Nutritional Status in Aging and Lung Disease

Lung diseases exert a negative impact on nutritional status, especially among older patients where aging per se is already associated with relevant changes in nutrient intake, metabolism, and body composition. Both respiratory (increased respiratory work, hypoxia, and local oxidative stress and inflammation) and nonrespiratory (sarcopenia, reduced mitochondrial biogenesis and anabolic hormones, balance of orexigenic/anorexigenic neuropeptides, and systemic inflammation and oxidative stress) contribute to the association between lung diseases and malnutrition. For these reasons, nutritional assessments are of paramount importance in older patients with lung diseases. Current evidence suggests that the Mini Nutritional Assessment is the most reliable instrument for nutritional screening in clinical practice. As regards body composition, bioimpedance analysis (BIA) is easy to apply and less expensive than dual energy X-ray absorptiometry (DEXA). Moreover, BIA may provide clinical benefit in the assessment of COPD patients. Nutritional interventions include correction of hypoxia, and supplementation of polyunsaturated fatty acids, branched-chain amino acids, vitamin D, iron, and antioxidants.