Food and Nutrition in China.
2025, 31(9):
5-12.
【Objective】To investigate the execution status to different nutritional medical therapy and the impact on pulmonary function, skeletal muscle mass and function of patients with chronic obstructive pulmonary disease (COPD) complicated by sarcopenia.【Methods】A randomized controlled trial was conducted, enrolling 159 COPD patients with sarcopenia who were randomly divided into three groups. These groups received oral nutritional supplementation (Group A), a high-fat, high-protein natural diet (Group B), or a high-energy balanced diet (standard control Group C), respectively. All groups were combined with respiratory and physical exercise rehabilitation training, reinforced by WeChat follow-up check-ins. The execution status to the three nutritional regimens and changes in pulmonary function, body weight, BMI, skeletal muscle mass, skeletal muscle index (SMI), grip strength, and other parameters were compared.【Results】Groups A and B exhibited higher proportions of meeting energy and protein intake targets compared to Group C. After 2 weeks of nutritional therapy, the energy intake compliance rates in Groups A and B were (86.84±2.37)% and (87.56±2.74)%, respectively, higher than that in Group C (77.48±6.34)%. The protein intake compliance rates in Groups A and B were (93.01±3.98)% and (95.85±4.82)%, respectively, higher than that in Group C (76.46±5.67)%, with statistically significant differences (H=71.48, F=243.306, all P<0.001). After 4 weeks of nutritional therapy, energy intake met the target in all three groups without significant differences between groups. However, the protein intake compliance rates in Groups A and B were (101.65±5.25)% and (101.98±7.00)%, respectively, higher than that in Group C (92.84±3.63)%, with a statistically significant difference between groups (H=67.455, P<0.001). After 8 weeks of nutritional therapy, improvements in SMI, BMI, and grip strength were observed in all groups. The increases in SMI (0.47±0.26, 0.41±0.21, kg/m2), BMI (0.60±1.33, 0.72±1.24, kg/m2), and grip strength (11.25±2.32, 10.68±2.31, kg) in Groups A and B were significantly greater than those in Group C (0.21±0.16, 0.49±0.23, and 5.08±1.28, respectively), with all P-values <0.05. The increases in FVC (0.62±0.13, 0.81±0.24 L) and FEV1 (0.40±0.10, 0.67±0.15, L) in Groups A and B were higher than those in Group C (0.38±0.15, 0.26±0.07, L), with all P-values <0.05. Group B showed a more significant reduction in CAT scores compared to Groups A and C, with a statistically significant difference (H=141.714, P<0.001). Pearson correlation analysis revealed that the increases in FVC, FEV1, grip strength, and the decrease in CAT scores were positively correlated with changes in SMI (r=0.423, 0.334, 0.435, 0.542, respectively) and appendicular muscle mass (r=0.425, 0.334, 0.440, 0.558, respectively), with all P-values <0.05. 【Conclusion】Both oral nutritional supplementation (ONS) and the high-fat, high-protein regimen demonstrated good execution status and efficacy in improving pulmonary function, skeletal muscle mass, and function, making them suitable for COPD patients with sarcopenia.