Department of Respiratory Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands.
Chest. 2013 Oct;144(4):1340-1345. doi: 10.1378/chest.13-0326.
COPD is an important global health problem. In addition to pulmonary impairment, systemic inflammation, musculoskeletal abnormalities, and cardiovascular comorbidity influence disease burden and mortality risk. Body weight and body composition are important discriminants in classifying disease heterogeneity. The rationale for and efficacy of caloric supplementation in preventing and treating involuntary weight loss is currently well established. For maintenance of muscle and bone tissue, appropriately timed, high-quality protein intake and addressing vitamin D deficiency must be considered. Specific nutrients (eg, n-3 polyunsaturated fatty acids and polyphenolic compounds) may have the pharmacologic potential to boost decreased muscle mitochondrial metabolism and enhance impaired physical performance, particularly when the metabolic stimulus of physical activity alone is limited. At this stage, evidence is insufficient to support an intake of high doses of single nutritional supplements to modulate respiratory pathology, but some small studies have identified micronutrient modulation via the diet as a promising intervention.
慢性阻塞性肺疾病是一个重要的全球健康问题。除了肺部损伤外，全身炎症、肌肉骨骼异常和心血管合并症也会影响疾病负担和死亡风险。体重和身体成分是分类疾病异质性的重要判别因素。目前已经充分证实了热量补充在预防和治疗非自愿性体重减轻方面的合理性和疗效。为了维持肌肉和骨骼组织，必须考虑适时、高质量的蛋白质摄入和维生素 D 缺乏症的问题。特定营养素（如 n-3 多不饱和脂肪酸和多酚类化合物）可能具有药理学潜力，可以改善肌肉线粒体代谢减少和受损的身体机能，特别是当单独的身体活动代谢刺激有限时。在现阶段，证据还不足以支持摄入高剂量的单一营养补充剂来调节呼吸病理，但一些小型研究已经确定了通过饮食进行微量营养素调节是一种很有前途的干预措施。
