Published: 2019-07-26

Assessment of nutritional status in chronic obstructive airways disease patients in a tertiary care hospital at Himachal Pradesh, India: a cross sectional study

Balbir Singh, Pramod Shridhar, Kamaljit Singh, Rajesh Garg, Herleen Pabla, Ena Sharma


Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortatlity worldwide. Malnourishment in COPD patients is very common and is a prognostic factor in its treatment. The present study has been conducted to assess nutritional status in COPD patients and its correlation with severity of disease.

Methods: This institutional based analytical cross sectional study was conducted in the Department of Pulmonary Medicine at tertiary care hospital in Himachal Pradesh (India) from 1 Dec 2017 to 31st May 2018. A total of 52 COPD participants attending the pulmonary Medicine OPD and fulfilling the inclusion criteria were enrolled.

Results: All participants reported being smoker since long with the mean years of smoking since 31 years and about 13.6 cigarettes being smoked per day. 22 (42%) of the participants were undernourished as per BMI criteria But when  compared with MUAC criteria, a large number 38 (73%) came out to be undernourished. haemoglobin and cholesterol levels were less in patients with severe diseases than mild and moderate category (76.9%).

Conclusions: The malnourishment and severity of the disease has direct correlation. More the severity of COPD, more is the malnourishment. Biochemical parameters, although not deranged significantly in any group, but more on the lower side in patients with severe COPD. There is a need for regular nutritional assessment of every COPD patient and recommendation of supplementary food for them.


COPD, Malnourishment, Body mass index, Mid-arm upper circumference, Anthropometry

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Buist AS, McBurnie MA, Vollmer WM, Gillespie S, Burnie P, Mannino DM, et al. International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet. 2007;1:370(9589).

Gupta D, Agarwal R, Aggarwal AN, Maturu VN, Dhooria S, Prasad KT, et al. Guidelines for diagnosis and management of chronic obstructive pulmonary disease: Joint ICS/NCCP (I) recommendations. Lung India. 2013;30(3):228-67.

Yuceege MB, Salman SO, Duru S, Saygıdeğer Y, Sonmez Z, Ardıç S. The evaluation of nutrition in male COPD patients using subjective global assesment and mini nutritional assesment. Int J Internal Med. 2013;2(1):1-5.

Hunter AM, Carey MA, Larsh HW. The nutritional status of patients with chronic obstructive pulmonary disease. Am Rev Respir dis. 1981;124(4):376-81.

Schols AM, Fredrix EW, Soeters PB, Westerterp KR, Wouters EF. Resting energy expenditure in patients with chronic obstructive pulmonary disease. Am J Clin Nutr. 1991;54(6):983-7.

Goldstein S, Askanazi J, Weissman C, Thomashow B, Kinney JM. Energy expenditure in patients with chronic obstructive pulmonary disease. Chest. 1987;91(2):222-4.

Sinde F, Gronberg AM, Engstrom CP, Rossander- Hulthen L, Larsson S. Individual dietary intervention in patients with COPD during multidisciplinary rehabilitation. Respir Med. 2002;96(5):330-6.

Gray-Donald K, Gibbons L, Shapiro SH, Macklem PT, Martin JG. Nutritional status and mortality in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1996;153(3):961-6.

WHO: Technical Report Series no. 916. Geneva; 2003.

Tang AM, Chung M, Dong K, Wanke C, Bahwere A, Bose K, et al. Determining a global mid upper arm circumference cutoff to assess underweight in adults (men and non-pregnant women). Food and Nutrition Technical Assistance; 2017: 42.

Pirabbasi E, Najafiyan M, Cheraghi M, Shahar S, Manaf ZA, Rajab N, et al. Factors of Nutritional Status of Male Chronic Obstructive Pulmonary Available at: /isrn/2012/782626/. Accessed 27 August 2017.

Ahmadi A, Haghighat N, Hakimrabet M, Tolide-ie H. Nutritional Evaluation in Chronic Obstructive Pulmonary Disease Patients. Pak J Biol Sci. 2012;15(10):501-5.

Fernandes AC, Bezerra OM de PA. Nutrition therapy for chronic obstructive pulmonary disease and related nutritional complications. J Bras Pneumol 2006;32(5):461-71.

Park SK, Richardson CR, Holleman RG, Larson JL. Frailty in people with COPD, using the National Health and Nutrition Evaluation Survey dataset (2003–2006). Heart & Lung J Acute Critical Care. 2013;1:42(3):163-70.