Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2305, Australia.
Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton, NSW 2305, Australia.
Nutrients. 2017 Oct 20;9(10):1147. doi: 10.3390/nu9101147.
There is a paucity of evidence to guide clinicians about appropriate management strategies for people with obesity and Chronic Obstructive Pulmonary Disease (COPD). We have recently published results from the first weight loss intervention in adults (>18 years) with obesity (body mass index; BMI ≥ 30 kg/m²) and COPD, using a low-calorie diet coupled with a partial meal replacement plan and resistance exercise training, which resulted in a 6.4% reduction in weight while maintaining skeletal muscle mass and improving health status. This sub-study aims to evaluate the intervention by (a) examining changes in dietary intake and nutritional biomarkers and (b) examining predictors of weight loss. Dietary intake was evaluated using four-day food diaries, and analysis of plasma fatty acids and plasma carotenoids as biomarkers of dietary fat intake and fruit and vegetable intake, respectively. Twenty-eight obese COPD subjects ( = 17 males, = 11 females) with a mean (standard deviation; SD) age of 67.6 (6.3) years completed the 12-week weight loss intervention. Pre-intervention, mean (SD) BMI was 36.3 (4.6) kg/m². Micronutrient intake improved from pre- to post-intervention, with the percentage of subjects meeting the Nutrient Reference Values increased for all micronutrients. Post-intervention, significant decreases in total ( = 0.009) and saturated fat intake ( = 0.037), and corresponding decreases in total ( = 0.007) and saturated plasma fatty acids ( = 0.003) were observed. There was a trend towards higher total carotenoids post-intervention ( = 0.078). Older age ( = 0.025), higher pre-intervention uncontrolled eating ( < 0.001) and plasma carotenoids ( = 0.009) predicted weight loss. This demonstrates the efficacy of a weight loss intervention in improving diet quality of obese COPD adults.
针对肥胖合并慢性阻塞性肺疾病（COPD）患者的适当管理策略，目前临床医生可参考的证据有限。我们最近发表了首例针对肥胖（体重指数；BMI≥30kg/m²）合并 COPD 的成年患者（>18 岁）进行减肥干预的研究结果，采用低热量饮食联合部分代餐方案和抗阻运动训练，结果体重减轻了 6.4%，同时保持了骨骼肌量并改善了健康状况。本亚研究旨在通过（a）评估饮食摄入和营养生物标志物的变化，以及（b）评估体重减轻的预测因素来评估该干预措施。采用 4 天食物日记评估饮食摄入，分析血浆脂肪酸和血浆类胡萝卜素，分别作为膳食脂肪摄入和水果、蔬菜摄入的生物标志物。28 名肥胖合并 COPD 的受试者（男性 17 名，女性 11 名）完成了为期 12 周的减肥干预，平均（标准差；SD）年龄为 67.6（6.3）岁，平均（SD）BMI 为 36.3（4.6）kg/m²。干预前，所有微量营养素的摄入量均有所改善，符合营养素参考值的受试者比例均增加。干预后，总摄入量（ = 0.009）和饱和脂肪摄入量（ = 0.037）显著减少，相应的总血浆脂肪酸（ = 0.007）和饱和血浆脂肪酸（ = 0.003）减少。干预后总类胡萝卜素水平呈升高趋势（ = 0.078）。年龄较大（ = 0.025）、干预前未控制的饮食（ < 0.001）和血浆类胡萝卜素（ = 0.009）较高与体重减轻相关。这表明减肥干预可有效提高肥胖合并 COPD 成年患者的饮食质量。
