Doctors increasingly recognize nutrition as a key factor in improving overall function, exercise tolerance and quality of life in patients with pulmonary fibrosis and other lung diseases. With that in mind, a team has reviewed current literature and summarized nutritional goals for lung disease patients.
For patients with idiopathic pulmonary fibrosis (IPF), a previous study suggested that excess weight and obesity were two risk factors for increased morbidity and mortality. In another study of 197 IPF patients, however, researchers found that those with higher body mass index (BMI) lived longer. BMI is a measure of body fat based on height and weight.
Current goals for IPF patients include a focus on maintaining nutritional intake to support positive nitrogen balance and adequate fat-free mass. Patients eligible for lung transplants should bear in mind that a healthy body weight is key to supporting functional lung capacity, and also leads to lower mortality.
“In addition, two important nutritional aspects of caring for patients with IPF are management of gastroesophageal reflux disease (GERD), present in approximately 90 percent of these patients, as well as control of salt intake which is associated with cardiac and renal fibrosis even in the absence of elevated blood pressure,” the team wrote.
IPF patients are often prescribed corticosteroids such as prednisone and methylprednisolone. Yet the long-term use of such medications causes weight gain, hyperglycemia (high blood sugar) and diabetes, dyslipidemia (abnormal amount of lipids in the blood), and osteoporosis. Therefore, patients should be closely monitored.
“Patients should be offered nutritional support, and regular physical activity should be encouraged,” said the team. “Pulmonary rehabilitation has also emerged as a standard of care for patients with chronic lung disease. The current official recommendation for pulmonary rehabilitation in IPF patients is weak; however, controlled trials have shown improvement in walking distance and quality of life, and most IPF patients should be referred to pulmonary rehabilitation when available.”