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Food Pyramid for Subjects with Chronic Obstructive Pulmonary Diseases

Authors Rondanelli M, Faliva MA, Peroni G, Infantino V, Gasparri C, Iannello G, Perna S, Alalwan TA, Al-Thawadi S, Corsico AG

Received 29 November 2019

Accepted for publication 20 April 2020

Published 19 June 2020 Volume 2020:15 Pages 1435—1448


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Richard Russell

Mariangela Rondanelli,1,2 Milena Anna Faliva,3 Gabriella Peroni,3 Vittoria Infantino,2 Clara Gasparri,3 Giancarlo Iannello,4 Simone Perna,5 Tariq AbdulKarim Alalwan,5 Salwa Al-Thawadi,5 Angelo Guido Corsico6,7

1IRCCS Mondino Foundation, Pavia 27100, Italy; 2Department of Public Health, Experimental and Forensic Medicine, Unit of Human and Clinical Nutrition, University of Pavia, Pavia 27100, Italy; 3Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, Pavia 27100, Italy; 4General Management, Azienda di Servizi alla Persona “Istituto Santa Margherita”, Pavia 27100, Italy; 5Department of Biology, College of Science, University of Bahrain, Sakhir 32038, Bahrain; 6Center for Diagnosis of Inherited Alpha 1-Antitrypsin Deficiency, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia 27100, Italy; 7Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia 27100, Italy

Correspondence: Gabriella Peroni
Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, Pavia 27100, Italy
, Tel +39 0382381739
Fax +39 0382381218

Abstract: Nutritional problems are an important part of rehabilitation for chronic obstructive pulmonary disease (COPD) patients. COPD patients often present with malnutrition, sarcopenia, and osteoporosis with possible onset of cachexia, with an inadequate dietary intake and a poor quality of life. Moreover, diet plays a pivotal role in patients with COPD through three mechanisms: regulation of carbon dioxide produced/oxygen consumed, inflammation, and oxidative stress. A narrative review based on 99 eligible studies was performed to evaluate current evidence regarding optimum diet therapy for the management of COPD, and then a food pyramid was built accordingly. The food pyramid proposal will serve to guide energy and dietary intake in order to prevent and treat nutritionally related COPD complications and to manage progression and COPD-related symptoms. The nutrition pyramid described in our narrative review is hypothetical, even in light of several limitations of the present review; the main limitation is the fact that to date there are no randomized controlled trials in the literature clearly showing that improved nutrition, via the regulation of carbon dioxide produced/oxygen consumed, inflammation and oxidative stress, improves symptoms and/or progression of COPD. Even if this nutritional pyramid is hypothetical, we hope that it can serve the valuable purpose of helping researchers focus on the often-ignored possible connections between body composition, nutrition, and COPD.

Keywords: COPD, nutrients, inflammation, fat free mass, antioxidants, gas exchanges

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