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Nutrition clinique et métabolisme
Volume 28, n° 4
pages 336-347 (décembre 2014)
Doi : 10.1016/j.nupar.2014.10.004
Received : 31 July 2014 ;  accepted : 4 October 2014
Activité physique et nutrition dans la broncho-pneumopathie chronique obstructive
Physical activity and nutrition in chronic obstructive pulmonary disease
 

Frédéric Costes a, , b , Christophe Pison c, d, e, f, g
a Service de physiologie clinique et exercice, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France 
b EA 4338, laboratoire de physiologie de l’exercice, université Jean-Monnet Saint-Étienne, 42000 Saint-Étienne cedex 2, France 
c Pôle thorax et vaisseaux, clinique universitaire de pneumologie, CHU de Grenoble, 38043 Grenoble cedex 9, France 
d Centre Henri-Bazire, 38134 Saint-Julien-de-Ratz, France 
e Inserm 1055, 38041 Grenoble, France 
f Université Grenoble Alpes, 38041 Grenoble cedex 9, France 
g European institute for systems biology and medicine, 69007 Lyon, France 

Auteur correspondant.
Résumé

L’état nutritionnel des patients présentant une broncho-pneumopathie chronique obstructive (BPCO) a longtemps été négligé, hormis la prise en charge de l’historique cachexie au stade terminal de l’insuffisance respiratoire chronique. On distingue désormais différents phénotypes de patients selon les modifications de composition corporelle, ayant un impact sur les capacités physiques et la mortalité. Les causes de perte de masse maigre dans la BPCO ne sont pas complètement connues mais l’état inflammatoire, l’hypoxie et un hypermétabolisme représentent les facteurs majeurs. Des méta-analyses récentes ont montré les liens entre l’état nutritionnel des patients et leurs aptitudes physiques, même si ces relations sont complexes, ainsi que le bénéfice d’interventions nutritionnelles seules ou couplées à une réhabilitation respiratoire (intervention multimodale). Cette revue fait le point des avancées récentes concernant les relations entre l’activité physique et l’état nutritionnel dans la BPCO et confirme le potentiel des interventions multimodales pour améliorer la composition corporelle et l’autonomie de ces patients.

The full text of this article is available in PDF format.
Abstract

The nutritional status of patients with chronic obstructive pulmonary disease (COPD) has long been neglected, except for the management of the historic cachexia associated with end-stage chronic respiratory failure. Different phenotypes of patients are now recognized according to the changes in body composition, which influence physical capacity and mortality. The causes of a loss of fat free mass are not completely understood but the main putative factors are an inflammatory state, hypoxia and a hypermetabolic state. Recent published meta-analyses pointed out the relationships between the nutritional status and the physical fitness, but these links appears complex and loose, as well as the benefit of nutrition interventions alone or coupled to a respiratory rehabilitation (multimodal intervention). This review focuses on recent advances regarding relationships between physical activity and nutritional status in COPD and confirms the potential of multimodal intervention to improve body composition and functioning.

The full text of this article is available in PDF format.

Mots clés : BPCO, Activités physiques, Nutrition, Réhabilitation nutritionnelle

Keywords : COPD, Physical activities, Nutrition, Nutritional rehabilitation




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