D1.10 Dietitian/Nutritionist

Excessive weight-loss is a common problem in patients with end-stage COPD. Conversely, obesity in patients with COPD is associated with sleep apnoea, CO2 retention and cor pulmonale. Dietitians play a central role in managing these problems.

A Cochrane Review of 17 studies (632 participants) that provided nutritional supplementation for patients with COPD for more than two weeks found growing evidence that nutritional supplementation improved body weight, respiratory muscle strength, walking and quality of life, especially if malnourished (Ferreira 2012).

In obese (body mass index ≥30 kg/m2) COPD patients a 12 week weight reduction program involving meal replacements and dietary counselling by a dietitian and resistance exercise training prescribed and supervised by a physiotherapist, with face to face review by the dietitian and physiotherapist every two weeks for counselling, achieved modest weight loss of 6.2%, and improved clinical outcomes including health status, symptoms, exercise and functional capacity, whilst preserving skeletal muscle mass (McDonald 2016b).