• Significant weight loss (5% of actual weight within three months or 10% within 6 months) is found in 25–40% of all cases when lung function is severely impaired (FEV1<50%).
• A pronounced loss of appetite (anorexia) and decreased food intake are of central importance in the weight loss which accompanies COPD.
• Weight loss and a low BMI predict a poor survival in COPD patients. However, there is limited evidence that COPD patients benefit from EN.
• The main aim of treatment is to meet calculated nutritional requirements and prevent weight loss.
• In patients with stable COPD there is no advantage of disease specific low carbohydrate, high fat ONS over standard or high protein or high energy ONS.
• It was suggested that standard formulae, which are usually rich in carbohydrates (50–60 energy %) would induce greater ventilatory demand due to a higher respiratory quotient)

Discuss parenteral nutrition in COPD?

In patients with stable COPD, glucose-based PN causes an increase in the respiratory
CO2 load. PN composition should accordingly be orientated towards lipids as the
energy source. The proportion of lipid-derived non-protein calories should probably be at least 35% (but probably not more than 65%).

Ref

1. ESPEN guidelines