The EAL is seeking RDNs and NDTRs who work with patients, clients, or the public to treat children and adolescents living with type 1 diabetes, for participation in a usability test and focus group. Interested participants should email a professional resume to by July 15, 2024.

Chronic Obstructive Pulmonary Disease (COPD) Systematic Review (2018-2019)

Chronic Obstructive Pulmonary Disease (COPD) Systematic Review (2018-2019)

Welcome to the Chronic Obstructive Pulmonary Disease Systematic Review

Chronic obstructive pulmonary disease (COPD) is a slowly progressive lung disease that is characterized by airflow obstruction. While the disease is treatable, it is not fully reversible.

The focus of this project is on medical nutrition therapy (MNT) for adults with COPD. The primary goals for people with COPD are to maintain appropriate body weight and body composition, maximize pulmonary status, reduce mortality and improve the quality of life (QOL). For the systematic review, the workgroup focused on the following subtopics:

  • Medical Nutrition Therapy
  • Methods to Estimate Energy Requirements (Predictive Equations)
  • Methods to Estimate Protein Requirements
  • Energy and Macronutrient Intake
  • Macronutrient Composition (% Distribution)
  • Body Weight and Body Composition
  • Micronutrients (Vitamin D)

Systematic Review Key Findings:

The systematic review found Grade I Good/Strong and Grade II, Fair evidence that in adults with COPD:

  • The lowest body mass index (BMI) groups had higher mortality rates when compared to higher BMI groups. A BMI of approximately 25.0-29.99kg/m2 appeared to lower the risk of mortality when compared to both higher and lower BMI classifications. (Grade I). 
  • As part of a multidisciplinary team, MNT intervention provided by an RDN (or international equivalent) improved BW, QOL and exercise capacity outcomes (Grade I) and improved body composition and lung function outcomes. (Grade II) 
  • There was improvement in dyspnea scores with higher energy intakes. (Grade II)
  • Vitamin D supplementation improved exacerbation outcomes in those with serum 25(OH)D levels 10ng per ml or lower. (Grade II) 
  • Evidence from 60% of studies reviewed, found positive associations between serum 25(OH)D and lung function measures. (Grade II)
  • In unadjusted results, a positive association was found between BMI and forced expiratory volume in 1 minute % predicted (FEV1 % predicted). An increasing BMI was also shown to reduce the longitudinal decline in FEV1 % predicted over time. (Grade II) 
  • Only Grade III, Limited Weak evidence was found for predictive equations to estimate resting metabolic rate (RMR) and total energy expenditure (TEE), the effectiveness of MNT alone, macronutrient composition, macronutrient intake and effect of body composition on outcomes.

Use the links on the left to access the content.


Return to the COPD home page