Vitamin D supplementation improves COPD rehab outcome
The American Thoracic Society's 2011 International Conference held May 13-18 in Denver was the site of a presentation concerning the finding of a benefit for vitamin D supplementation in patients participating in a rehabilitation program for chronic obstructive pulmonary disease (COPD).
"COPD can be considered as a respiratory disease with important nonrespiratory consequences, such as osteoporosis, cardiovascular disease and muscle weakness," explained researcher Miek Hornikx, who is a physiotherapist and doctoral student in the department of pneumology at Katholieke Universiteit Leuven, Belgium. "These consequences eventually will be negatively influenced by physical inactivity which, along with exercise intolerance, is a common feature among patients with COPD and is proven to be related to mortality."
"Low levels of vitamin D in the blood have been related with muscle weakness, a major target for respiratory rehabilitation and increased risk of falls," she added. "Since vitamin D is often depleted in patients with COPD, we wanted to see if vitamin D supplementation would have a beneficial effect on rehabilitation among these patients, perhaps by increasing muscle strength."
The current study included fifty older COPD patients with a history of exacerbations who had been referred for rehabilitation. The participants were divided to receive 100,000 international units (IU) vitamin D per month or a placebo during the three month rehabilitation period. Exercise capacity and peripheral and respiratory muscle strength were evaluated before and after treatment.
"Our study shows that high doses of vitamin D supplementation on top of a standard rehabilitation program improve the outcome in terms of exercise capacity and respiratory muscle strength," Dr Hornikx reported. "These results support the idea that correcting vitamin D deficiency by adding vitamin D supplements to training programs allows COPD patients to achieve better results from rehabilitation, including improvements in muscle strength and exercise capacity."
Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating lung disease. The disease is characterized by irreversible airflow limitation in the lungs. The umbrella of COPD encompasses the following conditions:
Emphysema, in which the alveoli in the lungs, the tiny sacs where oxygen transfer takes place, are destroyed and enlarged
Chronic bronchitis, or the permanent inflammation of airways, accompanied by a chronic cough
Nutritional supplementation aimed at increasing antioxidant capacity and reducing inflammation may offer significant added value (Schols A 2003; Romieu I et al 2001). In addition, people with COPD have increased energy requirements because it is harder for them to breathe. Difficulty breathing may affect eating, potentially resulting in malnutrition. Proper nutrition through a balanced diet and appropriate supplementation is important in COPD management.
Because of the role of oxidant stress in causing and perpetuating COPD (Drost EM et al 2005) and the low levels of natural antioxidants in patients’ tissues (Kluchova Z et al 2006; Rahman I et al 2006; Nadeem A et al 2005), antioxidant supplementation may be helpful (Kelly FJ 2005; Spurzem JR et al 2005; Romieu I et al 2001)
Levels of vitamins A and E are significantly lower during exacerbations of COPD than they are in stable COPD, suggesting that antioxidants should be used during exacerbations (Tug T et al 2005). Although vitamins A, C, and E are beneficial, vitamin A may be most important because it catalyzes removal of the most reactive form of oxygen radical (Tug T et al 2005).
Because air passage is obstructed in COPD, the lungs and heart work harder to carry oxygen throughout the body. Exercise programs strengthen chest muscles and facilitate breathing. Multidisciplinary pulmonary rehabilitation programs provide well-monitored exercise programs.
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