Systematic review and meta-analysis of nutrient supplements for treating sarcopenia in people with chronic obstructive pulmonary disease.

Aging clinical and experimental research. 2024;36(1):69

Plain language summary

Tobacco smoking and air pollution are leading causes of chronic obstructive pulmonary disease (COPD). Mortality and morbidity are on the rise worldwide due to the increase in COPD. COPD is a risk factor for sarcopenia, an age-related reduction in muscle mass and muscle strength. Non-pharmaceutical interventions, such as nutritional supplementation, are considered a management strategy for sarcopenia related to COPD, as they can address nutritional deficiencies and energy requirements in old age. This systematic review and meta-analysis included twenty-nine randomised controlled trials to assess the effects of nutritional supplementation for reducing sarcopenia in patients with COPD. The included studies used different nutritional supplements such as energy-type nutritional supplements, essential amino acids, essential amino acid-enriched nutritional supplements, whey protein, β-hydroxy β-methyl butyrate, creatine, creatine in combination with coenzyme Q10, vitamin D, vitamin B12, polyunsaturated fatty acids, magnesium citrate or nutritional antioxidant supplements. The intervention duration ranged from four weeks to twenty-four weeks. The result of this systematic review and meta-analysis showed a significant improvement in body weight, fat-free mass, and a 6-minute walk test. There was a non-significant improvement in handgrip strength and quadriceps muscle strength. Healthcare professionals can use the results of this study to understand the benefits of nutritional supplementation in improving body composition and muscle strength. However, further robust studies are required to evaluate the efficacy of nutritional supplementation in COPD patients due to the high heterogeneity of the included studies.

Abstract

Individuals with chronic obstructive pulmonary disease (COPD) are prone to malnutrition and sarcopenia as a result of nutritional deficiencies and increased energy metabolism. However, the effects of nutrient supplements (NS) on treating sarcopenia in patients with COPD are not well established from systematic evidence. This meta-analysis examined the effect of NS on sarcopenia in patients with COPD. A systematic search of multiple databases was conducted, and 29 randomized controlled trials involving 1625 participants (age, mean [SD] = 67.9 [7.8] years) were analyzed. NS demonstrated significant improvements in body weight (MD,1.33 kg; 95% CI, 0.60, 2.05 kg; P = 0.0003; I2 = 87%), fat-free mass index (MD, 0.74 kg/m2; 95% CI, 0.21, 1.27 kg/m2; P = 0.007; I2 = 75%), and 6-min walk test (MD, 19.43 m; 95% CI, 4.91, 33.94 m; P = 0.009; I2 = 81%) compared with control. However, NS had nonsignificant effects on handgrip strength (SMD, 0.36; 95% CI, - 0.15, 0.88; P = 0.16; I2 = 87%) and quadriceps muscle strength (SMD, 0.11; 95% CI, -  0.06, 0.27; P = 0.20; I2 = 25%) compared with the control. In conclusion, NS may be an effective treatment for improving body composition and physical performance in COPD. Future studies should explore the effects of intervention durations, specific NS types, or combined training in patients with COPD and sarcopenia.

Lifestyle medicine

Fundamental Clinical Imbalances : Immune and inflammation ; Structural
Patient Centred Factors : Mediators/Nutritional supplements
Environmental Inputs : Diet ; Nutrients ; Physical exercise
Personal Lifestyle Factors : Nutrition ; Exercise and movement
Functional Laboratory Testing : Not applicable

Methodological quality

Jadad score : Not applicable
Allocation concealment : Not applicable
Publication Type : Meta-Analysis ; Systematic Review

Metadata