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Nutritional status and the effect of physical training on fat-free mass in patients with (COPD)
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences.
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Manuscript (Other academic)
URN: urn:nbn:se:uu:diva-97939OAI: oai:DiVA.org:uu-97939DiVA: diva2:173064
Available from: 2008-12-22 Created: 2008-12-22 Last updated: 2010-01-13Bibliographically approved
In thesis
1. Nutritional Depletion in Chronic Obstructive Pulmonary Disease (COPD): Effect on Morbidity, Mortality and Physical Capacity
Open this publication in new window or tab >>Nutritional Depletion in Chronic Obstructive Pulmonary Disease (COPD): Effect on Morbidity, Mortality and Physical Capacity
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this work was to examine the effects of depleted nutritional status on some aspects of Chronic Obstructive Pulmonary Disease (COPD).

Morbidity. In paper І, we found that energy intake was lower than the calculated energy demand for all patients. A low body mass index (BMI) at inclusion and weight loss, during the one year follow-up period were independent risk factors for having a new exacerbation (p = 0.003 and 0.006, respectively).

Mortality. Nineteen percent of the patients in paper ІІ, where underweight (BMI<20). A significant positive correlation was found between BMI and FEV1, and this correlation remained significant after adjustment for age, sex and pack years (p<0.0001). Being underweight was related to increased overall mortality and respiratory mortality but not to mortality of other causes, 19% of the patients had died within 2 years. The lowest mortality was found among the overweight patients (BMI 25-30 kg/m).

Physical capacity and effect of training. In paper ІІІ we investigated baseline characteristics of patients that were starting physical training. We found that peak working capacity was positively related to BMI (r=0.35, p=0.02) and fat free mass index (FFMI) (r=0.49, p=0.004) and negatively related to S-Fibrinogen and serum C reactive protein (S-CRP). BMI and FFMI were significantly related to the 12 minutes walking distance when adjusted for body weight. Fifty to 76% of the variation in physical capacity was accounted for when age, gender, FEV1, FFMI and CRP were combined in a multiple regression model.

In Paper ІV the median change in fat free mass (FFM), after 4 months of physical training was 0.5 kg. Old age, low FEV1 and high level of dyspnoea were independent negative predictors of FFM increase after the training period.

In conclusion nutritional status is an important determinant of morbidity, mortality and physical capacity in COPD. Low FEV1 and high level of dyspnea are negative predictors for increased FFM after physical training.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. 55 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 411
chronic obstructive pulmonary disease, nutrition, pulmonary rehabilitation, physical capasity, systemic inflammation
National Category
Respiratory Medicine and Allergy
urn:nbn:se:uu:diva-9512 (URN)978-91-554-7381-5 (ISBN)
Public defence
2009-01-16, Roberg salen, A9, Ing 40, 5 tr, Akademiska sjukhuset, Uppsala, 09:15
Available from: 2008-12-22 Created: 2008-12-22Bibliographically approved

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