GUIDELINES ON NUTRITION SUPPORT IN ADULTS: oral nutrition support, enteral tube feeding and parenteral nutrition
www.library.nhs.uk/theatres/ViewResource.aspx?resID=122042&tabID=288&catID=9769


Cai B (2003) Effect of supplementing a high-fat, low-carbohydrate enteral formula in COPD patients. Nutrition, 19, 229-32
• pulmonary function in COPD improved by high-fat low-carbohydrate supplementary feeding

Cave MC, Hurt RT, Frazier TH (2008) Obesity, inflammation, and the potential application of pharmaconutrition. Nutr Clin Pract, 23, 1, 16-34
www.ncbi.nlm.nih.gov/pubmed/18203961
• obesity creates low-grade systemic inflammation which may prime the immune system, so that illness or trauma can lead to an exaggerated subsequent immune response; pharmaconutrition may assist these patients.

Cesari M (2004) Antioxidants and physical performance in elderly persons. Am J Clin Nutr, 79, 289-94
• higher dietary intakes of most antioxidants, especially vitamin C, is associated with higher skeletal muscular strength in elderly persons

Creutzberg EC, Schols AMWJ (2000) Characterization of nonresponse to high caloric oral nutritional therapy in depleted patients with Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med, 161, 745-52
/ajrccm.atsjournals.org/cgi/content/full/161/3/745
• nonresponse to nutritional therapy in COPD is associated with ageing, anorexia, and an elevated systemic inflammatory response

Darmon P, Kaiser MJ, Bauer JM (2010) Restrictive diets in the elderly: Never say never again? Clin Nutr, 29, 2, 170-4
• with increasing age, restrictive diets (e.g. for obesity, diabetes, hypertension or renal failure) are less effective in relation to morbidity, quality of life and mortality.

Editorial (2003) Immunonutrition. Br Med J, 327,117-18
• specific nutrients for surgical patients boost the immune system, and for critically ill patients may modulate the early hyperinflammatory response and the overcompensating immunosuppression

Hegazi RA, Wischmeye PE (2011) Clinical review: optimizing enteral nutrition for critically ill patients - a simple data-driven formula. Crit Care, 15, 234, doi:10.1186/cc10430
ccforum.com/content/15/6/234/abstract
• paradigm of 'therapeutic nutrition' is replacing traditional 'supportive nutrition'
• enteral formulas can attenuate hyperinflammatory response and enhance immune response

Love C (2002) Dietary needs for bone health and the prevention of osteoporosis. Br J Nurs, 12, 1, 12-21

Muscaritoli M, Anker SD, Argilés J et al (2010) Consensus definition of sarcopenia, cachexia and pre-cachexia. Clin Nutr, 29, 2, 154-9
• chronic disease is frequently associated with deterioration of nutritional status, loss of muscle mass and function, impaired QoL and increased risk for morbidity and mortality

Nieuwenhuizen WF, Weenen H, Rigby P (2010) Older adults and patients in need of nutritional support: Review of current treatment options and factors influencing nutritional intake. Clin Nutr, 29, 2, 160-9
• factors affecting nutritional intake are environment, the carer and the food
• small-volume, high-energy, nutrient-dense food can improve nutritional intake.

Pichard C (2004) Nutritional assessment: lean body mass depletion at hospital admission is associated with an increased length of stay.. Am J Clin Nutr, 79, 613-18,

Pokorski M, Marczak M (2003) Ascorbic acid enhances hypoxic ventilatory reactivity in elderly subjects. J Internat Res, 31, 448-57
• vitamin C may attenuate episodic hypoxia, especially with airway inflammation or sleep disturbance

Reignier G, Dimet J (2010) Before–after study of a standardized ICU protocol for early enteral feeding in patients turned in the prone position. Clin Nutr, 29, 2, 210-216
• ventilated patients being proned are at risk of malnutrition, but this risk is reduced by head elevation to 25°

Reiland KE (2000) Gastrointestinal surgical patients' outcomes influenced by nutrition. AORN J, 71, 199-204
• IV feeding is deficient in certain essential nutrients, trebles the incidence of pneumonia compared to enteral feeding and causes atrophy of the gut lining

Sahebjami H (2000) Influence of body weight on the severity of dyspnea in chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 161, 3, 886-890
ajrccm.atsjournals.org/cgi/content/abstract/161/3/886
• underweight patients experience greater SOB than normal-weight patients

Soto-Martinez M (2010) What goes around, comes around: childhood influences on later lung health? Relationship between environmental exposures in children and adult lung disease. Chr Respir Dis, 7, 173-186
• diet plays a significant role in respiratory health, including during foetal and infant development.
• ‘Mediterranean diet’ is associated with lung health, while a deficient diet has been associated with susceptibility to the effects of tobacco smoke, air pollution and allergens

Stubbs RJ (2004) A decrease in physical activity affects appetite, energy, and nutrient balance in lean men feeding ad libitum. Am J Clin Nutr, 79, 62-9
• a sedentary lifestyle does not induce a compensatory reduction of food intake, and leads to increased weight

Van Wetering CR et al (2010) Efficacy and costs of nutritional rehabilitation in muscle-wasted patients with COPD in a community-based setting. J Am Med Directors Ass, 11, 3, 179-87
• prolonged positive response to nutritional support integrated into a PR programme.

BLF leaflet for patients
www.lunguk.org/you-and-your-lungs/living-with-a-lung-condition/healthy-eating-and-your-lungs


AORN = Association of PeriOperative Registered Nurses.
BLF = British Lung Foundation
PR = pulmonary rehabilitation
QoL = quality of life