Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) is the term used to describe a number of lung conditions including emphysema and chronic bronchitis that cause inflammation in the airways and make it difficult to breathe1. Inflammation of the airways and the extra effort required to breathe increases the amount of energy (calories) and protein needed for a person with COPD to maintain their weight and strength2,3. If these increased requirements are not met, weight loss may occur.

Did you know?

  • 1.2 million people in the UK have been diagnosed with COPD1

  • 2/3 of people with COPD may remain underdiagnosed1

  • Malnutrition affects 1 in 3 inpatients4 and 1 in 5 outpatients5 with COPD

Malnutrition in patients with COPD is associated with poorer outcomes and reduced quality of life2,4,6-12

Patients with COPD and malnutrition may experience:

outcomes-associated-with-mn-in-copd-v1

Causes of malnutrition in patients with COPD

Malnutrition in patients with COPD can be caused by:

  • Reduced Oral Intake: Due to dry mouth, dyspnoea, taste alterations, loss of appetite and anxiety13,14
  • Increased Energy Requirements: Resting energy expenditure is 15-20% higher than those without COPD due to increased energy requirements for breathing2
  • Increased Protein Requirements: Patients with COPD require up to 50% more protein than those without the condition3

Identifying malnutrition is key to support patients with COPD 

Guidelines indicate the importance of identifying malnutrition in patients with COPD15. However, BMI alone may not be enough to identify this risk7. The BAPEN Malnutrition Universal Screening Tool ('MUST')16* combines 3 dimensions of risk: BMI score, unplanned weight loss score and acute disease effect score and is endorsed by the National Institute of Health and Care Excellence (NICE)17.

Oral Nutritional Supplements can support patients with COPD 

Oral nutritional supplements (ONS) should be considered for patients with COPD that are identified as being at risk of malnutrition15,. Nutrition support including ONS in COPD has been shown to:  

nutrition-support-outcomes-in-copd-1900x600-v1

Supporting nutrition in patients with COPD with Fortisip Compact Protein

FCP Profile - COPD Website Icon 2024

A high protein, high energy, low volume ONS has been used in a real-world study managing COPD at risk of malnutrition (n=26) 24. According to the Managing Malnutrition in COPD Pathway25, the outcomes included:

copd-real-world-study-outcomes

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  1. Commons Library. Support for people with chronic obstructive pulmonary disease. https://commonslibrary.parliament.uk/research-briefings/cdp-2021-0188/  [Accessed: September 2022]. 

  1. Ezzell, L. et al. Am J Clin Nut. 2000;72(6):1415-16. 

  1. Vermeeren, MA. et al. Eur Respir J 1997 10(10): 2264-9

  1. Steer, J. et al. Thorax. 2010; 65(4): A127-A. 

  1. Collins, P.F. et al.  Proc Nut Soc. 2010; 69(Issue OCE2): E148.  

  1. Vermeeren, M.A. et al. Respir Med. 2006 Aug;100(8):1349-55. 

  1. Gupta, B. et al. J Clin Med Res. 2010; 2(2):68-9.  

  1. Gattermann Pereira, T. et al. J Parenter Enteral Nutr.2022; 46(5):977-96.  

  1. Collins, PF. Et al. Clin Nutr. 2010 ; 5(2) :17.  

  1. Ingadottir, AR. Et al. Clin Nutr. 2018 ; 37(4) :1323-1331.  

  1. Ingadottir, AR. et al Br J Nutr. 2018; 119(05):543-551. 

  1. Hoong, JM. et al. Clin Nutr. 2017; 36(4):1105–1109 

  1. Grönberg, AM. et al. J Hum Nutr Diet. 2005; (6):445-52.  

  1. Schols, AM. et al. Nutritional assessment and therapy in COPD: a European Respiratory Society statement. 2014 

  1. NICE. NICE guideline NG115 Chronic obstructive pulmonary disease in over 16s: diagnosis and management (NICE Guideline NG115). Available at: https://www.nice.org.uk/guidance/NG115 [Accessed January 2024] 

 

  1. ‘MUST’: Malnutrition Universal Screening tool. Available at: https://www.bapen.org.uk/pdfs/must/ must_full.pdf [Accessed January 2024]. 

  1. NICE. Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition (Clinical Guideline 32), 2006. Available at: https://www.nice.org.uk/guidance/cg32 [Accessed January 2024]. 

  1. Collins, PF. et al. Respirology. 2013; 18:616-29 

  1. Collins, PF. et al. Am J Clin Nutr. 2012; 95(6):1385-95 

  1. Ferreira, IM. et al. Cochrane Database Syst Rev. 2012;12. 

  1. Regulations (EC) No. 1924/2006. 2006. European Parliament and of the Council of 20 December 2006 on nutrition and health claims made on foods. OJEU. L12:3-18 

  1. Hubbard, GP. et al. Clin Nutr Suppl. 2012; 31(3): 293-312. 

  1. Hubbard, GP. et al. Proc Nutr Soc. 2010; 69(OCE2):E164.  

  1. Cawood, A. et al.  Euopean Respiratory Journal. 2017;50(suppl 61):PA1609. 

  1. Managing Malnutrition in COPD. 2020. Available at: https://www.malnutritionpathway.co.uk/copd [Accessed January 2024].

 

*‘Malnutrition Universal Screening Tool’ (‘MUST’) is reproduced here with the kind permission of BAPEN (British Association for Parenteral and Enteral Nutrition). For further information on ‘MUST’ see www.bapen.org.uk’. 

**Product can be provided to patients upon the request of a Healthcare Professional. They are intended for the purpose of professional evaluation only.

Fortisip Compact Protein is a Food for Special Medical Purposes for the dietary management of disease related malnutrition and must be used under medical supervision.

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