Oral nutrition supplements and between-meal snacks for nutrition therapy in patients with COPD identified as at nutritional risk: a randomised feasibility trial

Introduction Intervention studies have mainly used oral nutritional supplements (ONS) for the management of patients with chronic obstructive pulmonary disease (COPD) identified as at nutritional risk. In this 12-month randomised feasibility trial, we assessed the (1) feasibility of the recruitment,...

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Main Authors: Arora Ros Ingadottir, Anne Marie Beck, Christine Baldwin, Christine Elizabeth Weekes, Olof Gudny Geirsdottir, Alfons Ramel, Thorarinn Gislason, Ingibjorg Gunnarsdottir
Format: Article
Language:English
Published: BMJ Publishing Group 2019-10-01
Series:BMJ Open Respiratory Research
Online Access:https://bmjopenrespres.bmj.com/content/6/1/e000349.full
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author Arora Ros Ingadottir
Anne Marie Beck
Christine Baldwin
Christine Elizabeth Weekes
Olof Gudny Geirsdottir
Alfons Ramel
Thorarinn Gislason
Ingibjorg Gunnarsdottir
author_facet Arora Ros Ingadottir
Anne Marie Beck
Christine Baldwin
Christine Elizabeth Weekes
Olof Gudny Geirsdottir
Alfons Ramel
Thorarinn Gislason
Ingibjorg Gunnarsdottir
author_sort Arora Ros Ingadottir
collection DOAJ
description Introduction Intervention studies have mainly used oral nutritional supplements (ONS) for the management of patients with chronic obstructive pulmonary disease (COPD) identified as at nutritional risk. In this 12-month randomised feasibility trial, we assessed the (1) feasibility of the recruitment, retention and provision of two interventions: ONS and between-meal snacks (snacks) and (2) the potential impact of the provision of snacks and ONS on body weight and quality of life in patients with COPD.Methods  Hospitalised patients with COPD, at nutritional risk, were randomised to ONS (n=19) or snacks (n=15) providing 600 kcal and 22 g protein a day in addition to regular daily diet. The intervention started in hospital and was continued for 12 months after discharge from the hospital.Results  Study recruitment rate was n=34 (45%) and retention rate at 12 months was similar for both groups: n=13 (68%) in the ONS group and n=10 (67%) in the Snacks group. Both groups gained weight from baseline to 12 months (2.3±4.6 kg (p=0.060) in the ONS group and 4.4±6.4 kg (p=0.030) in the Snacks group). The St George’s Respiratory Questionnaire total score improved from baseline to 12 months in both groups (score 3.9±11.0 (p=0.176) in the ONS group and score 8.9±14.1 (p=0.041) in the Snacks group).Discussion  In patients with COPD who are at nutritional risk snacks are at least as feasible and effective as ONS, however, adequately powered trials that take account of the difficulties in recruiting this patient group are required to confirm this effect.
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spelling doaj-art-a04873aa53af4a7b9888aa1c4e4ffde02025-08-20T02:10:50ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392019-10-016110.1136/bmjresp-2018-000349Oral nutrition supplements and between-meal snacks for nutrition therapy in patients with COPD identified as at nutritional risk: a randomised feasibility trialArora Ros Ingadottir0Anne Marie Beck1Christine Baldwin2Christine Elizabeth Weekes3Olof Gudny Geirsdottir4Alfons Ramel5Thorarinn Gislason6Ingibjorg Gunnarsdottir72 Department of Clinical Nutrition, Landspitali University Hospital, Reykjavik, Iceland3 Faculty of Health, Copenhagen University College, Copenhagen, Denmark5 Department of Nutritional Sciences, King`s College London, London, UK5 Department of Nutritional Sciences, King`s College London, London, UK1 Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland1 Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, IcelandLandspitali University Hospital, Reykjavik, Iceland1 Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, IcelandIntroduction Intervention studies have mainly used oral nutritional supplements (ONS) for the management of patients with chronic obstructive pulmonary disease (COPD) identified as at nutritional risk. In this 12-month randomised feasibility trial, we assessed the (1) feasibility of the recruitment, retention and provision of two interventions: ONS and between-meal snacks (snacks) and (2) the potential impact of the provision of snacks and ONS on body weight and quality of life in patients with COPD.Methods  Hospitalised patients with COPD, at nutritional risk, were randomised to ONS (n=19) or snacks (n=15) providing 600 kcal and 22 g protein a day in addition to regular daily diet. The intervention started in hospital and was continued for 12 months after discharge from the hospital.Results  Study recruitment rate was n=34 (45%) and retention rate at 12 months was similar for both groups: n=13 (68%) in the ONS group and n=10 (67%) in the Snacks group. Both groups gained weight from baseline to 12 months (2.3±4.6 kg (p=0.060) in the ONS group and 4.4±6.4 kg (p=0.030) in the Snacks group). The St George’s Respiratory Questionnaire total score improved from baseline to 12 months in both groups (score 3.9±11.0 (p=0.176) in the ONS group and score 8.9±14.1 (p=0.041) in the Snacks group).Discussion  In patients with COPD who are at nutritional risk snacks are at least as feasible and effective as ONS, however, adequately powered trials that take account of the difficulties in recruiting this patient group are required to confirm this effect.https://bmjopenrespres.bmj.com/content/6/1/e000349.full
spellingShingle Arora Ros Ingadottir
Anne Marie Beck
Christine Baldwin
Christine Elizabeth Weekes
Olof Gudny Geirsdottir
Alfons Ramel
Thorarinn Gislason
Ingibjorg Gunnarsdottir
Oral nutrition supplements and between-meal snacks for nutrition therapy in patients with COPD identified as at nutritional risk: a randomised feasibility trial
BMJ Open Respiratory Research
title Oral nutrition supplements and between-meal snacks for nutrition therapy in patients with COPD identified as at nutritional risk: a randomised feasibility trial
title_full Oral nutrition supplements and between-meal snacks for nutrition therapy in patients with COPD identified as at nutritional risk: a randomised feasibility trial
title_fullStr Oral nutrition supplements and between-meal snacks for nutrition therapy in patients with COPD identified as at nutritional risk: a randomised feasibility trial
title_full_unstemmed Oral nutrition supplements and between-meal snacks for nutrition therapy in patients with COPD identified as at nutritional risk: a randomised feasibility trial
title_short Oral nutrition supplements and between-meal snacks for nutrition therapy in patients with COPD identified as at nutritional risk: a randomised feasibility trial
title_sort oral nutrition supplements and between meal snacks for nutrition therapy in patients with copd identified as at nutritional risk a randomised feasibility trial
url https://bmjopenrespres.bmj.com/content/6/1/e000349.full
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