Effects of nutritional supplementation combined with conventional pulmonary rehabilitation in muscle-wasted chronic obstructive pulmonary disease: A prospective, randomized and controlled study

Background and objective Nutritional depletion in chronic obstructive pulmonary disease (COPD) adversely affects health status and mortality. We aimed to evaluate the effects of nutritional supplementation (NS) with pulmonary rehabilitation (PR) on body composition, mid‐thigh cross‐sectional area (CSA), dyspnoea, exercise capacity, health‐related quality of life, anxiety and depression in advanced COPD patients. Methods Forty‐six patients were randomized to PR and nutritional support (PRNS), PR or the control group. Dyspnoea was measured with Medical Research Council and BORG scales. Exercise capacity was measured through 6‐min walk test and shuttle tests; health‐related quality of life was assessed with St. George's Respiratory Questionnaire. Psychological status was measured with Hospital Anxiety and Depression Scale. Body weight and body mass indexes (BMI) were also evaluated. Fat‐free mass was measured through bioelectrical impedance analyser. The CSA of quadriceps was calculated in mid‐level of the thigh with magnetic resonance imaging. Results Dyspnoea and total scores of St. George's Respiratory Questionnaire improved in both groups (P