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Background: Lung cancer (LC) is the second most common cancer in both genders. LC often has a poor prognosis, and many patients are deemed unfit for anti-tumoral treatment. There is a high prevalence of malnutrition and sarcopenia among LC patients, with a significant risk of treatment cessation, treatment complications, mortality, and reduced quality of life. Early screening for malnutrition and sarcopenia is necessary to address these issues effectively. When diagnosed, LC patients face significant life changes and an intensive treatment plan with many hospital visits. Conducting nutritional assessment by telephone can secure an early nutritional assessment following diagnosis. This study examined the feasibility and acceptability of a remote nutritional assessment, conducted by telephone, in LC patients. Method: A cross-sectional study was conducted in February 2024 at the oncology outpatient clinic at the Zealand University Hospital in Naestved, including 37 patients aged 61-85 with various stages of LC undergoing various treatments. Telephone interviews included assessment of nutritional status, sarcopenia, frailty, physical function, symptoms, socioeconomics, and lifestyle. Feasibility was measured by recruitment and completion rates, and completion time. Acceptability was measured using the Acceptability E-scale, and questions regarding the preferred location for a nutritional assessment. The agreement between patients assessed at ‘risk of malnutrition’ according to NRS-2002 and a malnutrition diagnosis according to GLIM criteria was analyzed by percent agreement. The agreement between patients assessed as sarcopenic according to SARC-F and a measure of calf circumference was analyzed by percent agreement and Kappa coefficient. Results: The recruitment rate was 89 %, the completion rate was 90 %, and mean completion time was 13:07 min. The median total score on the Acceptability E

Iintroduction: The prevalence of cachexia in patients with chronic obstructive pulmonary disease (COPD) is high and associated with reduced quality of life, increased mortality and morbidity. We aimed to test the effect of a high protein diet combined with exercise on fat-free mass (FFM), functional capacity, symptom burden and dyspnoea. Methods: Outpatients with COPD and severe or very severe (GOLD grade III-IV) disease and malnutrition commencing pulmonary rehabilitation were randomised to a high-protein diet or standard care. FFM was measured by bio-impedance analysis (BIA), mid-upper arm circumference (MUAC) and mid-thigh circumference (MTC), peripheral muscle function by six-minute walking distance (6MWD) and handgrip strength (HGS), symptoms by the COPD Assessment Trial (CAT) and dyspnoea by the Medical Research Council dyspnoea scale and Borg scores; all at baseline and after 12 weeks. Results: Ten out of 13 randomised patients completed the trial. The intervention group was superior to the control group with respect to 6MWD (97 ± 93 m, p = 0.04) at 12 weeks. No differences were observed between the groups in HGS, anthropometrics, symptom burden or dyspnoea. Conclusion: In patients with COPD attending rehabilitation, a high protein diet combined with physical exercise had a clinically relevant effect on walking distance.

Background: Chronic Obstructive Lung Disease (COPD) is a heterogen disease with individual variation in symptoms, incidence and progression of complications. The presence of a hypermetabole state increases the body’s combustion of the body’s function- and structural protein, unless the requirement is not met by exogen nutrition. The prevalence of cachexia in COPD patients is common and increases the risk of mortality, morbidity and reduces quality of life. A systematic and efficient treatment of pulmonary cachexia is not yet found. Aim: The aim of this study is to evaluate the effect of a high protein diet in combination with physical activity on patients with severe and very severe COPD on clinically relevant outcomes. It is hypnotized that a high protein diet in combination with physical activity will increase FFM, functional capacity and quality of life in patients with severe and very severe COPD. Method: An unblended, randomized pilot study has examined the effect of a high protein diet (protein 25 E %) on the patients’ peripheral muscle function (measured by 6MWD and handgrip strength), fat free mass (measured by BIA, MUAC and MTG), quality of life (measured by CAT and OAS) and dyspnea (measured by MRC and Borg) in 13 outpatients with severe and very severe COPD who participated in pulmonary rehabilitation. Results: 3 of 6 patients from the control group dropped out and their data are not included in the statistical analyses. Data is analyzed by available cases, but not ITT method, due to the dropout rate. A significant difference in peripheral muscle function, measured by 6MWD (97±93,4 m, p=0.04), where the intervention group maintained their muscle function, while the control group reduced theirs. A difference was not found in hand grip strength, FFM, quality of life or dyspnea between the groups. Obtaining significant differences is complicated by the study’s low power and the large drop out. Conclusion: Intervention with a high protein diet, Baggrund: Kronisk obstruktiv lungesygdom (KOL) er en heterogen sygdom med individuel variation af symptomer, forekomst og progression af komplikationer. Tilstedeværelse af stressmetabol tilstand øger kroppens forbrænding af struktur- og funktionsprotein, såfremt behovet ikke imødekommes via eksogen ernæring. Forekomst af kakeksi hos KOL patienter er udbredt og øger risikoen for exacerbation, morbiditet og mortalitet samt reducerer patienternes livskvalitet. En systematisk og effektiv forebyggelse/behandling af pulmonal kakeksi er ikke fundet. Formål: Formålet med studiet er at evaluere effekten af højproteindiæt i kombination med fysisk træning hos patienter med svær og meget svær KOL på klinisk relevante endepunkter. Hypotesen er, at intervention med højproteindiæt i kombination med fysisk aktivitet vil kunne øge FFM, funktionsevne og livskvalitet hos patienter med svær eller meget svær KOL. Metode: Et ublindet, randomiseret pilotstudie har undersøgt effekten af intervention med højproteindiæt (protein 25 E %) på perifer muskelfunktion (målt ved 6MWD og håndgribestyrke), fedtfri masse (målt ved BIA, MUAC og MTG), livskvalitet (målt ved CAT og OAS), samt åndenød (målt ved MRC og Borg) hos 13 ambulante patienter med svær og meget svær KOL i ernæringsmæssig risiko, der deltog i fysisk træning via pulmonal rehabilitering. Resultater: 3 ud af 6 patienter fra kontrolgruppen faldt fra og er ikke inkluderet i de statistiske analyser. Grundet frafald er available cases metoden, men ikke ITT, anvendt i de statistiske analyser. Studiet fandt en signifikant forskel i perifer muskelfunktion mellem interventions- og kontrolgruppe målt ved 6MWD (97±93,4 m, p=0,04), hvor interventionsgruppen bevarede deres muskelfunktion, mens kontrolgruppen reducerede deres. Forskel i håndgribestyrke, FFM, livskvalitet og åndenød mellem grupperne var ikke signifikant. Studiets lave power og store frafald besværliggjorde signifikante fund. Konklusion: Intervention med