# Energy and Protein Intake in Mild-Moderate COPD Patients

## TL;DR

This study finds that younger COPD patients often have poor nutritional intake and low muscle mass, suggesting a need for dietary interventions.

## Contribution

The study highlights malnutrition in younger mild-to-moderate COPD patients, a group often overlooked.

## Key findings

- A significantly higher proportion of COPD patients had low fat-free mass index compared to healthy controls.
- More COPD patients failed to meet protein requirements than healthy non-smoking individuals.
- The findings suggest dietary interventions could prevent malnutrition-related complications in COPD.

## Abstract

Malnutrition is often overlooked as an extrapulmonary comorbidity in chronic obstructive pulmonary disease (COPD) and there is limited information regarding the nutritional status of younger individuals with mild-to-moderate disease in outpatient settings. We assessed energy and protein intakes in mild-to-moderate COPD patients compared to a group of healthy non-smoking individuals (HNS).

COPD patients and HNS were recruited; anthropometric measurements were assessed via BMI and bioelectrical impedance, while nutritional intake was assessed using a 7-day food diary and the EPIC-Norfolk Food Frequency Questionnaire (FFQ). Low fat-free mass index (FFMI) was defined as (a) < 15 kg/m2 for females and < 17 kg/m2 for males (Schols in Eur Respir J 44:1504–1520, 2014) or (b) adjusted for age, sex and BMI (Wei et al. in Front Endocrinol 14:1185221, 2023).

21 COPD participants and 15 HNS were recruited with a median age of 58.0 and 57.0, respectively [IQR: 55.0–63.0 and 50.0–60.0]. A significantly greater proportion of individuals with COPD had a low FFMI when using age-sex-BMI adjusted criteria (23.8 vs. 0.0%, p = 0.04). Using the estimated requirement threshold of 75%, more COPD patients did not meet nutritional protein requirements HNS (35% vs. 0%, respectively, p = 0.01).

Our findings suggest a potential opportunity for dietary intervention in younger individuals to prevent future sequalae of malnutrition in COPD.