[COPD, a systemic disease--nutritional approaches].

BACKGROUND

Within the last few years our knowledge concerning the pathogenesis of chronic obstructive pulmonary disease (COPD) has grown. We now know that COPD is not simply a lung disease but a type of systemic disease. The systemic inflammation which can be found in COPD and the oxidant burden lead to systemic changes in muscles, endocrinium, bones, and blood vessels. Patients with COPD are often undernourished and have a low muscle mass even if the body mass is normal.

MUSCLE AND WEIGHT LOSS: Loss of muscle mass, caused by different mechanisms, influences the muscle endurance of COPD patients. Weight loss as well as loss of muscle mass are negatively correlated with morbidity and mortality of these patients.

NUTRITIONAL SUPPORT AND EXERCISE: Nutritional support like dietary advice, including supplements especially in combination with exercise, which could improve the quality of life of these patients, are approaches which are not sufficiently considered in the treatment of COPD.