Chronic Obstructive Pulmonary Disease: A 2019 Evidence Analysis Center Evidence-Based Practice Guideline | JoVE Visualize

Area of Science:

Pulmonology and Nutritional Science
Evidence-Based Practice Guidelines

Background:

Chronic obstructive pulmonary disease (COPD) is a progressive lung disorder with significant pulmonary and systemic complications.
Medical nutrition therapy (MNT) is crucial for managing COPD, impacting lung function, mortality, and quality of life.
The Academy of Nutrition and Dietetics (Academy) initiated a systematic review to update its COPD Evidence-Based Nutrition Practice Guideline.

Purpose of the Study:

To systematically review and update the evidence-based nutrition practice guideline for COPD.
To outline the methods used in the Evidence Analysis Library (EAL) for the systematic review and guideline development.
To examine the recommendations and supporting evidence for MNT in COPD management.

Main Methods:

Systematic review conducted by an expert workgroup convened by the Academy of Nutrition and Dietetics.
Utilized the Academy's Evidence Analysis Library (EAL) methods for review and guideline creation.
Employed the Nutrition Care Process as a framework for developing practice recommendations.

Main Results:

Developed 14 recommendations based on eight conclusions from the systematic review.
Strong recommendations included assessing/monitoring body weight and MNT by a registered dietitian nutritionist.
Fair recommendations covered individualizing calorie/macronutrient prescriptions, monitoring energy intake, vitamin D levels, exacerbations, and determining vitamin D supplementation needs. Weak recommendations addressed energy expenditure prediction.

Conclusions:

The updated guideline provides valuable recommendations for registered dietitian nutritionists and healthcare professionals managing COPD patients.
Evidence supporting recommendations was limited, with fewer than one-third of conclusions directly supporting recommendations due to conflicting or insufficient data.
The guideline emphasizes the integral role of MNT, guided by a registered dietitian nutritionist, in optimizing COPD patient outcomes.