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Chronic obstructive pulmonary disease - Management
Basis for recommendation
These recommendations are based on the National Institute for Health and Clinical Excellence (NICE) clinical guideline Management of chronic obstructive pulmonary disease in adults in primary and secondary care (partial update) [National Clinical Guideline Centre, 2010; NICE, 2010].
- NICE found evidence from nine cohort studies that in people with COPD, low body mass index (BMI) is associated with worse outcomes (including mortality) compared with those with normal BMI. Weight loss in people with a low BMI is associated with poorer survival, weight gain in people with a low or normal BMI is associated with increased survival, and weight loss or no weight change is associated with increased survival in people with high BMI.
- NICE also cited evidence from a Cochrane systematic review that nutritional supplements have no significant benefit; it is unclear on what the NICE guideline development group has based the recommendation that people with COPD whose BMI is low should be given nutritional supplements to increase their total calorific intake.
- The recommendation to encourage people taking nutritional supplements to take exercise to augment the effects of the supplements is based on the opinion of the NICE guideline development group.
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