Nutritional Supplementation during Pulmonary Rehabilitation in COPD: A Systematic Review

ABSTRACT Background Uptake of nutritional supplementation during pulmonary rehabilitation (PR) for people with chronic obstructive pulmonary disease (COPD) has been limited by an absence of rigorous evidence-based studies supporting use. Our objective were to report and summarise the current evidence supporting use of nutritional supplementation to improve outcomes during pulmonary rehabilitation in stable COPD patients. Methods A systematic search was conducted up to May 7 th , 2019 (registration number CRD42018089142). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Six databases were included: Medical Literature Analysis and Retrieval System Online or MEDLARS Online (Medline), Allied and Complementary Medicine Database (AMED), the Cochrane Database of Systematic Reviews, Excerpta Medica dataBASE (Embase), Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Web of Science. Results This systematic search generated 580 initial matches, of which 24 studies (1035 COPD participants) met the pre-specified criteria and were included. Our analysis does not confirm an impact of nutritional supplementation during PR, but studies, supplements and PR programmes were heterogeneous in nature. Conclusion There is currently insufficient evidence on the effect of nutritional supplementation on improving outcomes during PR in patients with COPD. Therefore, controversy remains and further research is needed.