Systemic Inflammation in Chronic Obstructive Pulmonary Disease: May Diet Play a Therapeutic Role?

Abstract

Wherever possible, energy requirements of individuals should be measured using indirect calorimetry or other objective measures. Where measuring energy expenditure is not possible, prediction equations can be used, however, there is a lack of strong and consistent evidence supporting standardised predictive equations. As a result, when estimating requirements for protein and energy, the following should be taken into account. Starting point only Predictive equations are not considered accurate for individuals in the clinical setting. Although these provide a useful starting point, the emphasis should be on reviewing and reassessment, considering changes to treatment goals, clinical conditions, biochemical and anthropometric parameters, and patient activity levels. Ease of use Consider using predictive methods that are easy to apply, do not need calculators, and do not require multiple clinical measurements. At the bedside, these are just as likely to provide adequate estimates of requirements as those that take more time and effort. Using a data range Single figure estimates imply accuracy. This can be misleading and result in poor follow-up. Rounding data / units of Measure Consider rounding protein requirements in units of 5, and round kilojoules to the nearest 100kJ. Simple maths avoids the need for calculators. Clinical measurements