Dietary support to underweight patients with end-stage pulmonary disease assessed for lung transplantation

Background: Undernutrition in hospitalized patients is often not recognized and nutritional support neglected. Chronic obstructive pulmonary disease i s frequently characterized by weight loss. No data exist on the effects of nutritional supplementation in underweight lung transplantation candidates during hospitalization. Objective: To evaluate the effects on energy intake and body weight of an intensified nutritional support compared to the regu lar support during hospitalization. Methods:The participants were underweig ht (n = 42) and normal-weight (n = 29) patients with end-stage pulmonary di sease assessed for lung transplantation. The underweight patients were rand omized to receive either an energy-rich diet planned for 10 MJ/day and 45-5 0 energy percentage fat and offered supplements (group 1), or the normal ho spital diet planned for 8.5-9 MJ/day and 30-35 energy percentage fat and re gular support (group 2, control group). The normal-weight control patients (group 3) received the normal diet. Food intake was recorded for 3 days. Re sults: During a mean hospital stay of 12 days, the energy intake was signif icantly greater for the patients on intensified nutritional support (median 11.2 MJ) than for the underweight patients on the regular support (8.4 MJ; p < 0.02) and the normal-weight patients (7.0 MJ; p < 0.001). The increase in energy intake in group 1 resulted in a significant weight gain (median 1.2 kg) compared with group 2 (p < 0.01) and group 3 (p < 0.001). Conclusio ns: In a group of underweight patients with lung disease assessed for lung transplantation, it was possible to increase energy intake by an intensifie d nutritional support which was associated with a significant weight gain, compared to the regular nutritional support during a short hospital stay. C opyright (C) 2001 S. Karger AG, Basel.