NEW YORK (Reuters Health) – Dietary counseling and food fortification can improve symptoms and general health status for patients with chronic obstructive pulmonary disease (COPD) who are at risk of malnutrition, new research shows.

“This is one of the first randomized controlled trials to evaluate the specific impact of dietary counseling on outcome in any patient group,” Dr. C. Elizabeth Weekes, from St. Thomas’ Hospital, London, and colleagues note in the April issue of Thorax. “The study is unusual in that it measured the effect of intervention not only on nutritional outcomes but also on objective and subjective measures of functional status.”

Dr. Weekes’ team assessed the outcomes of 59 COPD outpatients who were randomized to receive dietary counseling and advice on food fortification or to receive a dietary advice leaflet only. After a 6-month intervention period, the subjects were followed for 6 months.

Daily caloric and protein intake was significantly greater in the intervention group than in controls. The intervention group gained about 2 kg in the first 6 months and maintained that gain, while the comparison group steadily lost about 3 kg over the 12 month study.

In terms of symptoms and functional outcomes, intervention patients had significantly better scores on the St. George’s Respiratory Questionnaire, the Short Form-36 health change score, and the Medical Research Council dyspnea score, than did controls. Many of the beneficial changes persisted during the follow-up period.

The Activities of Daily Living score was also better in the intervention group than in controls, although the difference fell short of statistical significance.

By contrast, the dietary intervention appeared to have no impact on respiratory function or on respiratory and skeletal muscle strength, the researchers note.

The authors call for further studies to identify which COPD patients are mostly likely to respond to dietary counseling and advice on food fortification.

Reference:
Thorax 2009;64:326-331.