Nutritional status and dietary intake of outpatients with chronic obstructive pulmonary disease.

Aim: To determine, in Australian chronic obstructive pulmonary disease (COPD) outpatients, the prevalence of nutritional depletion, adequacy of dietary intake and relationship between nutritional depletion and clinical indicators. Methods: Cross-sectional study of 66 stable COPD outpatients (mean forced expiratory volume in one second (FEV₁) of 60% predicted (95% confidence interval 54, 67) ). Nutritional status was assessed using body mass index (BMI) and fat-free mass index (FFMI). Four-day estimated food records were compared with the new Australian Nutrient Reference Values. Clinical indicators included respiratory function and quality of life (QoL) using the St George Respiratory Questionnaire. Results: Thirty per cent of subjects (n = 20) were nutritionally depleted (BMI < 20 kg/m² and/or FFMI < 16.7 kg/m² (male) or <14.6 kg/m² (female) ). Low FFMI despite normal/high BMI was present in 20% of subjects (n = 13). Many subjects were not meeting estimated requirements for energy (n = 43 of 57), calcium (n = 47), fibre (n = 47), folate (n = 37), magnesium (n = 28) and zinc (n = 14). Nutritionally depleted subjects had significantly lower respiratory function (FEV₁ (% predicted) ( P = 0.003) and FEV₁/forced vital capacity (%) ( P = 0.038) ), while QoL scores were not significantly different. Conclusion: While nutritional depletion is a recognised complication of COPD that is predictive of early mortality, this is the first nutritional analysis of stable ambulatory COPD patients in Australia. One-third of this sample was nutritionally depleted, characterised particularly by low fat-free mass. Intake of energy and several nutrients was also inadequate. Prompt diagnosis and treatment of nutritional depletion are required, as it is highly prevalent in this population and associated with poorer outcomes. [ABSTRACT FROM AUTHOR]