Effect of High-Intensity Exercise Training on Dietary Intake in Patients with Chronic Obstructive Pulmonary Disease:...

Chronic obstructive pulmonary disease (COPD) is frequently complicated by nutritional disorders, and low body weight is an independent prognostic factor. High-intensity exercise training may affect leptin, an appetite-regulating hormone, and dietary intake. However, longitudinal evidence regarding these associations in COPD is limited. This study aimed to examine changes in dietary intake and leptin levels during pulmonary rehabilitation in patients with COPD, with exploratory analyses according to attainment of high-intensity exercise training.

In this prospective observational study, patients with COPD participated in a 6-week pulmonary rehabilitation program. High-intensity exercise training (≥ 80% prescribed intensity) was performed whenever feasible. Dietary intake (primary outcome) and leptin were assessed before and after the program. In exploratory subgroup analyses, participants were classified as high-intensity "attainers" (Attainment group) or "nonattainers" (Nonattainment group), and within-group before and after changes as well as between-group differences in change scores were compared. Furthermore, multivariate linear regression analysis was performed to examine whether exercise intensity was independently associated with changes in dietary intake and leptin.

Of the 69 participants, 55 completed the study and were included in the analysis. Dietary intake increased significantly from 1367 to 1484 kcal/day (p = 0.01), whereas leptin did not change significantly in the overall cohort. Between-group comparisons of change scores revealed a significant difference in leptin (p < 0.01) but not in dietary intake (p = 0.16). Multivariable regression analysis showed that exercise intensity attainment was associated with changes in leptin (B = -4.47, p < 0.01) but not dietary intake (p = 0.12).

Dietary intake increased following pulmonary rehabilitation in patients with COPD. Although exploratory analyses suggested an association between attainment of high-intensity exercise training and changes in leptin levels, the relationship with dietary intake remains unclear.