[Nutrition status and obesity paradox in chronic obstructive pulmonary disease]

Chronic obstructive pulmonary disease (COPD) is one of the main causes of increasing morbidity and mortality worldwide, and therefore is becoming a major public health problem. The aim of this research was to summarize the data of observational and clinical studies concerning the influence of nutritional status (both malnutrition and obesity) on the COPD course and outcomes. Material and methods. The databases PubMed, RSCI, MEDLINE, EMBASE were used for the period from January 2008 to February 2021, with a total of 582 works viewed. Searches included the keywords: nutritional status, obesity paradox, chronic obstructive pulmonary disease. Results. In the pathogenesis of malnutrition in COPD, such phenomena as excessively enhanced metabolism, loss of appetite and dietary imbalance are most often described. It is proposed to pay great attention to preventing muscle loss in the correction of these phenomena. More than a third of COPD patients has obesity, which is associated according to some reports with a low quality of life, an increased frequency of hospitalizations for exacerbations, but also with better survival. The issue of the obesity paradox in COPD is increasingly discussed in scientific literature. Many authors emphasize that basic scientific research will help to understand the mechanisms of obesity and COPD relationship, as well as timely adjust the rehabilitation program, improving the quality of patients' life. Conclusion. Nutritional status is the important factor in COPD outcomes. Maintaining muscle mass is a priority in COPD patients, including those with obesity. The proposed dietary therapy should take into account the food intake according to the needs of patients, the correct proportion of macronutrients and the level of the body mass index.