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. 1991 Oct;46(10):695–699. doi: 10.1136/thx.46.10.695

Body composition and exercise performance in patients with chronic obstructive pulmonary disease.

A M Schols 1, R Mostert 1, P B Soeters 1, E F Wouters 1
PMCID: PMC463385  PMID: 1750015

Abstract

To investigate whether a compromised nutritional state may limit exercise performance in patients with chronic obstructive pulmonary disease we studied 54 such patients (FEV1 less than 50% and arterial oxygen tension (PaO2) greater than 7.3 kPa) whose clinical condition was stable and who were admitted to a pulmonary rehabilitation centre. Fat free mass was assessed anthropometrically (from skinfold measurements at four sites) and by bioelectrical impedance; creatinine height index and arm muscle circumference were also assessed. The mean (SD) distance walked in 12 minutes was 845 (178) m. No association was established between the distance walked and spirometric measures. A good correlation was found between the distance walked and fat free mass in the whole group (r = 0.73 for impedance measurements and 0.65 for skinfold thickness) and in a subgroup of 23 lean patients (body weight less than 90% of ideal weight; r = 0.66 for impedance measurements and 0.46 for skinfold thickness). Body weight correlated with the distance walked only in the whole group (r = 0.61). On stepwise regression analysis fat free mass measured by bioelectrical impedance, maximal inspiratory mouth pressure, and PaO2 accounted for 60% of the variation in the distance walked in 12 minutes. We conclude that fat free mass, independently of airflow obstruction, is an important determinant of exercise performance in patients with severe chronic obstructive pulmonary disease.

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Selected References

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  1. Beaumont A., Cockcroft A., Guz A. A self paced treadmill walking test for breathless patients. Thorax. 1985 Jun;40(6):459–464. doi: 10.1136/thx.40.6.459. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bishop C. W., Bowen P. E., Ritchey S. J. Norms for nutritional assessment of American adults by upper arm anthropometry. Am J Clin Nutr. 1981 Nov;34(11):2530–2539. doi: 10.1093/ajcn/34.11.2530. [DOI] [PubMed] [Google Scholar]
  3. Cotes J. E., Zejda J., King B. Lung function impairment as a guide to exercise limitation in work-related lung disorders. Am Rev Respir Dis. 1988 May;137(5):1089–1093. doi: 10.1164/ajrccm/137.5.1089. [DOI] [PubMed] [Google Scholar]
  4. Donahoe M., Rogers R. M., Wilson D. O., Pennock B. E. Oxygen consumption of the respiratory muscles in normal and in malnourished patients with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1989 Aug;140(2):385–391. doi: 10.1164/ajrccm/140.2.385. [DOI] [PubMed] [Google Scholar]
  5. Durnin J. V., Rahaman M. M. The assessment of the amount of fat in the human body from measurements of skinfold thickness. Br J Nutr. 1967 Aug;21(3):681–689. doi: 10.1079/bjn19670070. [DOI] [PubMed] [Google Scholar]
  6. Durnin J. V., Womersley J. Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr. 1974 Jul;32(1):77–97. doi: 10.1079/bjn19740060. [DOI] [PubMed] [Google Scholar]
  7. Edmonds C. J., Jasani B. M., Smith T. Total body potassium and body fat estimation in relationship to height, sex, age, malnutrition and obesity. Clin Sci Mol Med. 1975 May;48(5):431–440. doi: 10.1042/cs0480431. [DOI] [PubMed] [Google Scholar]
  8. Efthimiou J., Fleming J., Gomes C., Spiro S. G. The effect of supplementary oral nutrition in poorly nourished patients with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1988 May;137(5):1075–1082. doi: 10.1164/ajrccm/137.5.1075. [DOI] [PubMed] [Google Scholar]
  9. Faulkner J. A., Maxwell L. C., Ruff G. L., White T. P. The diaphragm as a muscle. Contractile properties. Am Rev Respir Dis. 1979 Feb;119(2 Pt 2):89–92. doi: 10.1164/arrd.1979.119.2P2.89. [DOI] [PubMed] [Google Scholar]
  10. Gray-Donald K., Gibbons L., Shapiro S. H., Martin J. G. Effect of nutritional status on exercise performance in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1989 Dec;140(6):1544–1548. doi: 10.1164/ajrccm/140.6.1544. [DOI] [PubMed] [Google Scholar]
  11. Lewis M. I., Sieck G. C., Fournier M., Belman M. J. Effect of nutritional deprivation on diaphragm contractility and muscle fiber size. J Appl Physiol (1985) 1986 Feb;60(2):596–603. doi: 10.1152/jappl.1986.60.2.596. [DOI] [PubMed] [Google Scholar]
  12. Lopes J., Russell D. M., Whitwell J., Jeejeebhoy K. N. Skeletal muscle function in malnutrition. Am J Clin Nutr. 1982 Oct;36(4):602–610. doi: 10.1093/ajcn/36.4.602. [DOI] [PubMed] [Google Scholar]
  13. Lukaski H. C., Johnson P. E., Bolonchuk W. W., Lykken G. I. Assessment of fat-free mass using bioelectrical impedance measurements of the human body. Am J Clin Nutr. 1985 Apr;41(4):810–817. doi: 10.1093/ajcn/41.4.810. [DOI] [PubMed] [Google Scholar]
  14. McGavin C. R., Gupta S. P., McHardy G. J. Twelve-minute walking test for assessing disability in chronic bronchitis. Br Med J. 1976 Apr 3;1(6013):822–823. doi: 10.1136/bmj.1.6013.822. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Schols A. M., Dingemans A. M., Soeters P. B., Wouters E. F. Within-day variation of bioelectrical resistance measurements in patients with chronic obstructive pulmonary disease. Clin Nutr. 1990 Oct;9(5):266–271. doi: 10.1016/0261-5614(90)90035-q. [DOI] [PubMed] [Google Scholar]
  16. Schols A. M., Mostert R., Soeters P. B., Greve L. H., Wouters E. F. Nutritional state and exercise performance in patients with chronic obstructive lung disease. Thorax. 1989 Nov;44(11):937–941. doi: 10.1136/thx.44.11.937. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Schols A. M., Wouters E. F., Soeters P. B., Westerterp K. R. Body composition by bioelectrical-impedance analysis compared with deuterium dilution and skinfold anthropometry in patients with chronic obstructive pulmonary disease. Am J Clin Nutr. 1991 Feb;53(2):421–424. doi: 10.1093/ajcn/53.2.421. [DOI] [PubMed] [Google Scholar]
  18. Seidell J. C., Oosterlee A., Thijssen M. A., Burema J., Deurenberg P., Hautvast J. G., Ruijs J. H. Assessment of intra-abdominal and subcutaneous abdominal fat: relation between anthropometry and computed tomography. Am J Clin Nutr. 1987 Jan;45(1):7–13. doi: 10.1093/ajcn/45.1.7. [DOI] [PubMed] [Google Scholar]
  19. Sieck G. C., Lewis M. I., Blanco C. E. Effects of undernutrition on diaphragm fiber size, SDH activity, and fatigue resistance. J Appl Physiol (1985) 1989 May;66(5):2196–2205. doi: 10.1152/jappl.1989.66.5.2196. [DOI] [PubMed] [Google Scholar]
  20. Swerts P. M., Mostert R., Wouters E. F. Comparison of corridor and treadmill walking in patients with severe chronic obstructive pulmonary disease. Phys Ther. 1990 Jul;70(7):439–442. doi: 10.1093/ptj/70.7.439. [DOI] [PubMed] [Google Scholar]
  21. Swinburn C. R., Cooper B. G., Mould H., Corris P. A., Gibson G. J. Adverse effect of additional weight on exercise against gravity in patients with chronic obstructive airways disease. Thorax. 1989 Sep;44(9):716–720. doi: 10.1136/thx.44.9.716. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Weits T., van der Beek E. J., Wedel M., Ter Haar Romeny B. M. Computed tomography measurement of abdominal fat deposition in relation to anthropometry. Int J Obes. 1988;12(3):217–225. [PubMed] [Google Scholar]
  23. Wilson D. O., Rogers R. M., Wright E. C., Anthonisen N. R. Body weight in chronic obstructive pulmonary disease. The National Institutes of Health Intermittent Positive-Pressure Breathing Trial. Am Rev Respir Dis. 1989 Jun;139(6):1435–1438. doi: 10.1164/ajrccm/139.6.1435. [DOI] [PubMed] [Google Scholar]

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