Energy and Protein Intake in Mild-Moderate COPD Patients

Malnutrition is often overlooked as an extrapulmonary comorbidity in chronic obstructive pulmonary disease (COPD) and there is limited information regarding the nutritional status of younger individuals with mild-to-moderate disease in outpatient settings. We assessed energy and protein intakes in mild-to-moderate COPD patients compared to a group of healthy non-smoking individuals (HNS).

COPD patients and HNS were recruited; anthropometric measurements were assessed via BMI and bioelectrical impedance, while nutritional intake was assessed using a 7-day food diary and the EPIC-Norfolk Food Frequency Questionnaire (FFQ). Low fat-free mass index (FFMI) was defined as (a) < 15 kg/m² for females and < 17 kg/m² for males (Schols in Eur Respir J 44:1504-1520, 2014) or (b) adjusted for age, sex and BMI (Wei et al. in Front Endocrinol 14:1185221, 2023).

21 COPD participants and 15 HNS were recruited with a median age of 58.0 and 57.0, respectively [IQR: 55.0-63.0 and 50.0-60.0]. A significantly greater proportion of individuals with COPD had a low FFMI when using age-sex-BMI adjusted criteria (23.8 vs. 0.0%, p = 0.04). Using the estimated requirement threshold of 75%, more COPD patients did not meet nutritional protein requirements HNS (35% vs. 0%, respectively, p = 0.01).

Our findings suggest a potential opportunity for dietary intervention in younger individuals to prevent future sequalae of malnutrition in COPD.