Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, JapanJapan
Department of Rehabilitation Medicine, Toho University School of Medicine, Tokyo, Japan Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease of the lungs characterized by persistent airflow obstruction resulting from inflammation and remodeling of the airways, and may include development of emphysema.
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Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease of the lungs characterized by persistent airflow obstruction resulting from inflammation and remodeling of the airways, and may include development of emphysema.1 Inflammatory activation in COPD induces a hypermetabolic state, characterized by catabolic and anabolic imbalance, which re-sults in weight loss,2 commonly seen in patients with COPD.
PULMONARY RESEARCH AND RESPIRATORY MEDICINE ISSN 2377-1658 http://dx.doi.org/10.17140/PRRMOJ-3-e004 Open Journal Editorial Taste Sensitivity and Nutrition in COPD * *Corresponding author Rehabilitation Masahiro Kohzuki, MD, PhD Professor and Chairman Department of Internal Medicine and 1* 2 Rehabilitation Science Masahiro Kohzuki, MD, PhD ; Satoru Ebihara, MD, PhD Disability Science Tohoku Universiry Graduate 1 Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine School of Medicine, Sendai, Japan 1-1, Seiryo-cho, Aoba-ku Sendai 980-8574, Japan 2Department of Rehabilitation Medicine, Toho University School of Medicine, Tokyo, Japan Tel. 022-717-7351 Fax: 022-717-7355 E-mail: kohzuki@med.tohoku.ac.jp Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease of the lungs characterized by persistent airflow obstruction resulting from inflammation and remodeling of Volume 3 : Issue 1 the airways, and may include development of emphysema.1 Inflammatory activation in COPD Article Ref. #: 1000PRRMOJ3e004 induces a hypermetabolic state, characterized by catabolic and anabolic imbalance, which re- sults in weight loss,2 commonly seen in patients with COPD. Weight loss and low body weight are independent risk factors of morbidity and mortality in such patients.3 One possible reason Article History th for weight loss in patients with COPD is altered taste sensitivity. Because patients with COPD Received: May 16 , 2016 th may need to consume additional energy to maintain or gain weight, the taste sensory quality of Accepted: May 19 , 2016 th meals becomes important.
Published: May 20 , 2016 Pulmonary rehabilitation is known to lead to improved exercise performance in pa- Citation tients with COPD. However, the relationship between pulmonary rehabilitation and taste sen- Kohzuki M, Ebihara S. Taste sen- sitivity has not been evaluated. Therefore, we compared taste sensitivity before and after pul- sitivity and nutrition in COPD re- 4 monary rehabilitation in patients with COPD. The six-min walk distance (6MWD), COPD habilitation. Pulm Res Respir Med Open J. 2016; 3(1): e1-e2. assessment test, and taste test were conducted before and after 4-week comprehensive pulmo- doi: 10.17140/PRRMOJ-3-e004 nary rehabilitation. Taste sensitivity was evaluated using the filter-paper disc method for 4 taste stimuli. Taste stimuli were salty, sweet, sour, and bitter tastes. Three taste thresholds (salty, sweet and bitter) were significantly lower at the end of the PR program than at the beginning.4 Each patient with COPD took part in the PR program, which consisted of a 20-min class one or more times a day. The exercise training consisted of walking on a treadmill, stair climbing, and ergometer cycling. Frequency of the training program was 5 times a week for 4 weeks.
The intensity of the training program was 60-70% of peak work rate.5 Following pulmonary rehabilitation, the 6MWD, COPD assessment test, salty recognition threshold, sweet recogni- tion threshold and bitter recognition threshold improved significantly, whereas there were no significant improvements in body mass index or sour recognition threshold.4 Pulmonary reha- bilitation may improve taste sensitivity in patients with COPD.4 In any wasting condition, the aim of nutritional intervention is not only to treat an- orexia or balance elevated energy requirements, but also to facilitate muscle protein synthesis. In the COPD field, Engelen et al.6 was the first to show elevated whole body protein turnover in COPD and identified abnormalities in amino acids profiles in wasted COPD patients as puta- tive therapeutic target.7 In 2012 Cochrane meta-analysis concluded that nutritional intervention is indeed effective to improve weight, body composition and exercise performance in mal- 8,9 nourished COPD patients.8,9 Therefore, nutritional supplementation is an important therapeutic intervention, particularly for severely ill COPD patients with malnutrition.
Copyright Difficulties may be experienced by these COPD patients, who are struggling to breathe ©2016 Kohzuki M. This is an open and eliminate CO2 from the lungs, resulting in dyspnea, hypercapnia, hypoxia, and respiratory access article distributed under the Creative Commons Attribution 4.0 acidosis, which exacerbates muscle loss through oxidative stress and inflammatory responses. International License (CC BY 4.0), To overcome these problems, nutritional supplements should aim to reduce metabolic CO2 which permits unrestricted use, production, lower respiratory quotient, and improve lung function. Several studies have shown distribution, and reproduction in that high-fat supplements produce less CO2 and have lower respiratory quotient value than any medium, provided the original work is properly cited. high-carbohydrate supplements. In addition, high-fat supplements may be the most efficient PULMONARY RESEARCH AND RESPIRATORY MEDICINE ISSN 2377-1658 http://dx.doi.org/10.17140/PRRMOJ-3-e004 Open Journal most beneficial to patients with prolonged mechanical ventilation where hypercapnia and malnutrition are most pronounced.10 The goal of effective COPD management is to relieve symptoms, slow disease progression, improve exercise tolerance, prevent and treat complications, and improve nutritional status and overall quality of life. In conclusion, this study suggests that a PR program may improve taste sensitivity in patients with COPD, contributing to avoiding weight loss and improving the prognosis for patients with COPD. Further studies are required to look at combining these optimal nutritional supplements with pulmonary rehabilitation for COPD patients according to their disease severity could be extremely useful and would provide a relatively cheap and simple method to improve clinical outcomes of COPD patients.