Predictors' factors of nutritional status of male chronic obstructive pulmonary disease patients

Dietary Behaviour and Nutrition in Patients with COPD Treated with Long-Term Oxygen Therapy

BACKGROUND

It is the first study in Poland and one of the first in the world to assess the nutrition of patients with chronic obstructive pulmonary disease (COPD) treated with long-term oxygen therapy (LTOT).

METHODS

The study group consisted of 110 COPD patients treated with LTOT. Anthropometric measurements and spirometry were performed. The diet of patients was assessed using a 3-day nutrition diary.

RESULTS

When assessing the degree of airflow obstruction (FEV1% N) depending on the BMI in patients treated with LTOT, a statistically significant correlation was demonstrated between the BMI and the value of the FEV% N parameter (p = 0.0093). Patients with COPD with a BMI >30 had statistically significantly higher values of FEV1% N than patients with a BMI in the range of 20-24.9 (p = 0.0278). Intake of calcium, vitamins A, C, D, E and folates was lower than the recommended daily intake in more than 95% of COPD patients.

CONCLUSIONS

The diet of COPD patients treated with long-term oxygen therapy was improperly balanced, with deficiencies of important nutrients. Airflow obstruction in the respiratory tract was significantly smaller in obese patients, and greater in patients with diagnosed malnutrition.

Serum Albumin Concentrations in Stable Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Background: Chronic obstructive pulmonary disease (COPD) is a progressive condition characterized by chronic airway inflammation and lung parenchyma damage. Systemic inflammation and oxidative stress also play a role in the pathogenesis of COPD. Serum albumin is a negative acute-phase protein with antioxidant effects and an important marker of malnutrition. The aim of this meta-analysis was to investigate differences in serum albumin concentrations between patients with stable COPD and non-COPD subjects. Methods: A systematic search was conducted, using the terms “albumin” and “chronic obstructive pulmonary disease” or “COPD”, in the electronic databases PubMed and Web of Science, from inception to May 2020. Results: Twenty-six studies were identified on a total of 2554 COPD patients and 2055 non-COPD controls. Pooled results showed that serum albumin concentrations were significantly lower in COPD patients (standard mean difference, SMD = −0.50, 95% CI −0.67 to −0.32; p < 0.001). No significant differences were observed in SMD of serum albumin concentrations between COPD patients with forced expiratory volume in the 1st second (FEV1) < 50% and those with FEV1 > 50%. Conclusions: Our systematic review and meta-analysis showed that serum albumin concentrations are significantly lower in patients with stable COPD compared to non-COPD controls. This supports the presence of a deficit in systemic anti-inflammatory and antioxidant defense mechanisms in COPD.

Nutritional deficiency and associated factors among new pulmonary tuberculosis patients of Bale Zone Hospitals, southeast Ethiopia

Objective

Tuberculosis remains deadliest communicable diseases accountable for health problem among various individuals annually and is related to malnutrition. Addressing nutritional deficiency in Tuberculosis patients is a crucial side of tuberculosis management programme. Therefore, the aim was to assess the magnitude of nutritional deficiency and associated factors among new pulmonary tuberculosis patients of Bale Zone Hospitals, south-east Ethiopia, 2018. Cross-sectional study design was utilized. Data collection was carried out using structured questionnaires and anthropometric measurements. Body mass index was calculated to see nutritional deficiency. Crude and adjusted odds ratios in conjunction with their corresponding 95% confidence intervals were computed. p-value < 0.05 was thought of to declare a result as statistically associated.

Results

Prevalence of nutritional deficiency was 63.2%. The mean Body mass index for all listed participants was 17.86 kg/m². Employment status of the patients, p-value 0.012 (AOR = 1.82; 95% CI 1.14, 2.89) and Khat chewing, p-value 0.02 (AOR = 0.43; 95% CI 0.23, 0.85) were factors independently associated with nutritional deficiency. Prevalence of nutritional deficiency was found to be high. Nutritional support for the impoverished, regular nutritional assessment and dietary counseling are necessary for better treatment outcome and effective Tuberculosis management programme.

The effect of the training program on the quality of life in patients with asthma based on the Precede model in Ahvaz, Iran

Aim

The aim of the study was to determine the effect of the training program based on the Precede model and its main components on improving the quality of life in patients with asthma.

Material and methods

It was a randomized quasi-experimental study done on 120 patients with asthma who were referred to the Imam Khomeini hospital in Ahvaz who were selected using the convenience sampling method and were randomly divided into intervention and control groups. The data collection tool consisted of two questionnaires. The first questionnaire evaluated the quality of life in patients with asthma and the other one was developed by the researcher based on the structures of the Precede model. Training intervention was conducted during four sessions twice a week and each session was carried out for an hour based on the structures of the Precede model. In order to achieve the results, SPSS software, even t-test, and χ² were used.

Results

The results showed that after the training intervention in the experimental group, the mean scores of predisposing factors (p < 0.001), enabling factors, reinforcing factors and behavioral factors were significantly increased (p < 0.001) as compared to the control group. A significant difference was observed in the mean scores of quality of life in two groups after the intervention (p < 0.001), and the quality of life of patients in the experimental group was improved after the training intervention.

Conclusions

The design and implementation of the training program based on the Precede model can have a positive effect on the improvement of quality of life in patients with asthma.

Anthropometric Indicators Associated with Dyspnea and Spirometric Parameters in Patients with Chronic Obstructive Pulmonary Disease

BACKGROUND

This study aimed to determine anthropometric indicators associated with dyspnea and spirometric parameters in patients with chronic obstructive pulmonary disease (COPD).

MATERIALS AND METHODS

A cross-sectional and observational study was carried out on 88 patients with COPD, who were visited in an outpatient respiratory clinic of a university hospital during two months. Patient height, weight, body mass index (BMI), waist circumference (WC), mid-upper arm circumference (MUAC), triceps skinfold thickness (TSFT) and subscapular skinfold thickness (SST) were recorded. Also, data on lung function and dyspnea were collected. The association between anthropometric indices and other parameters was studied.

RESULTS

Pearson's correlation coefficient showed that forced expiratory volume in one second (FEV1)% predicted was positively correlated with BMI (R=0.239, P<0.05) and MUAC (R=0.431, P<0.01). By applying ANOVA, we found that the relationship between FEV1% predicted and BMI (P=0.007), WC (P=0.019) and MUAC (P<0.001) was statistically significant. Chi-square test showed that there was an association between MUAC and dyspnea (P<0.05).

CONCLUSION

There was a relationship between FEV1% predicted and some anthropometric indices such as BMI, MUAC and WC; also, we found an association between MUAC and dyspnea.

Dietary intake of patients with moderate to severe COPD in relation to fat-free mass index: a cross-sectional study

BACKGROUND

Fat-free mass (FFM) depletion has been shown to be a better predictor of mortality than BMI in chronic obstructive pulmonary disease (COPD) patients. The specific aim of the current study was to assess the nutritional status of stable COPD patients in relation to fat free mass index profiles.

METHODS

We investigated 65 male moderate-to-severe stable COPD patients. A self-reported questionnaire was applied about general characteristics and smoking history. Nutritional intake was assessed by using a 54-item quantitative food frequency questionnaire. Weight, height, mid-upper arm circumference (MUAC), waist circumference (WC), handgrip strength and body composition measurements were taken by a trained dietitian. The data were analyzed with SPSS 15.0 software.

RESULTS

The mean age of the patients was 62.1 ± 8.9 years. Among all of the patients 13.8% was underweight (BMI < 21 kg/m(2)) and 18.5% had a low fat-free mass index (FFMI < 16 kg/m(2)). The percentages of the patients who did not meet the daily recommended intakes (RNI) were highest for magnesium (93.8%) and calcium (92.3%). Mean daily consumptions of milk-yogurt, red meat and fruits were significantly low in the low FFMI group compared to normal FFMI group (for all; p < 0.05). Patients with normal FFMI had significantly higher weight, height, WC, MUAC, handgrip strength, fat and fat-free mass than the patients with low FFMI (for all; p < 0.05).

CONCLUSIONS

Dieticians should be aware of COPD patients with low FFMI in order to evaluate the nutritional intake and therefore plan nutritional strategies to improve prognosis of the disease.

Nutritional status of an elderly population in Southwest China: a cross-sectional study based on comprehensive geriatric assessment

OBJECTIVE

Few data is available on the nutritional status of old Chinese. The present study aimed to describe the nutritional status and clinical correlates for malnutrition risk in the older people.

DESIGN

Cross-sectional study.

SETTING

Hospital- and community-based older people were recruited in the region of Chongqing, China.

PARTICIPANTS

558 individuals aged 60 years old or over between April 2011 and October 2012.

MEASUREMENTS

Comprehensive geriatric assessment was performed and nutritional status was assessed by the Mini Nutritional Assessment Short Form (MNA-SF). Nutrition-associated factors were analyzed, including health status (chronic diseases, depression, cognition, function impaired), social factors (education status, marital status, the type of work before 60 years old) and life style factors (smoking, drinking, diet).

RESULTS

The mean age was 73.1±8.0 years and 43.9% were men. Prevalence of malnutrition and risk for malnutrition were 3.2% and 19.3 %, respectively. Several factors increased poor nutrition independently including self-rated health, comorbidity, chronic obstructive pulmonary disease, gastrointestinal disease and cognitive impairment. Fish decreased the risk of poor nutrition.

CONCLUSIONS

The prevalence was relatively low in older people of Chongqing, Southwest China. Poor nutrition was found to be increased due to the common health problems. Thus the patients with these problems should pay more attention on nutritional status. The older people should often have fish because of their nutritional benefit.