Poor outcomes are a prevalent but curable consequence of chronic obstructive pulmonary disease (COPD), known as undernutrition, which is also under-reported. An increase in detection could trigger dietary changes that lead to better results. For a study, researchers sought to determine whether combining the widely used body mass index (BMI) measurement with a measure of muscle mass (fat-free mass index, FFMI) or a malnutrition screening tool (Mini Nutritional Assessment, MNA®) would assist in identifying undernutrition in COPD patients.

A retrospective chart study of 86 outpatients with COPD was done. Data on demographics and the severity of the condition were gathered, and nutritional status was evaluated using BMI, FFMI, and MNA®.

Patients were mostly male (55%) and had a median age of 71.5 years. They had severe COPD (median FEV1 = 0.74 (30.5% expected) and had severe symptoms (median COPD Assessment Test (CAT) = 23). Twenty-eight% of the patients had low BMIs, 27% had low FFMIs, 22% were malnourished, and 43% were at risk of malnutrition, according to MNA® classification. A modest correlation between MNA® and BMI was found, and 55% of healthy or high BMI individuals were identified as malnourished or at risk of malnutrition. Strong correlations were found between FFMI and BMI, and low FFMI was seen in 5% of healthy/high BMI individuals. The illness severity and undernutrition indicators also had weak to moderate relationships (spirometry data), and MNA® was weakly correlated with symptom impact (CAT).

More patients with undernutrition were found by the MNA® than by FFMI or BMI. Furthermore, it was connected to the severity of the condition and the overall load of symptoms. The MNA® seemed to be a straightforward the technique for the earlier identification of individuals who could benefit from nutritional intervention, possibly improving their quality of life.

Reference: resmedjournal.com/article/S0954-6111(22)00291-8/fulltext