pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2016-26-1-13-28pulmo-668Research ArticleКЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИCLINICAL GUIDELINESОценка нутритивного статуса и его коррекция при хронической обструктивной болезни легкихEvaluation of nutritional status and nutritional therapy in chronic obstructive pulmonary diseaseРедакционнаястатьяEditorialArticle2016190420162611328Copyright © Редакционная с., 20162016Редакционная с.Editorial a.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/668

При хронической обструктивной болезни легких (ХОБЛ) активно изучаются такие научные направления, как питание и метаболизм. Однако в клинической практике существует недостаточное понимание того, что пищевые привычки, нутритивный статус и нутритивные вмешательства могут влиять на распространенность ХОБЛ, ее прогрессирование и исходы. Для анализа доказательств и описания существующей клинической практики по оценке нутритивного статуса и его коррекции у больных ХОБЛ, а также для разработки направлений будущих клинических исследований Европейским респираторным обществом создана Рабочая группа. Членами Рабочей группы проведен обзор литературы по соответствующим темам. Известно, что нутритивный статус, в частности, изменение телосложения, является самостоятельным фактором, определяющим исход ХОБЛ. Для оценки нутритивного риска Рабочей группой выделены несколько метаболических фенотипов ХОБЛ, что важно как для построения дизайна клинических исследований, так и для консультативной работы. Возможно, нутритивные вмешательства могут быть эффективными у больных с дефицитом массы тела, особенно в сочетании с физическими тренировками. Для социальной поддержки такого лечения и, как следствие, повышения его доступности необходимы доказательства его экономической эффективности. В целом согласно существующим сегодня доказательствам показано, что хорошо сбалансированное питание оказывает положительное влияние на всех больных ХОБЛ, в первую очередь за счет снижения метаболического и кардиоваскулярного риска.

Recently, nutrition and metabolism have been actively investigated in patients with chronic obstructive pulmonary disease (COPD) but clinicians generally underestimate the significance of dietary habits, nutritional status and nutritional interventions in COPD and their influence on progression and outcome of the disease. The European Respiratory Society organized a Task Force Group to review evidence on nutritional status evaluation and nutritional support in COPD patients and to determine future research directions. The Task Force members reviewed the literature on relevant topics. Nutritional status is recognized to be an independent factor influencing outcome of COPD. The Task Force described several metabolic phenotypes of COPD in order to nutritional risk assessment which is important for development clinical trial designs and counselling of the patients. Nutritional interventions could be useful in undernourished COPD patients especially when combined with physical rehabilitation. Evidence of cost-effectiveness of nutritional assessment and intervention are required for social support and reimbursement and for increased availability of this therapy. Generally, current evidence demonstrates that well-balanced nutrition is effective in all COPD patients mostly due to reduction in metabolic and cardiovascular risks.

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The authors declare that there are no conflicts of interest present.