included. Exercise training increased mid-thigh cross-sectional area (k=3, standardised mean difference (SMD) 1.04, 95% CI 0.02-2.06; p=0.04), but not FFM (k=4, SMD 0.03, 95% CI -0.18-0.24; p=0.75). Nutritional supplementation significantly increased FFM index (k=11, SMD 0.31, 95% CI 0.13-0.50; p<0.001), but not FFM (k=19, SMD 0.16, 95% CI -0.06-0.39; p=0.16). Combined exercise training and nutritional supplementation increased measures related to FFM in 67% of studies. Anabolic steroids increased FFM (k=4, SMD 0.98, 95% CI 0.24-1.72; p=0.009). Neuromuscular electrical stimulation increased measures related to FFM in 50% of studies. No interventions were more at risk of serious adverse events, low compliance or attrition. Discussion Exercise training and nutritional supplementation were not effective in isolation to increase FFM, but were for localised muscle and index measures, respectively. Combined, exercise and nutritional supplementation shows promise as a strategy to increase FFM in COPD. Anabolic steroids are efficacious for increasing FFM in COPD.
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Affiliation(s)
- Alex R. Jenkins
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montréal, QC, Canada
| | - Kaveh Gaynor-Sodeifi
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montréal, QC, Canada
| | - Hayley Lewthwaite
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montréal, QC, Canada
- Centre of Research Excellence in Treatable Traits, College of Health, Medicine, and Wellbeing, University of Newcastle, Newcastle, NSW, Australia
- Asthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Jaycie Triandafilou
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montréal, QC, Canada
| | - Letícia F. Belo
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montréal, QC, Canada
- Laboratory of Research in Respiratory Physiotherapy, Physiotherapy Department, State University of Londrina, Londrina, Brazil
| | - Mayron Faria de Oliveira
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montréal, QC, Canada
- Science Division, Exercise Science, Lyon College, Batesville, AR, USA
| | - Dennis Jensen
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montréal, QC, Canada
- Translational Research in Respiratory Diseases Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada
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18
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Beijers RJHCG, Steiner MC, Schols AMWJ. The role of diet and nutrition in the management of COPD. Eur Respir Rev 2023; 32:32/168/230003. [PMID: 37286221 DOI: 10.1183/16000617.0003-2023] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/27/2023] [Indexed: 06/09/2023] Open
Abstract
In 2014, the European Respiratory Society published a statement on nutritional assessment and therapy in COPD. Since then, increasing research has been performed on the role of diet and nutrition in the prevention and management of COPD. Here, we provide an overview of recent scientific advances and clinical implications. Evidence for a potential role of diet and nutrition as a risk factor in the development of COPD has been accumulating and is reflected in the dietary patterns of patients with COPD. Consuming a healthy diet should, therefore, be promoted in patients with COPD. Distinct COPD phenotypes have been identified incorporating nutritional status, ranging from cachexia and frailty to obesity. The importance of body composition assessment and the need for tailored nutritional screening instruments is further highlighted. Dietary interventions and targeted single or multi-nutrient supplementation can be beneficial when optimal timing is considered. The therapeutic window of opportunity for nutritional interventions during and recovering from an acute exacerbation and hospitalisation is underexplored.
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Affiliation(s)
- Rosanne J H C G Beijers
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Michael C Steiner
- Leicester NIHR Biomedical Research Centre - Respiratory, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Annemie M W J Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
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19
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Baalbaki N, Blankestijn JM, Abdel-Aziz MI, de Backer J, Bazdar S, Beekers I, Beijers RJHCG, van den Bergh JP, Bloemsma LD, Bogaard HJ, van Bragt JJMH, van den Brink V, Charbonnier JP, Cornelissen MEB, Dagelet Y, Davies EH, van der Does AM, Downward GS, van Drunen CM, Gach D, Geelhoed JJM, Glastra J, Golebski K, Heijink IH, Holtjer JCS, Holverda S, Houweling L, Jacobs JJL, Jonker R, Kos R, Langen RCJ, van der Lee I, Leliveld A, Mohamed Hoesein FAA, Neerincx AH, Noij L, Olsson J, van de Pol M, Pouwels SD, Rolink E, Rutgers M, Șahin H, Schaminee D, Schols AMWJ, Schuurman L, Slingers G, Smeenk O, Sondermeijer B, Skipp PJ, Tamarit M, Verkouter I, Vermeulen R, de Vries R, Weersink EJM, van de Werken M, de Wit-van Wijck Y, Young S, Nossent EJ, Maitland-van der Zee AH. Precision Medicine for More Oxygen (P4O2)-Study Design and First Results of the Long COVID-19 Extension. J Pers Med 2023; 13:1060. [PMID: 37511673 PMCID: PMC10381397 DOI: 10.3390/jpm13071060] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 07/30/2023] Open
Abstract
Introduction: The coronavirus disease 2019 (COVID-19) pandemic has led to the death of almost 7 million people, however, with a cumulative incidence of 0.76 billion, most people survive COVID-19. Several studies indicate that the acute phase of COVID-19 may be followed by persistent symptoms including fatigue, dyspnea, headache, musculoskeletal symptoms, and pulmonary functional-and radiological abnormalities. However, the impact of COVID-19 on long-term health outcomes remains to be elucidated. Aims: The Precision Medicine for more Oxygen (P4O2) consortium COVID-19 extension aims to identify long COVID patients that are at risk for developing chronic lung disease and furthermore, to identify treatable traits and innovative personalized therapeutic strategies for prevention and treatment. This study aims to describe the study design and first results of the P4O2 COVID-19 cohort. Methods: The P4O2 COVID-19 study is a prospective multicenter cohort study that includes nested personalized counseling intervention trial. Patients, aged 40-65 years, were recruited from outpatient post-COVID clinics from five hospitals in The Netherlands. During study visits at 3-6 and 12-18 months post-COVID-19, data from medical records, pulmonary function tests, chest computed tomography scans and biological samples were collected and questionnaires were administered. Furthermore, exposome data was collected at the patient's home and state-of-the-art imaging techniques as well as multi-omics analyses will be performed on collected data. Results: 95 long COVID patients were enrolled between May 2021 and September 2022. The current study showed persistence of clinical symptoms and signs of pulmonary function test/radiological abnormalities in post-COVID patients at 3-6 months post-COVID. The most commonly reported symptoms included respiratory symptoms (78.9%), neurological symptoms (68.4%) and fatigue (67.4%). Female sex and infection with the Delta, compared with the Beta, SARS-CoV-2 variant were significantly associated with more persisting symptom categories. Conclusions: The P4O2 COVID-19 study contributes to our understanding of the long-term health impacts of COVID-19. Furthermore, P4O2 COVID-19 can lead to the identification of different phenotypes of long COVID patients, for example those that are at risk for developing chronic lung disease. Understanding the mechanisms behind the different phenotypes and identifying these patients at an early stage can help to develop and optimize prevention and treatment strategies.
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Affiliation(s)
- Nadia Baalbaki
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands
| | - Jelle M Blankestijn
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands
| | - Mahmoud I Abdel-Aziz
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands
- Department of Clinical Pharmacy, Faculty of Pharmacy, Assiut University, Assiut 71526, Egypt
| | | | - Somayeh Bazdar
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands
| | - Inés Beekers
- ORTEC BV, Department of Health, Houtsingel 5, 2719 EA Zoetermeer, The Netherlands
| | - Rosanne J H C G Beijers
- Department of Respiratory Medicine, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands
| | - Joop P van den Bergh
- Department of Internal Medicine, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands
- Department of Internal Medicine, VieCuri Medical Center, 5912 BL Venlo, The Netherlands
| | - Lizan D Bloemsma
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands
| | - Harm Jan Bogaard
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | - Job J M H van Bragt
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands
| | - Vera van den Brink
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | | | - Merel E B Cornelissen
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands
| | - Yennece Dagelet
- Breathomix B.V., Bargelaan 200, 2333 CW Leiden, The Netherlands
| | - Elin Haf Davies
- Aparito Netherlands B.V., Galileiweg 8, BioPartner 3 Building, 2333 BD Leiden, The Netherlands
| | - Anne M van der Does
- Department of Pulmonology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - George S Downward
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584 CL Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Cornelis M van Drunen
- Department of Otorhinolaryngology, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | - Debbie Gach
- Department of Respiratory Medicine, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands
| | - J J Miranda Geelhoed
- Department of Pulmonology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Jorrit Glastra
- Quantib-U, Westblaak 106, 3012 KM Rotterdam, The Netherlands
| | - Kornel Golebski
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
- Department of Otorhinolaryngology, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | - Irene H Heijink
- Department of Pulmonology, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
- Department Pathology & Medical Biology, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Judith C S Holtjer
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584 CL Utrecht, The Netherlands
| | | | - Laura Houweling
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584 CL Utrecht, The Netherlands
| | - John J L Jacobs
- ORTEC BV, Department of Health, Houtsingel 5, 2719 EA Zoetermeer, The Netherlands
| | - Renée Jonker
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | - Renate Kos
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands
| | - Ramon C J Langen
- Department of Respiratory Medicine, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands
| | - Ivo van der Lee
- Department of Pulmonology, Spaarne Hospital, 2134 TM Hoofddorp, The Netherlands
| | - Asabi Leliveld
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | - Firdaus A A Mohamed Hoesein
- Department of Radiology, University Medical Center Utrecht and Utrecht University, 3508 GA Utrecht, The Netherlands
| | - Anne H Neerincx
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands
| | - Lieke Noij
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands
| | - Johan Olsson
- Smartfish AS, Oslo Science Park, Gaustadalléen 21, 0349 Oslo, Norway
| | - Marianne van de Pol
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | - Simon D Pouwels
- Department of Pulmonology, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
- Department Pathology & Medical Biology, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Emiel Rolink
- Long Alliantie Nederland, Address Stationsplein 125, 3818 LE Amersfoort, The Netherlands
| | - Michael Rutgers
- Longfonds, Stationsplein 125, 3818 LE Amersfoort, The Netherlands
| | - Havva Șahin
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | - Daphne Schaminee
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | - Annemie M W J Schols
- Department of Respiratory Medicine, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands
| | - Lisanne Schuurman
- Department of Respiratory Medicine, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands
| | - Gitte Slingers
- Breathomix B.V., Bargelaan 200, 2333 CW Leiden, The Netherlands
| | - Olie Smeenk
- Sodaq, Bussumerstraat 34, 1211 BL Hilversum, The Netherlands
| | | | - Paul J Skipp
- TopMD Precision Medicine Ltdincorporated, Southhampton SO45 3PN, UK
| | - Marisca Tamarit
- Breathomix B.V., Bargelaan 200, 2333 CW Leiden, The Netherlands
| | - Inge Verkouter
- ORTEC BV, Department of Health, Houtsingel 5, 2719 EA Zoetermeer, The Netherlands
| | - Roel Vermeulen
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584 CL Utrecht, The Netherlands
| | - Rianne de Vries
- Breathomix B.V., Bargelaan 200, 2333 CW Leiden, The Netherlands
| | - Els J M Weersink
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | - Marco van de Werken
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | - Yolanda de Wit-van Wijck
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands
| | - Stewart Young
- Philips GmbH Innovative Technologies, 4646 AG Eindhoven, The Netherlands
| | - Esther J Nossent
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | - Anke H Maitland-van der Zee
- Department of Pulmonary Medicine, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health, 1105 AZ Amsterdam, The Netherlands
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20
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Tramontano A, Palange P. Nutritional State and COPD: Effects on Dyspnoea and Exercise Tolerance. Nutrients 2023; 15:nu15071786. [PMID: 37049625 PMCID: PMC10096658 DOI: 10.3390/nu15071786] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a disease that is spreading worldwide and is responsible for a huge number of deaths annually. It is characterized by progressive and often irreversible airflow obstruction, with a heterogeneous clinical manifestation based on disease severity. Along with pulmonary impairment, COPD patients display different grades of malnutrition that can be linked to a worsening of respiratory function and to a negative prognosis. Nutritional impairment seems to be related to a reduced exercise tolerance and to dyspnoea becoming a major determinant in patient-perceived quality of life. Many strategies have been proposed to limit the effects of malnutrition on disease progression, but there are still limited data available to determine which of them is the best option to manage COPD patients. The purpose of this review is to highlight the main aspects of COPD-related malnutrition and to underline the importance of poor nutritional state on muscle energetics, exercise tolerance and dyspnoea.
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Affiliation(s)
- Angela Tramontano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Respiratory and Critical Care, Policlinico Umberto I Hospital, 00161 Rome, Italy
| | - Paolo Palange
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Respiratory and Critical Care, Policlinico Umberto I Hospital, 00161 Rome, Italy
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21
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Zailani H, Satyanarayanan SK, Liao WC, Liao HF, Huang SY, Gałecki P, Su KP, Chang JPC. Omega-3 Polyunsaturated Fatty Acids in Managing Comorbid Mood Disorders in Chronic Obstructive Pulmonary Disease (COPD): A Review. J Clin Med 2023; 12:jcm12072653. [PMID: 37048736 PMCID: PMC10095486 DOI: 10.3390/jcm12072653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/15/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is the third-leading cause of mortality globally, significantly affecting people over 40 years old. COPD is often comorbid with mood disorders; however, they are frequently neglected or undiagnosed in COPD management, thus resulting in unintended treatment outcomes and higher mortality associated with the disease. Although the exact link between COPD and mood disorders remains to be ascertained, there is a broader opinion that inflammatory reactions in the lungs, blood, and inflammation-induced changes in the brain could orchestrate the onset of mood disorders in COPD. Although the current management of mood disorders such as depression in COPD involves using antidepressants, their use has been limited due to tolerability issues. On the other hand, as omega-3 polyunsaturated fatty acids (n-3 PUFAs) play a vital role in regulating inflammatory responses, they could be promising alternatives in managing mood disorders in COPD. This review discusses comorbid mood disorders in COPD as well as their influence on the progression and management of COPD. The underlying mechanisms of comorbid mood disorders in COPD will also be discussed, along with the potential role of n-3 PUFAs in managing these conditions.
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Affiliation(s)
- Halliru Zailani
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan
- Graduate Institute of Nutrition, China Medical University, Taichung 404, Taiwan
| | - Senthil Kumaran Satyanarayanan
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan
| | - Wei-Chih Liao
- Division of Pulmonary and Critical Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 404, Taiwan
| | - Hsien-Feng Liao
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan
| | - Shih-Yi Huang
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110, Taiwan
- Nutrition Research Centre, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Piotr Gałecki
- Department of Adult Psychiatry, Medical University of Lodz, 91-229 Lodz, Poland
| | - Kuan-Pin Su
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan
- College of Medicine, China Medical University, Taichung 404, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404, Taiwan
- An-Nan Hospital, China Medical University, Tainan 833, Taiwan
| | - Jane Pei-Chen Chang
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan
- College of Medicine, China Medical University, Taichung 404, Taiwan
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22
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Mehdawi A, Mohammad BA, Mosleh I, Khader HA, Habash M, Nassar RI, Awwad S, Hasoun L, Abu-Samak MS. Combined Effect of Omega-3 Fatty Acid and Vitamin D 3 on Oxidized LDL-C and Non-HDL-C Levels in People With Vitamin D Deficiency: A Randomized Controlled Trial. J Cardiovasc Pharmacol 2023; 81:251-258. [PMID: 36630694 DOI: 10.1097/fjc.0000000000001398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023]
Abstract
ABSTRACT The present randomized clinical trial (RCT) was conducted on Jordanian participants with vitamin D deficiency (VDD) with no other medical conditions, to evaluate the combined effect of 1,25-dihydroxy vitamin D 3 (Vit.D 3 ) and omega-3 fatty acid (n-3FA) supplements (D+) on oxidized low-density lipoprotein (Ox-LDL) and non-high-density lipoprotein cholesterol (non-HDL-C) levels as common predictors of cardiovascular diseases (CVDs). Participants were randomized into 4 groups as follows: a control group (C) that received no supplementations, a Vit.D 3 group that received 50,000 IU of Vit.D 3 every week, an n-3FA group that received 300 mg of omega-3 fatty acid every day, and a D+ group that received a combination of both supplements, with the same dosage administered by the previous groups but with a 4-6-hour time interval between Vit.D 3 and n-3FA administration to avoid any possible interaction. All supplementations were administered orally for 8 weeks. Forty-seven participants were allocated to each group. Twenty-six in the control group, 37 participants in the Vit.D 3 group, 37 participants in the n-3FA group, and 46 participants in the D+ group completed the study to the end. The D+ supplementations significantly increased non-HDL-C (118.99 ± 60.98 to 155.26 ± 43.36 mg/dL, P << 0.05) but decreased Ox-LDL-C levels (69.29 ± 37.69 to 52.81 ± 17.30 pg/mL, P = 0.03). The stepwise regression showed that the serum LDL-C level was the main independent variable involved in the elevation of non-HDL levels (R 2 = 0.837) observed at the end of the trial in the D+ group. The groups that were supplemented with either Vit.D 3 alone or n-3FA alone had an insignificant decrease in the level of Ox-LDL-C. In conclusion, despite the observed hyperlipidemic effect, the combination treatment is recommended by the research team because the decrease in Ox-LDL may offset the hyperlipidemic effect.
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Affiliation(s)
- Amani Mehdawi
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Beisan A Mohammad
- Department of Pharmaceutical Sciences, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia
| | - Ibrahim Mosleh
- Department of Medical Laboratory Sciences, University of Jordan, Amman, Jordan
| | - Heba A Khader
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, The Hashemite University,, Zarqa, Jordan
| | - Maha Habash
- Michael Sayegh Faculty of Pharmacy, Aqaba University of Technology, Aqaba, Jordan; and
| | - Razan I Nassar
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Shady Awwad
- Department of Pharmaceutical Chemistry & Pharmacognosy, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Luai Hasoun
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Mahmoud S Abu-Samak
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
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23
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Developing an Evidence and Theory Based Multimodal Integrative Intervention for the Management of Renal Cachexia: A Theory of Change. Healthcare (Basel) 2022; 10:healthcare10122344. [PMID: 36553868 PMCID: PMC9777598 DOI: 10.3390/healthcare10122344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/04/2022] [Accepted: 11/09/2022] [Indexed: 11/23/2022] Open
Abstract
In this study, we aimed to develop a theoretical framework for a multimodal, integrative, exercise, anti-inflammatory and dietary counselling (MMIEAD) intervention for patients with renal cachexia with reference to how this addresses the underlying causal pathways for renal cachexia, the outcomes anticipated, and how these will be evaluated. We used a Theory of Change (ToC) approach to guide six steps. Step 1 included inputs from a workshop to obtain key stakeholder views on the potential development of a multimodal intervention for renal cachexia. Step 2 included the findings of a mixed-methods study with Health Care Practitioners (HCPs) caring for individuals with End Stage Kidney Disease (ESKD) and cachexia. Step 3 included the results from our systematic literature review on multimodal interventions for cachexia management. In step 4, we used the body of our research team's cachexia research and wider relevant research to gather evidence on the specific components of the multimodal intervention with reference to how this addresses the underlying causal pathways for renal cachexia. In steps 5 and 6 we developed and refined the ToC map in consultation with the core research team and key stakeholders which illustrates how the intervention components of MMIEAD interact to achieve the intended long-term outcomes and anticipated impact. The results of this study provide a theoretical framework for the forthcoming MMIEAD intervention for those with renal cachexia and in subsequent phases will be used to determine whether this intervention is effective. To the best of our knowledge no other multimodal intervention trials for cachexia management have reported a ToC. Therefore, this research may provide a useful framework and contribute to the ongoing development of interventions for cachexia management.
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Engelen MPKJ, Jonker R, Sulaiman H, Fisk HL, Calder PC, Deutz NEP. ω-3 polyunsaturated fatty acid supplementation improves postabsorptive and prandial protein metabolism in patients with chronic obstructive pulmonary disease: a randomized clinical trial. Am J Clin Nutr 2022; 116:686-698. [PMID: 35849009 PMCID: PMC9437982 DOI: 10.1093/ajcn/nqac138] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/18/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Disturbances in protein metabolism and impaired muscle health have been observed in chronic obstructive pulmonary disease (COPD). The ω-3 (n-3) PUFAs EPA and DHA are known for their anti-inflammatory and muscle health-enhancing properties. OBJECTIVES We examined whether daily EPA + DHA supplementation can improve daily protein homeostasis in patients with COPD by reducing postabsorptive whole-body protein breakdown (PB) and enhancing the anabolic response to feeding in a dose-dependent way. METHODS Normal-weight participants with moderate to severe COPD (n = 32) received daily for 4 wk, according to a randomized double-blind placebo controlled 3-group design, a high dose (3.5 g, n = 10) of EPA + DHA, a low dose (2.0 g, n = 10) of EPA + DHA, or placebo (olive oil, n = 12) via gel capsules. At pre- and postintervention, stable isotope tracers were infused to assess postabsorptive netPB [postabsorptive PB - protein synthesis (PS)] and the anabolic response (prandial netPS = prandial PS-PB) to a protein meal. In addition, muscle mass and function were measured. RESULTS Plasma phosphatidylcholine EPA and DHA concentrations were higher after 4 wk of supplementation in both EPA + DHA groups (P < 0.004), and there was a trend toward higher values for plasma EPA after the high compared with the low dose of EPA + DHA (P = 0.065). Postabsorptive PB was lower after 4 wk of the high dose of EPA + DHA, whereas netPB was lower independent of the dose of EPA + DHA (low dose, P = 0.037; high dose, P = 0.026). Prandial netPS was increased only after the high dose of EPA + DHA (P = 0.03). Extremity lean mass but not muscle function was increased, independent of the EPA + DHA dose (P < 0.05). CONCLUSIONS Daily n-3 PUFA supplementation for 4 wk induces a shift toward a positive daily protein homeostasis in patients with COPD in part in a dose-dependent way. Daily doses up to 3.5 g EPA and DHA are still well tolerated and lead to protein gain in these patients. This trial was registered at clinicaltrials.gov as NCT01624792.
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Affiliation(s)
| | - Renate Jonker
- Center for Translational Research in Aging & Longevity, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - Hooriya Sulaiman
- Center for Translational Research in Aging & Longevity, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - Helena L Fisk
- School of Human Development and Health, Faculty of Medicine, University of Southampton and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - Philip C Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - Nicolaas E P Deutz
- Center for Translational Research in Aging & Longevity, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
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25
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Zúñiga-Hernández J, Sambra V, Echeverría F, Videla LA, Valenzuela R. N-3 PUFAs and their specialized pro-resolving lipid mediators on airway inflammatory response: beneficial effects in the prevention and treatment of respiratory diseases. Food Funct 2022; 13:4260-4272. [PMID: 35355027 DOI: 10.1039/d1fo03551g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Respiratory diseases include a wide range of pathologies with different clinical manifestations, affecting the normal airways and lung function. An increase in the inflammatory response is considered a characteristic hallmark of these diseases, being also a critical factor for their progression. The n-3 polyunsaturated fatty acids (n-3 PUFAs) eicosapentaenoic acid (C20:4n-3, EPA), docosahexaenoic acid (C22:6n-3, DHA) and their lipid mediators are known to have an inflammation pro-resolution effect. The effects of these n-3 PUFAs in the prevention and treatment of respiratory diseases are beginning to be understood. Consequently, this article aims to analyze the influence of n-3 PUFAs and their lipid mediators on the inflammatory response in respiratory health, emphasizing recent data concerning their beneficial effects in the prevention and possible treatment of different respiratory diseases, particularly asthma, airway allergic syndromes and chronic obstructive pulmonary disease. The review includes studies regarding the effects of EPA, DHA, and their specialized pro-resolving lipid mediators (SPMs) on in vivo and in vitro models of respiratory disease, concluding that EPA and DHA have a positive impact in attenuating the pro-inflammatory response in respiratory diseases, reducing symptoms like nasal congestion, fever and difficulty in breathing. Controversial data reported are probably due to differences in several factors, including the dosages, administration vehicles, and the supplementation times employed, which are aspects that remain to be addressed in future studies.
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Affiliation(s)
| | - Verónica Sambra
- Nutrition Department, Faculty of Medicine, University of Chile, Santiago, Chile.
| | - Francisca Echeverría
- Nutrition Department, Faculty of Medicine, University of Chile, Santiago, Chile. .,Carrera de Nutrición y Dietética, Departamento Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis A Videla
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Science, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Rodrigo Valenzuela
- Nutrition Department, Faculty of Medicine, University of Chile, Santiago, Chile.
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26
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Bernardes S, Eckert IDC, Burgel CF, Teixeira PJZ, Silva FM. Increased energy and/or protein intake improves anthropometry and muscle strength in chronic obstructive pulmonary disease patients: a systematic review with meta-analysis on randomised controlled clinical trials. Br J Nutr 2022; 129:1-18. [PMID: 35416134 DOI: 10.1017/s0007114522000976] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Compromised nutritional status is associated with a poor prognosis in chronic obstructive pulmonary disease (COPD) patients. However, the impact of nutritional support in this group of patients is controversial. The present study systematically reviewed the effect of energy and or protein supplements or food fortification on anthropometry and muscle strength of COPD patients. We searched MEDLINE (PubMed), EMBASE, Cochrane Library and Scopus for all published randomised clinical trials without language restriction up to May 2021. Three reviewers performed study selection and data extraction independently. We judged the risk of bias by RoB 2 and the certainty of evidence by the GRADE approach. We included thirty-two randomised controlled trials and compiled thirty-one of them (1414 participants) in the random-effects model meta-analyses. Interventions were energy and/or protein oral nutritional supplements or food fortification added to the diet for at least one week. Pooled analysis revealed that nutritional interventions increased body weight (muscle circumference (MD) = 1·44 kg, 95 % CI 0·81, 2·08, I2 = 73 %), lean body mass (standardised mean difference (SMD) = 0·37; 95 % CI 0·15, 0·59, I2 = 46 %), midarm muscle circumference (MD = 0·29 mm2, 95 % CI 0·02, 0·57, I2 = 0 %), triceps skinfold (MD = 1·09 mm, 95 % CI 0·01, 2·16, I2 = 0 %) and handgrip strength (SMD = 0·39, 95 % CI 0·07, 0·71, I2 = 62 %) compared with control diets. Certainty of evidence ranged from very low to low, and most studies were judged with some concerns or at high risk of bias. This meta-analysis revealed, with limited evidence, that increased protein and/or energy intake positively impacts anthropometric measures and handgrip strength of COPD patients.
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Affiliation(s)
- Simone Bernardes
- Post-Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Igor da Conceição Eckert
- Undergraduate Nutrition Program, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Camila Ferri Burgel
- Nutrition Service, Santa Casa de Misericordia of Porto Alegre Hospital Complex, Porto Alegre, Rio Grande do Sul, Brazil
| | - Paulo José Zimermann Teixeira
- Post-Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
- Undergraduate Medicine Program, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
- Pulmologist at Pulmonary Rehabilitation Program, Hospital Pavilhão Pereira Filho, Santa Casa de Misericordia of Porto Alegre Hospital Complex, Porto Alegre, Rio Grande do Sul, Brazil
| | - Flávia Moraes Silva
- Nutrition Department and Postgraduate Program in Nutrition Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Rio Grande do Sul, Brazil
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27
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Malnutrition treatment and follow-up in Clinical Nutrition Outpatient Clinic was associated with increased muscle mass. Nutrition 2022; 101:111680. [DOI: 10.1016/j.nut.2022.111680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/10/2022] [Accepted: 03/31/2022] [Indexed: 11/18/2022]
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De Brandt J, Beijers RJHCG, Chiles J, Maddocks M, McDonald MLN, Schols AMWJ, Nyberg A. Update on the Etiology, Assessment, and Management of COPD Cachexia: Considerations for the Clinician. Int J Chron Obstruct Pulmon Dis 2022; 17:2957-2976. [PMID: 36425061 PMCID: PMC9680681 DOI: 10.2147/copd.s334228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 10/31/2022] [Indexed: 11/19/2022] Open
Abstract
Cachexia is a commonly observed but frequently neglected extra-pulmonary manifestation in patients with chronic obstructive pulmonary disease (COPD). Cachexia is a multifactorial syndrome characterized by severe loss of body weight, muscle, and fat, as well as increased protein catabolism. COPD cachexia places a high burden on patients (eg, increased mortality risk and disease burden, reduced exercise capacity and quality of life) and the healthcare system (eg, increased number, length, and cost of hospitalizations). The etiology of COPD cachexia involves a complex interplay of non-modifiable and modifiable factors (eg, smoking, hypoxemia, hypercapnia, physical inactivity, energy imbalance, and exacerbations). Addressing these modifiable factors is needed to prevent and treat COPD cachexia. Oral nutritional supplementation combined with exercise training should be the primary multimodal treatment approach. Adding a pharmacological agent might be considered in some, but not all, patients with COPD cachexia. Clinicians and researchers should use longitudinal measures (eg, weight loss, muscle mass loss) instead of cross-sectional measures (eg, low body mass index or fat-free mass index) where possible to evaluate patients with COPD cachexia. Lastly, in future research, more detailed phenotyping of cachectic patients to enable a better comparison of included patients between studies, prospective longitudinal studies, and more focus on the impact of exacerbations and the role of biomarkers in COPD cachexia, are highly recommended.
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Affiliation(s)
- Jana De Brandt
- Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Rosanne J H C G Beijers
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Joe Chiles
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Matthew Maddocks
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Merry-Lynn N McDonald
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Annemie M W J Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - André Nyberg
- Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
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29
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Huang WJ, Fan XX, Yang YH, Zeng YM, Ko CY. A review on the Role of Oral Nutritional Supplements in Chronic Obstructive Pulmonary Disease. J Nutr Health Aging 2022; 26:723-731. [PMID: 35842763 DOI: 10.1007/s12603-022-1822-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Due to the high smoking rate in developing countries and the rising aging population in high-income countries, the global prevalence of chronic obstructive pulmonary disease (COPD), estimated to be 11.7%, is increasing and is the third-leading cause of mortality. COPD is likely to be present in elderly individuals with impaired gastro-enteric functions. Gastrointestinal congestion, dyspnea, and anxiety are pathophysiological characteristics of COPD, contributing to poor appetite, reduced dietary intake, and high-energy expenditure. These factors are implicated in the progression of malnutrition in COPD patients. Malnutrition is detrimental to lung functions and is associated with an increased risk of infection, exacerbation and mortality, and a longer duration of hospitalization. Therefore, nutritional support to treat malnutrition in COPD patients is very vital. Oral nutritional supplements (ONS) may hold the key to COPD treatment. To clarify this statement, we review current evidence for ONS in COPD patients to benefit from clinical outcomes.
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Affiliation(s)
- W-J Huang
- Chih-Yuan Ko, The Second Affiliated Hospital of Fujian Medical University, No. 34, Zhongshanbei Rd, Licheng District, Quanzhou, Fujian Province, China, 362000. Tel.: +86 0595-26655200. E-mail address:
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30
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Heffernan M, Doherty LC, Hack Mendes R, Clarke M, Hodge S, Clements M, McAnena L, Rivelsrud M, Ward M, Strain JJ, McNulty H, Brennan L. Effectiveness of a fortified drink in improving B vitamin biomarkers in older adults: a controlled intervention trial. Nutr Metab (Lond) 2021; 18:104. [PMID: 34876175 PMCID: PMC8650259 DOI: 10.1186/s12986-021-00630-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/25/2021] [Indexed: 11/10/2022] Open
Abstract
Background Older adults are reported to have sub-optimal B vitamin status; targeted food-based solutions may help to address this. The objectives of the OptiAge food intervention study were to develop and investigate the effectiveness of a B vitamin-fortified drink in improving B vitamin biomarkers in older Irish adults with a primary outcome of change in the B vitamin biomarker status. Methods A double-blinded randomised controlled trial was performed in parallel at University College Dublin and Ulster University. Participants aged > 50 years were recruited following screening for exclusion criteria (i.e. taking medications known to interfere with B vitamin metabolism, supplements containing B vitamins, consuming > 4 portions of B vitamin-fortified foods per week or diagnosed with gastrointestinal, liver or pulmonary disease). Recruited participants meeting the inclusion criteria were randomised (by sex and study centre) to receive daily for 16 weeks either B vitamin-fortified or placebo drinks as developed by Smartfish, Norway. Each B vitamin-fortified drink (200 ml) contained 200 µg folic acid, 10 µg vitamin B12, 10 mg vitamin B6 and 5 mg riboflavin, while the placebo was an identical, isocaloric formulation without added B vitamins. Fasting blood samples were collected pre- and post-intervention which were used to measure the primary outcome of change in B vitamin biomarker levels. Results A total of 95 participants were randomised, of which 81 commenced the trial. Of these, 70 completed (37 in the active and 33 in the placebo groups). Intention to treat (ITT) analysis of the B vitamins demonstrated a significant improvement in all B vitamin biomarkers in the active compared to placebo groups: p < 0.01 for each of serum folate, serum vitamin B12 and plasma pyridoxal 5′-phosphate (vitamin B6) and the functional riboflavin biomarker, erythrocyte glutathione reductase activation coefficient (EGRac). Correspondingly, a significant lowering of serum homocysteine from 11.9 (10.3–15.1) µmol/L to 10.6 (9.4–13.0) µmol/L was observed in response to the active treatment (P < 0.001). Similar results were seen in a per-protocol analysis. Conclusions The results demonstrate that a B vitamin-fortified drink was effective in optimising B vitamin status, making this a useful intervention option to improve B vitamin status in older adults. Trial registration ISRCTN, ISRCTN61709781—Retrospectively registered, https://www.isrctn.com/ISRCTN61709781 Supplementary Information The online version contains supplementary material available at 10.1186/s12986-021-00630-8.
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Affiliation(s)
- Maria Heffernan
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Leanne C Doherty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Roberta Hack Mendes
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Michelle Clarke
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Stephanie Hodge
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Michelle Clements
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Liadhan McAnena
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | | | - Mary Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Lorraine Brennan
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland.
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31
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Wouters EFM. Nutritional Status and Body Composition in Patients Suffering From Chronic Respiratory Diseases and Its Correlation With Pulmonary Rehabilitation. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:725534. [PMID: 36188872 PMCID: PMC9397774 DOI: 10.3389/fresc.2021.725534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/08/2021] [Indexed: 11/13/2022]
Abstract
As part of an individualized intervention to improve the physical, emotional, and social functioning of patients with chronic respiratory diseases in general and chronic obstructive pulmonary disease in particular, awareness of the presence and consequences of changes in body composition increased enormously during the last decades, and nutritional intervention is considered as an essential component in the comprehensive approach of these patients. This review describes the prevalence and the clinical impact of body composition changes and also provides an update of current intervention strategies. It is argued that body composition, preferentially a three-component evaluation of fat, lean, and bone mass, must become part of a thorough assessment of every patient, admitted for pulmonary rehabilitation.
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Affiliation(s)
- Emiel F. M. Wouters
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, Netherlands
- *Correspondence: Emiel F. M. Wouters
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32
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Bird JK, Troesch B, Warnke I, Calder PC. The effect of long chain omega-3 polyunsaturated fatty acids on muscle mass and function in sarcopenia: A scoping systematic review and meta-analysis. Clin Nutr ESPEN 2021; 46:73-86. [PMID: 34857251 DOI: 10.1016/j.clnesp.2021.10.011] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS Sarcopenia is characterized by the progressive loss of skeletal muscle mass and function, which reduces mobility and quality of life. Risk factors for sarcopenia include advanced age, physical inactivity, obesity, and chronic diseases such as cancer or rheumatoid arthritis. Omega-3 long chain polyunsaturated fatty acids (LC PUFAs) might be associated with a reduction in risk of sarcopenia due to their anti-inflammatory effects. METHODS We conducted a systematic review and meta-analysis to quantify the effects of omega-3 LC PUFAs on muscle mass, volume and function parameters. The National Library of Medicine's MEDLINE/PubMed database was searched on 9th October 2020 for randomized controlled trials that used omega-3 LC PUFAs as an intervention with muscle-related endpoints. A snowballing search to identify additional studies was completed on 23rd April 2021. The meta-analysis was conducted using meta-essentials worksheet 3. Bias was assessed using the Jadad scale. RESULTS 123 studies were identified with the systematic searches. Most studies were performed in disease populations, such as cancer or chronic obstructive pulmonary disease (COPD), or in healthy individuals after a fatiguing exercise bout. The endpoints lean body mass, skeletal muscle mass, mid-arm muscle circumference, handgrip strength, quadriceps maximal voluntary capacity (MVC), and 1-repetition maximum chest press were selected for meta-analysis based on the number of available studies; thus 66 studies were included in the quantitative synthesis. Using a random effects model and 2-tailed p-value, there was a significant relationship in favor of omega-3 LC PUFA supplementation for lean body mass (effect size 0.27, 95%CI 0.04 to 0.51), skeletal muscle mass (effect size 0.31, 95%CI 0.01 to 0.60) and quadriceps MVC (effect size 0.47, 95%CI 0.02 to 0.93). CONCLUSION The results indicate that there is a positive effect of omega-3 LC PUFA supplementation on overall body muscle mass and strength. Small study size and heterogeneity limit the applicability of these findings for sarcopenia prevention. Larger trials in populations at risk of sarcopenia would strengthen the evidence base.
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Affiliation(s)
- Julia K Bird
- Bird Scientific Writing, Wassenaar, 2242, the Netherlands.
| | - Barbara Troesch
- Nutrition Science and Advocacy, DSM Nutritional Products, 4303, Kaiseraugst, Switzerland.
| | - Ines Warnke
- R&D Human Nutrition and Health, DSM Nutritional Products, 4303, Kaiseraugst, Switzerland.
| | - Philip C Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, SO16 6YD, United Kingdom; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, SO16 6YD, United Kingdom.
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Yu H, Su X, Lei T, Zhang C, Zhang M, Wang Y, Zhu L, Liu J. Effect of Omega-3 Fatty Acids on Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Int J Chron Obstruct Pulmon Dis 2021; 16:2677-2686. [PMID: 34588776 PMCID: PMC8476109 DOI: 10.2147/copd.s331154] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/13/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Omega-3 fatty acid is an emerging hotspot on anti-inflammation and chronic obstructive pulmonary disease (COPD) is known as a chronic inflammatory disease. The effect of Omega-3 fatty acid supplement on patients with COPD remains mixed for insufficient evidence. This systematic review and meta-analysis is based on neat randomized controlled trials trying to give a clearer impression on the effect of Omega-3 on patients with COPD. METHODS This systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) statements. Randomized clinical trials (RCTs) published in electronic databases including Medline, Embase, Cochrane Library, ClinicalTrials.gov and China National Knowledge Infrastructure (CNKI) by May 10, 2021 were searched. Data extracted from 6 predetermined domains (nutritional condition, lipid composition, inflammatory biomarker, lung function, physical endurance and quality of life [QoL]) were reviewed and analyzed. RESULTS A total of 8 RCTs evaluating 418 patients (age, mean [SD] = 67.3 [10.2] years) were included. Statistical differences were found in 3 parameters of 3 domains - weight (Wt) (0.25 [95% CI, 0.02 to 0.48], P = 0.03) in nutritional condition, low-density lipoprotein (LDL) (0.70 [95% CI, 0.30 to 1.10], P = 0.00) in lipid composition and interleukin-6 (IL-6) level (-0.32 [95% CI, -0.60 to -0.05], P = 0.02) in inflammatory biomarker - while no significant difference was found in lung function, physical endurance or QoL. CONCLUSION Comparing with placebo, Omega-3 intake was associated with more weight-gaining, LDL increase and IL-6 reduction. These results should be interpreted cautiously for the quality and quantity of available evidence are limited.
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Affiliation(s)
- Haichuan Yu
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, People’s Republic of China
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou City, People’s Republic of China
| | - Xiaojie Su
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, People’s Republic of China
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou City, People’s Republic of China
| | - Ting Lei
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, People’s Republic of China
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou City, People’s Republic of China
| | - Chuchu Zhang
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, People’s Republic of China
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou City, People’s Republic of China
| | - Meng Zhang
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, People’s Republic of China
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou City, People’s Republic of China
| | - Yalei Wang
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, People’s Republic of China
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou City, People’s Republic of China
| | - Lei Zhu
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, People’s Republic of China
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou City, People’s Republic of China
| | - Jian Liu
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, People’s Republic of China
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou City, People’s Republic of China
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Xue M, Zeng Y, Lin R, Qu HQ, Zhang T, Zhang XD, Liang Y, Zhen Y, Chen H, Huang Z, Hu H, Zheng P, Hakonarson H, Zhou L, Sun B. Metabolomic profiling of anaerobic and aerobic energy metabolic pathways in chronic obstructive pulmonary disease. Exp Biol Med (Maywood) 2021; 246:1586-1596. [PMID: 33957804 DOI: 10.1177/15353702211008808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
While there is no cure for chronic obstructive pulmonary disease (COPD), its progressive nature and the formidable challenge to manage its symptoms warrant a more extensive study of the pathogenesis and related mechanisms. A new emphasis on COPD study is the change of energy metabolism. For the first time, this study investigated the anaerobic and aerobic energy metabolic pathways in COPD using the metabolomic approach. Metabolomic analysis was used to investigate energy metabolites in 140 COPD patients. The significance of energy metabolism in COPD was comprehensively explored by the Global Initiative for Chronic Obstructive Lung Disease-GOLD grading, acute exacerbation vs. stable phase (either clinical stability or four-week stable phase), age group, smoking index, lung function, and COPD Assessment Test (CAT) score. Through comprehensive evaluation, we found that COPD patients have a significant imbalance in the aerobic and anaerobic energy metabolisms in resting state, and a high tendency of anaerobic energy supply mechanism that correlates positively with disease progression. This study highlighted the significance of anaerobic and low-efficiency energy supply pathways in lung injury and linked it to the energy-inflammation-lung ventilatory function and the motion limitation mechanism in COPD patients, which implies a novel therapeutic direction for this devastating disease.
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Affiliation(s)
- Mingshan Xue
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Yifeng Zeng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Runpei Lin
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Hui-Qi Qu
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Teng Zhang
- State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology, Macao 999078, China
| | - Xiaohua Douglas Zhang
- State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology, Macao 999078, China
| | - Yueting Liang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Yingjie Zhen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Hao Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Zhifeng Huang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Haisheng Hu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Peiyan Zheng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Hakon Hakonarson
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.,Divisions of Human Genetics and Pulmonary Medicine, Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Luqian Zhou
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Baoqing Sun
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
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Prado CM, Anker SD, Coats AJ, Laviano A, von Haehling S. Nutrition in the spotlight in cachexia, sarcopenia and muscle: avoiding the wildfire. J Cachexia Sarcopenia Muscle 2021; 12:3-8. [PMID: 33382196 PMCID: PMC7890147 DOI: 10.1002/jcsm.12673] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Carla M. Prado
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional ScienceUniversity of AlbertaEdmontonABCanada
| | - Stefan D. Anker
- BIH Centre for Regenerative TherapiesCharité Uinversitätsmedizin BerlinBerlinGermany
- Department of Cardiology (Campus Virchow‐Klinikum)Charité Universitätsmedizin BerlinBerlinGermany
- German Centre for Cardiovascular Research (DZHK), partner site BerlinBerlinGermany
| | - Andrew J.S. Coats
- Monash UniversityMelbourneAustralia
- University of Warwick (UK)WarwickUK
| | - Alessandro Laviano
- Department of Translational and Precision MedicineSapienza UniversityRomeItaly
| | - Stephan von Haehling
- Department of Cardiology and PneumologyUniversity Medicine GoettingenGoettingenGermany
- German Centre for Cardiovascular Research (DZHK), partner site GöttingenGöttingenGermany
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36
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van Bakel SIJ, Gosker HR, Langen RC, Schols AMWJ. Towards Personalized Management of Sarcopenia in COPD. Int J Chron Obstruct Pulmon Dis 2021; 16:25-40. [PMID: 33442246 PMCID: PMC7800429 DOI: 10.2147/copd.s280540] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/21/2020] [Indexed: 12/13/2022] Open
Abstract
The awareness of the presence and consequences of sarcopenia has significantly increased over the past decade. Sarcopenia is defined as gradual loss of muscle mass and strength and ultimately loss of physical performance associated with aging and chronic disease. The prevalence of sarcopenia is higher in chronic obstructive pulmonary disease (COPD) compared to age-matched controls. Current literature suggests that next to physical inactivity, COPD-specific alterations in physiological processes contribute to accelerated development of sarcopenia. Sarcopenia in COPD can be assessed according to current guidelines, but during physical performance testing, ventilatory limitation should be considered. Treatment of muscle impairment can halt or even reverse sarcopenia, despite respiratory impairment. Exercise training and protein supplementation are currently at the basis of sarcopenia treatment. Furthermore, effective current and new interventions targeting the pulmonary system (eg, smoking cessation, bronchodilators and lung volume reduction surgery) may also facilitate muscle maintenance. Better understanding of disease-specific pathophysiological mechanisms involved in the accelerated development of sarcopenia in COPD will provide new leads to refine nutritional, exercise and physical activity interventions and develop pharmacological co-interventions.
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Affiliation(s)
- Sophie I J van Bakel
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, Department of Respiratory Medicine, Maastricht, The Netherlands
| | - Harry R Gosker
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, Department of Respiratory Medicine, Maastricht, The Netherlands
| | - Ramon C Langen
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, Department of Respiratory Medicine, Maastricht, The Netherlands
| | - Annemie M W J Schols
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, Department of Respiratory Medicine, Maastricht, The Netherlands
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Schneider J, Ye D, Hill AM, Whitehorn AS. Continued post-retraction citation of a fraudulent clinical trial report, 11 years after it was retracted for falsifying data. Scientometrics 2020. [DOI: 10.1007/s11192-020-03631-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AbstractThis paper presents a case study of long-term post-retraction citation to falsified clinical trial data (Matsuyama et al. in Chest 128(6):3817–3827, 2005. 10.1378/chest.128.6.3817), demonstrating problems with how the current digital library environment communicates retraction status. Eleven years after its retraction, the paper continues to be cited positively and uncritically to support a medical nutrition intervention, without mention of its 2008 retraction for falsifying data. To date no high quality clinical trials reporting on the efficacy of omega-3 fatty acids on reducing inflammatory markers have been published. Our paper uses network analysis, citation context analysis, and retraction status visibility analysis to illustrate the potential for extended propagation of misinformation over a citation network, updating and extending a case study of the first 6 years of post-retraction citation (Fulton et al. in Publications 3(1):7–26, 2015. 10.3390/publications3010017). The current study covers 148 direct citations from 2006 through 2019 and their 2542 second-generation citations and assesses retraction status visibility of the case study paper and its retraction notice on 12 digital platforms as of 2020. The retraction is not mentioned in 96% (107/112) of direct post-retraction citations for which we were able to conduct citation context analysis. Over 41% (44/107) of direct post-retraction citations that do not mention the retraction describe the case study paper in detail, giving a risk of diffusing misinformation from the case paper. We analyze 152 second-generation citations to the most recent 35 direct citations (2010–2019) that do not mention the retraction but do mention methods or results of the case paper, finding 23 possible diffusions of misinformation from these non-direct citations to the case paper. Link resolving errors from databases show a significant challenge in a reader reaching the retraction notice via a database search. Only 1/8 databases (and 1/9 database records) consistently resolved the retraction notice to its full-text correctly in our tests. Although limited to evaluation of a single case (N = 1), this work demonstrates how retracted research can continue to spread and how the current information environment contributes to this problem.
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38
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McKeaveney C, Maxwell P, Noble H, Reid J. A Critical Review of Multimodal Interventions for Cachexia. Adv Nutr 2020; 12:523-532. [PMID: 32970097 PMCID: PMC8262513 DOI: 10.1093/advances/nmaa111] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/18/2020] [Accepted: 08/14/2020] [Indexed: 12/17/2022] Open
Abstract
Currently, there are no standardized treatments for cachexia or severe wasting. There is a growing consensus advocating multimodal interventions to address the complex pathogenesis and metabolic alterations in these conditions. This review examined multimodal treatments intended to alleviate and/or stabilize cachexia and severe wasting. The objectives of this review were to 1) identify multimodal interventions for the treatment of cachexia or associated wasting syndromes in patients with a chronic illness, 2) assess the quality of these studies, and 3) assess the effectiveness of multimodal interventions. Electronic databases including PubMed, MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Library, CINAHL, PEDro, OpenGrey, and clinicaltrials.org were systematically searched using both text words and MeSH (medical subject heading) terms. The literature revealed a dearth of large, well-conducted trials in this area. Fourteen trials (n = 5 cancer, n = 5 chronic obstructive pulmonary disease, n = 4 chronic kidney disease) were included in this review. A total of 1026 patients were included across all studies; sample size ranged between 21 and 138 patients. Baseline and follow-up data were collected between 6 wk and 24 mo. All demonstrated some improvement in favor of the treatment groups, in relevant measures of body composition, nutrition, biomarkers, and functionality; however, caution should be applied due to the heterogenous nature of the interventions and small sample sizes. Overall, the evidence from this review supports the role of multimodal interventions in the treatment of severe wasting. However, randomized controlled trials with a powered sample size and sufficiently lengthy interaction period are necessary to assess if multimodal interventions are effective forms of therapy for improving body composition and nutritional and physical status in patients with cachexia and wasting. The protocol for this review is registered with Prospero (ID: CRD42019124374).
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Affiliation(s)
- Clare McKeaveney
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University
Belfast, Belfast, Northern Ireland
| | - Peter Maxwell
- Centre for Public Health, Queen's University Belfast, Institute of Clinical
Science, Royal Victoria Hospital, Belfast, Northern Ireland,Regional Nephrology Unit, Belfast City Hospital, Belfast Health Social Care
Trust, Belfast, Northern Ireland
| | - Helen Noble
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University
Belfast, Belfast, Northern Ireland
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Ahmadi A, Eftekhari MH, Mazloom Z, Masoompour M, Fararooei M, Eskandari MH, Mehrabi S, Bedeltavana A, Famouri M, Zare M, Nasimi N, Sohrabi Z. Fortified whey beverage for improving muscle mass in chronic obstructive pulmonary disease: a single-blind, randomized clinical trial. Respir Res 2020; 21:216. [PMID: 32807165 PMCID: PMC7430110 DOI: 10.1186/s12931-020-01466-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 07/23/2020] [Indexed: 04/22/2024] Open
Abstract
Background The development of effective nutritional supports for patients with chronic obstructive pulmonary diseases (COPD) is still challenging. This study was conducted to investigate the efficacy of daily consumption of fortified whey on inflammation, muscle mass, functionality, and quality of life in patients with moderate-to-severe COPD. Methods A single-blind, randomized trial study was performed on patients with COPD (n = 46). Participants in the intervention group (n = 23) daily received 250 ml of whey beverage fortified with magnesium and vitamin C for 8 weeks. Any changes in inflammatory cytokines (including interleukin- 6 (IL-6) and tumor necrosis factor (TNFα)) were the primary outcomes and the secondary outcomes were fat-free mass, handgrip strength, malnutrition, glutathione and malondialdehyde serum concentrations, and health-related quality of life (HRQoL). Body composition and muscle strength were measured by Bioelectrical Impedance Analysis (BIA) and hydraulic hand dynamometer, respectively. Fat-free mass index (FFMI) was also calculated. Results At the end of the study, 44 patients were analyzed. There were significant decreases in IL-6 concentrations in the intervention group compared to the control group. Also, FFMI, body protein, and handgrip strength increased significantly in the intervention group with significant changes between two groups. Moreover, improvement in health-related quality of life was observed in the intervention group compared to the control group. There were no significant changes in other study variables. Conclusions This novel nutritional intervention decreased inflammatory cytokines levels, improved indices of skeletal muscle mass and muscle strength, and ultimately, increased HRQoL in patients with moderate-to-severe COPD. Thus, it is suggested to do further studies to assess the effects of nutrition intervention on COPD progression. Trial registration IR.SUMS.REC.1396.85 (https://www.irct.ir/).
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Affiliation(s)
- Afsane Ahmadi
- Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hassan Eftekhari
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Zohreh Mazloom
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoom Masoompour
- Non-communicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Fararooei
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hadi Eskandari
- Department of Food Sciences and Technology, School of Agriculture, Shiraz University, Shiraz, Iran
| | - Samrad Mehrabi
- Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Bedeltavana
- Dairy Expert at Research and Development of Zarrin Ghazal Company (DAITY), Shiraz, Iran
| | - Mandana Famouri
- Dairy Expert at Research and Development of Zarrin Ghazal Company (DAITY), Shiraz, Iran
| | - Morteza Zare
- Nutrition Reasearch Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasrin Nasimi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Sohrabi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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van der Meij BS, Mazurak VC. Fish oil supplementation and maintaining muscle mass in chronic disease: state of the evidence. Curr Opin Clin Nutr Metab Care 2020; 23:164-173. [PMID: 32167986 DOI: 10.1097/mco.0000000000000648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE OF REVIEW Providing eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), in the form of fish oils, to benefit muscle is an emerging area of interest. The aim of this work was to evaluate the current literature that has assessed muscle mass as an outcome during a fish oil intervention in any chronic disease. RECENT FINDINGS The vast majority of studies published in the last 3 years (12 of 15) have been conducted in the oncological setting, in patients undergoing treatment for cancers of the gastrointestinal tract, breast, head and neck, lung, cervix, and hematological cancers. Three studies were conducted in patients with chronic obstructive pulmonary disease (COPD). Fish oil was provided as part of nutrient mixtures in 12 studies and as capsules in three studies. SUMMARY Overall, the evidence for an effect of fish oil supplementation on muscle mass in patients with cancer undergoing treatment and in COPD remains unequivocal and reveals limited new knowledge in the area of fish oil supplementation in the cancer setting. Recent literature continues to provide mixed evidence on the efficacy of fish oil on muscle mass and function. The present review highlights challenges in comparing and interpreting current studies aimed at testing fish oil supplementation for muscle health.
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Affiliation(s)
- B S van der Meij
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences & Medicine, Gold Coast
- Nutrition and Dietetics, Mater Group, Brisbane
- Mater Research Institute, University of Queensland, Brisbane, Australia
| | - Vera C Mazurak
- Faculty of Agricultural Life and Environmental Sciences, University of Alberta, Edmonton, Canada
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41
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van Beers M, Rutten-van Mölken MP, van de Bool C, Boland M, Kremers SP, Franssen FM, van Helvoort A, Gosker HR, Wouters EF, Schols AM. Clinical outcome and cost-effectiveness of a 1-year nutritional intervention programme in COPD patients with low muscle mass: The randomized controlled NUTRAIN trial. Clin Nutr 2020; 39:405-413. [DOI: 10.1016/j.clnu.2019.03.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/20/2019] [Accepted: 03/04/2019] [Indexed: 01/18/2023]
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42
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Anker MS, Anker SD, Coats AJ, von Haehling S. The Journal of Cachexia, Sarcopenia and Muscle stays the front-runner in geriatrics and gerontology. J Cachexia Sarcopenia Muscle 2019; 10:1151-1164. [PMID: 31821753 PMCID: PMC6903443 DOI: 10.1002/jcsm.12518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Markus S. Anker
- Division of Cardiology and Metabolism, Department of CardiologyCharité Universitätsmedizin BerlinBerlinGermany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT)BerlinGermany
- German Centre for Cardiovascular Research (DZHK) partner site BerlinBerlinGermany
- Department of CardiologyCharité Campus Benjamin FranklinBerlinGermany
| | - Stefan D. Anker
- Division of Cardiology and Metabolism, Department of CardiologyCharité Universitätsmedizin BerlinBerlinGermany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT)BerlinGermany
- German Centre for Cardiovascular Research (DZHK) partner site BerlinBerlinGermany
- Department of Cardiology (CVK)Charité Universitätsmedizin BerlinBerlinGermany
- Charité Universitätsmedizin BerlinBerlinGermany
| | | | - Stephan von Haehling
- Department of Cardiology and Pneumology, Heart Center GöttingenUniversity of Göttingen Medical Center, Georg‐August‐UniversityGöttingenGermany
- German Center for Cardiovascular Medicine (DZHK), partner site GöttingenGöttingenGermany
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43
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Collins PF, Yang IA, Chang YC, Vaughan A. Nutritional support in chronic obstructive pulmonary disease (COPD): an evidence update. J Thorac Dis 2019; 11:S2230-S2237. [PMID: 31737350 DOI: 10.21037/jtd.2019.10.41] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) primarily affects the lungs but due to the accompanying chronic systematic inflammation and the symptoms associated with the disease there are many extrapulmonary effects which include complex physical and metabolic adaptations. These changes have been associated with reduced exercise capacity, increased nutritional requirements, altered metabolic processes and compromised nutritional intake. As a result, nutritional depletion in COPD is multi-faceted and can involve imbalances of energy (weight loss), protein (sarcopenia), and periods of markedly increased inflammation (pulmonary cachexia) which can increase nutritional losses. As a result, depletion of both fat-mass (FM) and fat-free mass (FFM) can occur. There is good evidence that nutritional support, in the form of oral nutritional supplements (ONS), can overcome energy and protein imbalances resulting in improved nutritional status and functional capacity. However, in order to treat the aetiology of sarcopenia, frailty and cachexia, it is likely that targeted multi-modal interventions are required to address energy and protein imbalance, specific nutrient deficiencies, reduced androgens and targeted exercise training. Furthermore, interventions taking a disease-course approach, are likely to hold the key to effectively managing the common and costly problem of nutritional depletion in COPD.
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Affiliation(s)
- Peter F Collins
- School of Human Movement and Nutrition Science, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Ian A Yang
- University of Queensland Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia.,Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Australia
| | - Yuan-Chin Chang
- University of Queensland Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia.,Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Australia
| | - Annalicia Vaughan
- University of Queensland Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia.,Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Australia
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44
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Mareschal J, Achamrah N, Norman K, Genton L. Clinical Value of Muscle Mass Assessment in Clinical Conditions Associated with Malnutrition. J Clin Med 2019; 8:jcm8071040. [PMID: 31319519 PMCID: PMC6678556 DOI: 10.3390/jcm8071040] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/08/2019] [Accepted: 07/16/2019] [Indexed: 01/06/2023] Open
Abstract
Malnutrition results from a reduction of food intake or an alteration of nutrient assimilation and leads to decreased lean mass. Strong evidence shows that malnutrition associated with loss of muscle mass negatively impacts clinical outcomes. The preservation or improvement of muscle mass represents a challenge. This review aims to (1) describe current methods to assess muscle mass in clinical practice, (2) describe the associations between muscle mass and clinical outcomes, and (3) describe the impact of interventions aiming at increasing muscle mass on clinical outcomes. It highlights the importance of assessing muscle mass as part of the screening and the follow-up of malnutrition in clinical practice.
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Affiliation(s)
- Julie Mareschal
- Clinical Nutrition, Geneva University Hospitals, 1205 Geneva, Switzerland.
| | - Najate Achamrah
- Department of Clinical Nutrition, Rouen University Hospital, Normandie University, 76000 Rouen, France
| | - Kristina Norman
- Research Group on Geriatrics, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13347 Berlin, Germany
- Department of Nutrition and Gerontology, German Institute for Human Nutrition Potsdam-Rehbrücke, 14558 Nuthetal, Germany
| | - Laurence Genton
- Clinical Nutrition, Geneva University Hospital, 1205 Geneva, Switzerland.
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45
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[Functional recovery of the cardio-respiratory patient]. NUTR HOSP 2019; 36:38-43. [PMID: 31189320 DOI: 10.20960/nh.02679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Heart failure (HF), chronic obstructive pulmonary disease (COPD), and most chronic diseases are associated with mild to moderate chronic or recurrent inflammation. This inflammation contributes to malnutrition through different mechanisms: anorexia, decreased intake, alteration of metabolism with increased energy expenditure at rest and increased muscle catabolism. The decrease in lean mass has been included as a phenotypic criterion in the recently coined definition of malnutrition. In addition, a greater importance is given to the evaluation of the function, together with that of the morphological parameters. The grip strength, measured with a manual dynamometer and compared to reference populations, is a simple measure of muscle strength and correlates with the strength of the legs. On the other hand, the so-called "paradox of obesity" occurs in both patients with HF and COPD, since overweight and obese patients have lower overall mortality than patients with normal or low body mass index (BMI). The nutritional treatment, with an adequate contribution of macro and micronutrients and a contribution of proteins of fast absorption, with a higher content of leucine or its metabolite β-hydroxy-β-methylbutyrate, seems to offer a benefit in the preservation of muscle mass and its functionality in the patient with cardiorespiratory pathology. Nutritional treatment, associated with a pulmonary or cardiac rehabilitation regimen, is essential to obtain good morphological and functional results.
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46
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Carbone JW, Pasiakos SM. Dietary Protein and Muscle Mass: Translating Science to Application and Health Benefit. Nutrients 2019; 11:nu11051136. [PMID: 31121843 PMCID: PMC6566799 DOI: 10.3390/nu11051136] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/08/2019] [Accepted: 05/20/2019] [Indexed: 12/14/2022] Open
Abstract
Adequate consumption of dietary protein is critical for the maintenance of optimal health during normal growth and aging. The current Recommended Dietary Allowance (RDA) for protein is defined as the minimum amount required to prevent lean body mass loss, but is often misrepresented and misinterpreted as a recommended optimal intake. Over the past two decades, the potential muscle-related benefits achieved by consuming higher-protein diets have become increasingly clear. Despite greater awareness of how higher-protein diets might be advantageous for muscle mass, actual dietary patterns, particularly as they pertain to protein, have remained relatively unchanged in American adults. This lack of change may, in part, result from confusion over the purported detrimental effects of higher-protein diets. This manuscript will highlight common perceptions and benefits of dietary protein on muscle mass, address misperceptions related to higher-protein diets, and comment on the translation of academic advances to real-life application and health benefit. Given the vast research evidence supporting the positive effects of dietary protein intake on optimal health, we encourage critical evaluation of current protein intake recommendations and responsible representation and application of the RDA as a minimum protein requirement rather than one determined to optimally meet the needs of the population.
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Affiliation(s)
- John W Carbone
- School of Health Sciences, Eastern Michigan University, Ypsilanti, MI 48197, USA.
| | - Stefan M Pasiakos
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine (USARIEM), Natick, MA 01760, USA.
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47
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Spruit MA, Rochester CL, Pitta F, Kenn K, Schols AMWJ, Hart N, Wouters EFM, Nava S, Dreher M, Janssen DJA, Johnson MJ, Curtis RJ, Sastry M, Franssen FME. Pulmonary rehabilitation, physical activity, respiratory failure and palliative respiratory care. Thorax 2019; 74:693-699. [PMID: 30872364 DOI: 10.1136/thoraxjnl-2018-212044] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 02/07/2019] [Accepted: 02/11/2019] [Indexed: 12/13/2022]
Abstract
The CIRO Academy in Horn (the Netherlands) organised a 2-day meeting to present and discuss the studies published in 2017 pertaining to key priority areas of respiratory and critical care medicine. This review summarises studies focussing on pulmonary rehabilitation and exercise training, physical activity, chronic respiratory failure and palliative respiratory care published in 2017.
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Affiliation(s)
- Martijn A Spruit
- REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium .,Department of Research and Education, CIRO, Horn, The Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), NUTRIMSchool of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Carolyn L Rochester
- Section of Pulmonary and Critical Care, Yale University School of Medicine, New Haven, Connecticut, USA.,VA Connecticut Healthcare System, West Haven, CT, United States
| | - Fabio Pitta
- Department of Physiotherapy, Laboratory of Research in Respiratory Physiotherapy, Londrina, Brazil
| | - Klaus Kenn
- Department of Respiratory Medicine and Pulmonary Rehabilitation, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany.,Department of Pulmonary Rehabilitation, University of Marburg, Marburg, Germany
| | - Annemie M W J Schols
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), NUTRIMSchool of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Nicholas Hart
- Lane Fox Respiratory Service, Guy's & St Thomas' NHS Foundation Trust, London, UK.,Lane-Fox Clinical Respiratory Physiology Research Centre, Guy's and St Thomas' NHS Trust, St Thomas' Hospital, London, United Kingdom
| | - Emiel F M Wouters
- Department of Research and Education, CIRO, Horn, The Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), NUTRIMSchool of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Stefano Nava
- Alma Mater University, Dept. of Clinical, Integrated and Experimental Medicine (DIMES), Respiratory and Critical Care Unit, S. Orsola-Malpighi Hospital Bologna, Bologna, Italy
| | - Michael Dreher
- Pneumology, Universitatsklinikum Aachen, Aachen, Germany
| | - Daisy J A Janssen
- Department of Research and Education, CIRO, Horn, The Netherlands.,Centre of Expertise for Palliative Care, MUMC+, Maastricht, The Netherlands
| | - Miriam J Johnson
- Wolfson Palliative Care Research Centre, Hull York Medical School, The University of Hull, Hull, UK
| | - Randall J Curtis
- Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington, USA.,Cambia Palliative Care Center of Excellence, University of Washington, Seattle, United States
| | | | - Frits M E Franssen
- Department of Research and Education, CIRO, Horn, The Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), NUTRIMSchool of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
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48
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Suzuki T, Palus S, Springer J. Skeletal muscle wasting in chronic heart failure. ESC Heart Fail 2018; 5:1099-1107. [PMID: 30548178 PMCID: PMC6300810 DOI: 10.1002/ehf2.12387] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 11/07/2018] [Indexed: 02/06/2023] Open
Abstract
Patients suffering from chronic heart failure (CHF) show an increased prevalence (~20% in elderly CHF patients) of loss of muscle mass and muscle function (i.e. sarcopenia) compared with healthy elderly people. Sarcopenia, which can also occur in obese patients, is considered a strong predictor of frailty, disability, and mortality in older persons and is present in 5–13% of elderly persons aged 60–70 years and up to 50% of all octogenarians. In a CHF study, sarcopenia was associated with lower strength, reduced peak oxygen consumption (peak VO2, 1173 ± 433 vs. 1622 ± 456 mL/min), and lower exercise time (7.7 ± 3.8 vs. 10.22 ± 3.0 min, both P < 0.001). Unfortunately, there are only very limited therapy options. Currently, the main intervention remains resistance exercise. Specialized nutritional support may aid the effects of resistance training. Testosterone has significant positive effects on muscle mass and function, and low endogenous testosterone has been described as an independent risk factor in CHF in a study with 618 men (hazard ratio 0.929, P = 0.042). However, the use of testosterone is controversial because of possible side effects. Selective androgen receptor modulators have been developed to overcome these side effects but are not yet available on the market. Further investigational drugs include growth hormone, insulin‐like growth factor 1, and several compounds that target the myostatin pathway. The continuing development of new treatment strategies and compounds for sarcopenia, muscle wasting regardless of CHF, and cardiac cachexia makes this a stimulating research area.
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Affiliation(s)
- Tsuyoshi Suzuki
- Department of Cardiology and Pneumology, University Medical Center Göttingen (UMG), Göttingen, Germany
| | - Sandra Palus
- Department of Cardiology and Pneumology, University Medical Center Göttingen (UMG), Göttingen, Germany
| | - Jochen Springer
- Department of Cardiology and Pneumology, University Medical Center Göttingen (UMG), Göttingen, Germany
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49
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Pizzini A, Lunger L, Sonnweber T, Weiss G, Tancevski I. The Role of Omega-3 Fatty Acids in the Setting of Coronary Artery Disease and COPD: A Review. Nutrients 2018; 10:nu10121864. [PMID: 30513804 PMCID: PMC6316059 DOI: 10.3390/nu10121864] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/09/2018] [Accepted: 11/22/2018] [Indexed: 12/30/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a growing healthcare concern and will represent the third leading cause of death worldwide within the next decade. COPD is the result of a complex interaction between environmental factors, especially cigarette smoking, air pollution, and genetic preconditions, which result in persistent inflammation of the airways. There is growing evidence that the chronic inflammatory state, measurable by increased levels of circulating cytokines, chemokines, and acute phase proteins, may not be confined to the lungs. Cardiovascular disease (CVD) and especially coronary artery disease (CAD) are common comorbidities of COPD, and low-grade systemic inflammation plays a decisive role in its pathogenesis. Omega-3 polyunsaturated fatty acids (n-3 PUFAs) exert multiple functions in humans and are crucially involved in limiting and resolving inflammatory processes. n-3 PUFAs have been intensively studied for their ability to improve morbidity and mortality in patients with CVD and CAD. This review aims to summarize the current knowledge on the effects of n-3 PUFA on inflammation and its impact on CAD in COPD from a clinical perspective.
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Affiliation(s)
- Alex Pizzini
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
| | - Lukas Lunger
- Department of Urology, Klinikum rechts der Isar, Technische Universität München, 81675 Munich, Germany.
| | - Thomas Sonnweber
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
| | - Guenter Weiss
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
| | - Ivan Tancevski
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
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50
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Shewan LG. Contemporary publication patterns in the Journal of Cachexia, Sarcopenia and Muscle by type and sub-speciality: facts and numbers. J Cachexia Sarcopenia Muscle 2018; 9:1192-1195. [PMID: 30697979 PMCID: PMC6351672 DOI: 10.1002/jcsm.12385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Louise G. Shewan
- Sydney Medical SchoolUniversity of SydneySydneyNew South Wales2006Australia
- University of MelbourneParkvilleVictoria3010Australia
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