Physical activity and nutrition in chronic obstructive pulmonary disease

The nutritional status of patients with chronic obstructive pulmonary disease (COPD) has long been neglected, except for the management of the historic cachexia associated with end-stage chronic respiratory failure. Different phenotypes of patients are now recognized according to the changes in body composition, which influence physical capacity and mortality. The causes of a loss of fat free mass are not completely understood but the main putative factors are an inflammatory state, hypoxia and a hypermetabolic state. Recent published meta-analyses pointed out the relationships between the nutritional status and the physical fitness, but these links appears complex and loose, as well as the benefit of nutrition interventions alone or coupled to a respiratory rehabilitation (multimodal intervention). This review focuses on recent advances regarding relationships between physical activity and nutritional status in COPD and confirms the potential of Multimodal intervention to improve body composition and functioning. (C) 2014 Elsevier Masson SAS. All rights reserved.