Improvement of Lung Function by Micronutrient Supplementation in Patients with COPD: A Systematic Review and Meta-Analysis

Overview

Journal Nutrients

Date 2024 Apr 13

PMID 38613061

Authors

Mingxin Li

Liangjie Zhao

Chenchen Hu

Yue Li

Yang Yang

Xiaoqi Zhang

Quanguo Li

Aiguo Ma

Jing Cai

Affiliations

Soon will be listed here.

Abstract

Background: A healthy, well-balanced diet plays an essential role in respiratory diseases. Since micronutrient deficiency is relatively common in patients with chronic obstructive pulmonary disease (COPD), micronutrient supplementation might have the beneficial health effects in those patients. This systematic review and meta-analysis aimed to demonstrate the impact of micronutrient supplementation on the lung function of patients with COPD.

Methods: The PubMed, Cochrane Library, and Web of Science databases were searched from their corresponding creation until February 2024. Search terms included 'chronic obstructive pulmonary disease', 'COPD', 'micronutrients', 'dietary supplements', 'vitamins', 'minerals', and 'randomized controlled trials'. Meta-analysis was performed to evaluate the effects of micronutrient supplementation alone or complex on lung function in patients with COPD.

Results: A total of 43 RCTs fulfilled the inclusion criteria of this study. Meta-analysis revealed that vitamin D supplementation could significantly improve FEV1% (WMD: 6.39, 95% CI: 4.59, 8.18, < 0.01; WMD: 7.55, 95% CI: 5.86, 9.24, < 0.01) and FEV1/FVC% (WMD: 6.88, 95%CI: 2.11, 11.65, WMD: 7.64, 95% CI: 3.18, 12.10, < 0.001), decrease the odds of acute exacerbations, and improve the level of T-cell subsets, including CD3%, CD4%, CD8%, and CD4/CD8% (all < 0.01). The effects of compound nutrients intervention were effective in improving FEV1% (WMD: 8.38, 95%CI: 1.89, 14.87, WMD: 7.07, 95%CI: -0.34, 14.48) and FEV1/FVC% (WMD: 7.58, 95% CI: 4.86, 10.29, WMD: 6.00, 95% CI: 3.19, 8.81). However, vitamin C and vitamin E supplementation alone had no significant effects on lung function ( > 0.05).

Conclusions: Micronutrient supplementation, such as vitamin D alone and compound nutrients, has improved effect on the lung function of patients with COPD. Therefore, proper supplementation with micronutrients would be beneficial to stabilize the condition and restore ventilation function for COPD patients.

Citing Articles

The Role of Trace Elements in COPD: Pathogenetic Mechanisms and Therapeutic Potential of Zinc, Iron, Magnesium, Selenium, Manganese, Copper, and Calcium.

Fekete M, Lehoczki A, Csipo T, Fazekas-Pongor V, Szappanos A, Major D Nutrients. 2024; 16(23).

PMID: 39683514 PMC: 11644833. DOI: 10.3390/nu16234118.

Genetic information supports a causal relationship between trace elements, inflammatory proteins, and COPD: evidence from a Mendelian randomization analysis.

Cao Z, Zhao S, Wu T, Sun F, Ding H, Hu S Front Nutr. 2024; 11:1430606.

PMID: 39206312 PMC: 11349556. DOI: 10.3389/fnut.2024.1430606.

References

Higgins M, Izadi A, Kaviani M . Antioxidants and Exercise Performance: With a Focus on Vitamin E and C Supplementation. Int J Environ Res Public Health. 2020; 17(22). PMC: 7697466. DOI: 10.3390/ijerph17228452. View

Keranis E, Makris D, Rodopoulou P, Martinou H, Papamakarios G, Daniil Z . Impact of dietary shift to higher-antioxidant foods in COPD: a randomised trial. Eur Respir J. 2010; 36(4):774-80. DOI: 10.1183/09031936.00113809. View

Itoh M, Tsuji T, Nemoto K, Nakamura H, Aoshiba K . Undernutrition in patients with COPD and its treatment. Nutrients. 2013; 5(4):1316-35. PMC: 3705350. DOI: 10.3390/nu5041316. View

Schrumpf J, van der Does A, Hiemstra P . Impact of the Local Inflammatory Environment on Mucosal Vitamin D Metabolism and Signaling in Chronic Inflammatory Lung Diseases. Front Immunol. 2020; 11:1433. PMC: 7366846. DOI: 10.3389/fimmu.2020.01433. View

Zanforlini B, Ceolin C, Trevisan C, Alessi A, Seccia D, Noale M . Clinical trial on the effects of oral magnesium supplementation in stable-phase COPD patients. Aging Clin Exp Res. 2021; 34(1):167-174. PMC: 8794984. DOI: 10.1007/s40520-021-01921-z. View

Bialek-Gosk K, Rubinsztajn R, Bialek S, Paplinska-Goryca M, Krenke R, Chazan R . Serum Vitamin D Concentration and Markers of Bone Metabolism in Perimenopausal and Postmenopausal Women with Asthma and COPD. Adv Exp Med Biol. 2018; 1070:27-36. DOI: 10.1007/5584_2018_157. View

Molmen K, Hammarstrom D, Pedersen K, Lian Lie A, Steile R, Nygaard H . Vitamin D supplementation does not enhance the effects of resistance training in older adults. J Cachexia Sarcopenia Muscle. 2021; 12(3):599-628. PMC: 8200443. DOI: 10.1002/jcsm.12688. View

van de Bool C, Rutten E, van Helvoort A, Franssen F, Wouters E, Schols A . A randomized clinical trial investigating the efficacy of targeted nutrition as adjunct to exercise training in COPD. J Cachexia Sarcopenia Muscle. 2017; 8(5):748-758. PMC: 5659064. DOI: 10.1002/jcsm.12219. View

Park H, Byun M, Kim H, Kim J, Kim Y, Yoo K . Dietary vitamin C intake protects against COPD: the Korea National Health and Nutrition Examination Survey in 2012. Int J Chron Obstruct Pulmon Dis. 2016; 11:2721-2728. PMC: 5098518. DOI: 10.2147/COPD.S119448. View

10.

Nakagiri T, Warnecke G, Avsar M, Thissen S, Kruse B, Kuhn C . Lung function early after lung transplantation is correlated with the frequency of regulatory T cells. Surg Today. 2011; 42(3):250-8. DOI: 10.1007/s00595-011-0087-3. View

11.

Gouzi F, Maury J, Heraud N, Molinari N, Bertet H, Ayoub B . Additional Effects of Nutritional Antioxidant Supplementation on Peripheral Muscle during Pulmonary Rehabilitation in COPD Patients: A Randomized Controlled Trial. Oxid Med Cell Longev. 2019; 2019:5496346. PMC: 6501222. DOI: 10.1155/2019/5496346. View

12.

Zhai T, Li S, Hu W, Li D, Leng S . Potential Micronutrients and Phytochemicals against the Pathogenesis of Chronic Obstructive Pulmonary Disease and Lung Cancer. Nutrients. 2018; 10(7). PMC: 6073117. DOI: 10.3390/nu10070813. View

13.

. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020; 396(10258):1204-1222. PMC: 7567026. DOI: 10.1016/S0140-6736(20)30925-9. View

14.

Alavi Foumani A, Mehrdad M, Jafarinezhad A, Nokani K, Jafari A . Impact of vitamin D on spirometry findings and quality of life in patients with chronic obstructive pulmonary disease: a randomized, double-blinded, placebo-controlled clinical trial. Int J Chron Obstruct Pulmon Dis. 2019; 14:1495-1501. PMC: 6625601. DOI: 10.2147/COPD.S207400. View

15.

Gozzi-Silva S, Emidio Teixeira F, Duarte A, Sato M, Oliveira L . Immunomodulatory Role of Nutrients: How Can Pulmonary Dysfunctions Improve?. Front Nutr. 2021; 8:674258. PMC: 8453008. DOI: 10.3389/fnut.2021.674258. View

16.

Zhou J, Jin F, Wu F . Clinical significance of changes in serum inflammatory factors in patients with chronic obstructive pulmonary disease and pulmonary infection. J Int Med Res. 2021; 49(5):3000605211013275. PMC: 8150426. DOI: 10.1177/03000605211013275. View

17.

Schols A . Nutrition as a metabolic modulator in COPD. Chest. 2013; 144(4):1340-1345. DOI: 10.1378/chest.13-0326. View

18.

Barnes P . Oxidative Stress in Chronic Obstructive Pulmonary Disease. Antioxidants (Basel). 2022; 11(5). PMC: 9138026. DOI: 10.3390/antiox11050965. View

19.

Scoditti E, Massaro M, Garbarino S, Toraldo D . Role of Diet in Chronic Obstructive Pulmonary Disease Prevention and Treatment. Nutrients. 2019; 11(6). PMC: 6627281. DOI: 10.3390/nu11061357. View

20.

Ahmadi A, Eftekhari M, Mazloom Z, Masoompour M, Fararooei M, Eskandari M . Fortified whey beverage for improving muscle mass in chronic obstructive pulmonary disease: a single-blind, randomized clinical trial. Respir Res. 2020; 21(1):216. PMC: 7430110. DOI: 10.1186/s12931-020-01466-1. View