Chronic obstructive pulmonary disease (COPD) is a progressive, respiratory disease characterized by persistent airflow limitation due to damage, caused mainly by smoking. It is the third leading cause of death by disease in the US. COPD primarily affects the lungs but due to the chronic systematic inflammation it also causes metabolic adaptations in the whole body. These alterations lead to an increased nutritional requirement. However, COPD patients often suffer from a comprised nutritional intake.
COPD patients run the risk of entering a vicious circle. It has been shown that malnourishment leads to poorer lung capacity and is also likely to lead to a loss of lung tissue as well as the reduction in the size and contractility of the muscles associated with breathing. This also may impair the ability to generate enough cough pressure to clean the lungs of secretions that may be infected (Collins, Yang, Chang, & Vaughan, 2019).
Weight loss in COPD patients was in the past seen as an inevitable consequence of severe respiratory disease and as a result not amenable to nutritional intervention. However, systemic reviews and meta-analyses in stable COPD outpatients have found that malnourishment is possible to address, leading to significant improvements in functional capacity, respiratory muscle strength and quality of life (Collins, Elia, & Stratton, 2013). As with many other diseases, mainly the muscle mass is affected negatively. Meeting the dietary protein requirement is crucial. Nutritional requirements for COPD patients should be assessed individually considering the patients clinical state (stable vs exacerbation) and disease severity (mild to very severe) as well as their activity levels. In patients with COPD, identified as malnourished, nutritional support should target a weight gain of >2kg in 8 weeks. This could be facilitated by an energy intake of at least 45 kcal/kg body weight/day and a protein intake of at least 1.2 g/kg body weight/ day (potentially higher when the aim is to improve the muscle mass). (Collins, Yang, Chang, & Vaughan, 2019). Oxidative stress and inflammation play an important role in the pathology of COPD. Several vitamins (A, C and E) could have protective effects. Since a high % of malnourished patients have shown to have low levels of vitamins, supplementation with a complete product could be beneficial. (Collins, Yang, Chang, & Vaughan, 2019).
There is also evidence that in non-malnourished patients, nutritional support can improve body weight and exercise performance, suggesting a potential role for nutritional support beyond the treatment of malnutrition.
S-core provides a high caloric and high protein ONS that can be used for the dietary management of COPD.