TY  - JOUR
T1  - Evaluation of Dietary Intake of Chronic Obstructive Pulmonary Patients Based on Severity
TT  - Kronik Obstrüktif Akciğer Hastalarının Diyet Alımının Hastalığın Evrelerine Göre Değerlendirilmesi
AU  - Sarıkaya, Buse
AU  - Aktaç, Şule
AU  - Çetinkaya, Erdoğan
PY  - 2025
DA  - March
Y2  - 2024
DO  - 10.37989/gumussagbil.1505155
JF  - Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi
JO  - Gümüşhane Sağlık Bilimleri Dergisi
PB  - Gumushane University
WT  - DergiPark
SN  - 2146-9954
SP  - 1
EP  - 13
VL  - 14
IS  - 1
LA  - en
AB  - ABSTRACTDietary patterns high in anti-inflammatory foods are recommended as part of the treatment for Chronic obstructive pulmonary disease (COPD). This study aims to assess the dietary intake of COPD at different severity levels.A cross-sectional study was conducted on 65 patients aged 50-80 diagnosed with COPD differen severity as moderate, severe and very severe. Participants' nutritional intake was calculated from 24-hour dietary recalls. Energy and nutritional intake were evaluated using the BEBIS 8.1 dietary analysis program, which utilizes the Turkish Food Composition Database. Dietary intake was compared against the Turkey Dietary Guidelines. The mean age of the patients was 65.16 ± 7.69 years, with the majority being male, 86.2% (n=56). Severe patients had the lowest intake of omega-3, energy, and protein. Energy intake meeting the Dietary Reference Intake (DRI) levels was 67.64 ± 33.11%, with the lowest in the severe group. Total energy (r=-0.282), carbohydrate (r=-0.258), and sodium intake were negatively correlated with Forced Expiratory Volume in 1 Second/ Forced Vital Capacity (FEV1/FVC), (p<0.05).The study found that patients with severe COPD have lower intake of energy, protein, carbohydrates, and omega-3, with essential micronutrients falling below 60% of recommended levels. Given these findings, Nutrition specialists should accurately assess the energy and protein needs of COPD patients and provide antioxidant support.
KW  - COPD
KW  - dietary intake
KW  - macronutrients
KW  - micronutrients
KW  - nutrient deficiencies
N2  - Kronik obstrüktif akciğer hastalığı (KOAH) tedavisinin bir parçası olarak, anti-inflamatuar gıdalar bakımından zengin beslenme düzenleri önerilir. Bu çalışmanın amacı, farklı evrelerdeki KOAH hastalarının beslenme alışkanlıklarını değerlendirmektir. KOAH tanısı alan, orta, ağır ve çok ağır olmak üzere farklı evrelerde, 50-80 yaş arası 65 hasta üzerinde kesitsel bir çalışma yapılmıştır. Katılımcıların beslenme alışkanlıkları 24 saatlik besin tüketim kayıtlarından elde edilmiştir. Enerji ve besin alımı, Türk Gıda Bileşenleri Veritabanı'nı kullanan BEBİS 8.1 beslenme analiz programıyla değerlendirilmiştir. Beslenme alışkanlıkları Türkiye Beslenme Rehberleri’nin önerileri ile karşılaştırılmıştır. Hastaların yaş ortalaması 65.16 ± 7.69 yıl olup, çoğunluğunun erkek olduğu saptanmıştır (%86.2, n=56). Ağır hastaların omega-3, enerji ve protein alımı en düşük seviyede olduğu bulunmuştur. Ortalama enerji alımı Beslenme Referans Alımı (DRA) %67.64 ± 33.11’ini karşılamıştır ve en düşük karşılama oranı ağır grupda saptanmıştır. Toplam enerji (r=-0.282), karbonhidrat (r=-0.258) ve sodyum alımı Zorlu Ekspiratuvar Volüm 1. Saniye/ Zorlu Vital Kapasite (FEV1/FVC) ile negatif korelasyon göstermiştir (p<0.05). Çalışma, ağır KOAH hastalarının enerji, protein, karbonhidrat ve omega-3 alımının düşük olduğunu, temel mikrobesin maddelerinin ise önerilen düzeylerin altında kaldığını buldu. Bu bulgular göz önüne alındığında, diyetisyenler KOAH hastalarının enerji ve protein ihtiyaçlarını doğru bir şekilde değerlendirmeli ve antioksidan desteği sağlamalıdır.
CR  - 1. Global Initiative for Chronic Obstructive Lung Disease (GOLD). “Global strategy for the diagnosis, management, and prevention of COPD: 2024 Report”. Accessed June 25, 2024. https://goldcopd.org/wp-content/uploads/2024/02/GOLD-2024_v1.2-11Jan24_WMV.pdf
CR  - 2. Bezerra, F.S, Lanzetti, M, Nesi, R.T, Nagato, A.C, Silva, C.P. and Kennedy-Feitosa, E. (2023). “Oxidative stress and inflammation in acute and chronic lung injuries”. Antioxidants, 12(3):548. https://doi.org/10.3390/antiox12030548
CR  - 3. Rogliani, P, Matera, M.G, Puxeddu, E, Mantero, M, Blasi F. and Cazzola M. (2018). “Emerging biological therapies for treating chronic obstructive pulmonary disease: a pairwise and network meta-analysis”. Pulmonary Pharmacology & Therapeutics, 50:28-37. https://dx.doi.org/10.1016/j.pupt.2018.03.004
CR  - 4. Gea, J, Sancho-Muñoz, A. and Chalela, R. (2018). “Nutritional status and muscle dysfunction in chronic respiratory diseases: stable phase versus acute exacerbations”. Journal of Thoracic Disease, 10(Suppl 12):1332-1354. https://doi.org/10.21037/jtd.2018.02.66
CR  - 5. Collins, P.F, Yang, I.A, Chang, Y.C. and Vaughan, A. (2019). “Nutritional support in chronic obstructive pulmonary disease (COPD): an evidence update”. Journal of Thoracic Disease, 11(Suppl 17):2230. https://doi.org/10.21037/jtd.2019.10.41
CR  - 6. Yazdanpanah, L, Shidfar, F, Moosavi, A.J, Heidarnazhad, H. and Haghani, H. (2010). “Energy and protein intake and its relationship with pulmonary function in chronic obstructive pulmonary disease (COPD) patients”. Acta Medica Iranica, 374-379.
CR  - 7. Ingadottir, A.R, Beck, A.M, Baldwin, C, Weekes, C.E, Geirsdottir, O.G. and Ramel A. (2018). “Association of energy and protein intakes with length of stay, readmission and mortality in hospitalised patients with chronic obstructive pulmonary disease”. British Journal of Nutrition, 119(5):543-551. https://doi.org/10.1017/S0007114517003919
CR  - 8. Yılmaz, D, Çapan, N, Canbakan, S. and Besler, H.T. (2015). “Dietary intake of patients with moderate to severe COPD in relation to fat-free mass index: a cross-sectional study”. Nutrition Journal, 14:1-10. https://doi.org/10.1186/s12937-015-0020-5
CR  - 9. van de Bool, C, Mattijssen-Verdonschot, C, van Melick, P.P.M.J, Spruit, M.A, Franssen, F.M.E, Wouters, E.F.M, Schols, A.M.W.J. and Rutten, E.P.A.  (2014). “Quality of dietary intake in relation to body composition in patients with chronic obstructive pulmonary disease eligible for pulmonary rehabilitation”. European Journal of Clinical Nutrition, 68(2):159-165. https://doi.org/10.1038/ejcn.2013.257
CR  - 10. Andersson, I, Grönberg, A, Slinde, F, Bosaeus, I. and Larsson, S. (2007). “Vitamin and mineral status in elderly patients with chronic obstructive pulmonary disease”. The Clinical Respiratory Journal, 1(1):23-29. https://doi.org/10.1111/j.1752-699X.2007.00003.x
CR  - 11. Vibhuti, A, Ari,f E, Deepak, D, Singh, B. and Pasha, M.Q. (2007). “Correlation of oxidative status with BMI and lung function in COPD”. Clinical Biochemistry, 40(13-14):958-963. https://doi.org/10.1016/j.clinbiochem.2007.04.020
CR  - 12. Tug, T, Karatas F. And Terzi, S.M. (2004). “Antioxidant Vitamins (A, C and E) and malondialdehyde levels in acute exacerbation and stable periods of patients with chronic obstructive pulmonary disease”. Clinical and Investigative Medicine, 27(3):123-123.
CR  - 13. Heefner, A, Simovic, T, Mize, K. and Rodriguez-Miguelez P. (2024). “The Role of nutrition in the development and management of chronic obstructive pulmonary disease”. Nutrients, 16(8):1136. https://doi.org/10.3390/nu16081136
CR  - 14. de Batlle, J, Romieu, I, Antó, J.M, Mendez, M, Rodríguez, E. and Balcells, E. (2009) “Dietary habits of firstly admitted spanish copd patients”. Respiratory Medicine, 103(12):1904-1910. https://doi.org/10.1183/09031936.00116911
CR  - 15. Janciauskiene, S. (2020). “The beneficial effects of antioxidants in health and diseases”. chronic obstructive pulmonary diseases, Journal of the COPD Foundation. 7(3):182. https://doi.org/10.15326/jcopdf.7.3.2019.0152
CR  - 16. Ghalibaf, M.H.E, Kianian, F, Beigoli, S, Behrouz, S, Marefati, N. and Boskabady M. “The Effects of vitamin C on respiratory, allergic and immunological diseases: an experimental and clinical-based review”. Inflammopharmacology, 2023;31(2):653-72. https://doi.org/10.1007/s10787-023-01169-1
CR  - 17. Burns, J.S, Dockery, D.W, Neas, L.M, Schwartz, J, Coull, B.A and Raizenne, M. (2007). “Low dietary nutrient intakes and respiratory health in adolescents”. Chest, 132(1):238-245. https://doi.org/10.1378/chest.07-0038
CR  - 18. Kim, T, Choi, H. and Kim, J. (2020). “Association between dietary nutrient intake and chronic obstructive pulmonary disease severity: a nationwide population-based representative sample copd”. Journal of Chronic Obstructive Pulmonary Disease, 17(1):49-58. https://doi.org/10.1080/15412555.2019.1698530
CR  - 19. Pirabbasi, E, Shahar, S, Manaf, Z.A, Rajab, N.F. and Manap, R.A. (2016). “Efficacy of ascorbic acid (vitamin c) and/n-acetylcysteine (NAC) supplementation on nutritional and antioxidant status of male chronic obstructive pulmonary disease (COPD) patients”. Journal of Nutritional Science and Vitaminology, 62(1):54-61. https://doi.org/10.3177/jnsv.62.54
 
20. Norton, K.I. (2018). “Kinanthropometry and exercise physiology”. London/Routledge.
CR  - 21. Cao, C, Wang, R, Wang, J, Bunjhoo, H, Xu, Y. and Xiong, W. (2012). “Body mass index and mortality in chronic obstructive pulmonary disease: a meta-analysis.” PloS One, 7(8): e43892. https://doi.org/10.1371/journal.pone.0043892
CR  - 22. Celli, B.R. (2004) “Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper”. European Respiratory Journal, 23:932-946.
CR  - 23. Beslenme Bilgi Sistemi (BEB_IS) nutrition data base software version 8. Data base: the German food code and nutrient data base (BLS) with additions from USDA-sr and other sources. Stuttgart, Germany: Hohenhim University; 2018. Avaliable from: https://bebis.com.tr/anasayfa.
CR  - 24. Pekcan, A.G, Şanlıer, N, Baş, M, Başoğlu, S. ve Acar Tek, N. (2016). “Türkiye beslenme rehberi TÜBER 2015”. T.C. Sağlık Bakanlığı Yayın (1031).
CR  - 25. Yorgancioğlu, A, Polatli, M, Aydemir, Ö, Demirci, N.Y, Kırkıl, G. ve Atış S. (2012). “KOAH değerlendirme testinin Türkçe geçerlilik ve güvenilirliği”. Tüberküloz ve Toraks Dergisi, 60(4):314-320.
CR  - 26. Costes, F. and Pison, C. (2014). “Physical activity and nutrition in chronic obstructive pulmonary disease”. Nutrition Clinique Et Metabolisme, 28(4):336-347. https://doi.org/10.1016/j.nupar.2014.10.004
CR  - 27. Kırkıl, G. and Muz, M.H. (2008). “B group vitamin levels in patients with chronic obstructive pulmonary disease and the relation between pulmonary functions”. Turkish Thoracic Journal, 9(3).
CR  - 28. Saetta, M, Baraldo, S. and Zuin R. (2003). “Neutrophil chemokines in severe exacerbations of chronic obstructive pulmonary disease: fatal chemo-attraction?” American Journal of Respiratory and Critical Care Medicine, 168(8):911-930. https://doi.org/10.1164/rccm.2308002
CR  - 29 .Chambaneau, A, Filaire, M, Jubert, L, Bremond, M. and Filaire, E. (2016). “Nutritional intake, physical activity and quality of life in COPD patients”. International Journal of Sports Medicine, 730-737. 
https://doi.org/10.1055/s-0035-1569368
CR  - 30. Deutz, N.E, Bauer, J.M, Barazzoni, R, Biolo, G, Boirie, Y. And Bosy-Westphal, A. (2014). “Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN expert group”. Clinical Nutrition, 33(6):929-936. https://doi.org/10.1016/j.clnu.2014.04.007
CR  - 31. Kuo, C.D, Shiao, G.M. and Lee, J.D. (1993). “The effects of high-fat and high-carbohydrate diet loads on gas exchange and ventilation in COPD patients and normal subjects”. Chest, 104(1):189-96. https://doi.org/10.1378/chest.104.1.189
CR  - 32. Budden, K.F, Shukla, S.D, Bowerman, K.L, Vaughan, A, Gellatly, S.L and Wood, D.L. (2024). “Faecal microbial transfer and complex carbohydrates mediate protection against COPD”. Gut, 73(5), 751-769. https://doi.org/10.1136/gutjnl-2023-330521
CR  - 33. Schols, A.M, Ferreira, I.M, Franssen, F.M, Gosker, H.R, Janssens, W. and Muscaritoli M. (2014). “Nutritional assessment and therapy in COPD: a European respiratory society statement”. European Respiratory Society, 1504-1520. https://doi.org/10.1183/09031936.00070914
CR  - 34. Hsieh, M.J, Yang, T.M and Tsai, Y.H. (2016). “Nutritional supplementation in patients with chronic obstructive pulmonary disease”. Journal of the Formosan Medical Association, 115(8):595-601. https://doi.org/10.1016/j.jfma.2015.10.008
CR  - 35. Scoditti, E, Massaro, M, Garbarino, S. and Toraldo, D.M. (2019). “Role of diet in chronic obstructive pulmonary disease prevention and treatment”. Nutrients. 11(6):1357. https://doi.org/10.3390/nu11061357
36. Déniz, C, Raba-Parodi, C, García-Raimundo, E, Macía, I, Rivas, F. and Ureña, A. (2022). “Preoperative omega-6/omega-3 fatty acid ratio could predict postoperative outcomes in patients with surgically resected non-small-cell lung cancer.” Current Oncology, 29(10), 7086-7098. https://doi.org/10.3390/curroncol29100556
 
37. Déniz, C, Ramos, R, Macía, I, Rivas, F, Ureña, A. and Rosado, G. (2019). “P2.17-10 Effects of the omega-6/omega-3 ratio on postoperative complications after lung resection: Preliminary results.” Journal of Thoracic Oncology, 14(10), S887. https://doi.org/10.1016/j.jtho.2019.08.1921
CR  - 38. DiNicolantonio, J. J. and O'Keefe, J. (2020). “The importance of maintaining a low omega-6/omega-3 ratio for reducing the risk of inflammatory cytokine storms.” Missouri Medicine, 117(6), 539.
CR  - 39. Shaheen, S, Jameson, K, Syddall, H, Sayer, A.A, Dennison, E. and Cooper, C. (2010). “The Relationship of dietary patterns with adult lung function and copd”. European Respiratory Journal, 36(2):277-284. https://doi.org/10.1183/09031936.00114709
CR  - 40. Garcia-Larsen, V, Amigo, H, Bustos P, Bakolis, I. and Rona, R.J. (2015). “Ventilatory function in young adults and dietary antioxidant intake”. Nutrients, 7(4):2879-2896. https://doi.org/10.3390/nu7042879
CR  - 41. Jiménez-Cepeda, A, Dávila-Said, G, Orea-Tejeda, A, González-Islas, D, Elizondo-Montes, M. and Pérez-Cortes, G. “Dietary intake of fatty acids and its relationship with FEV1/FVC in patients with chronic obstructive pulmonary disease (2019)”. Clinical Nutrition ESPEN, 29:92-96. https://doi.org/10.1016/j.clnesp.2018.11.015
CR  - 42. Sun, Y, Milne, S, Jaw, J.E, Yang, C.X, Xu, F. and Li, X. (2019). “BMI is associated with FEV1 decline in chronic obstructive pulmonary disease: a meta-analysis of clinical trials”. Respiratory Research. 20:1-10. https://doi.org/10.1186/s12931-019-1209-5
CR  - 43. Bhatti, U, Laghari, Z.A. and Syed B.M. (2019). “Effect of body mass index on respiratory parameters: a cross-sectional analytical study”. Pakistan Journal of Medical Sciences, 35(6):1724. https://doi.org/10.12669/pjms.35.6.746
CR  - 44. Tang, X, Lei, J, Li, W, Peng, Y, Wang, C. and Huang, K. (2022). “The relationship between bmi and lung function in populations with different characteristics: a cross-sectional study based on the enjoying breathing program in China”. International Journal of Chronic Obstructive Pulmonary Disease, 2677-2692. https://doi.org/10.2147/COPD.S378247
UR  - https://doi.org/10.37989/gumussagbil.1505155
L1  - https://dergipark.org.tr/en/download/article-file/4022913
ER  -