Relationship Between Body Mass Index, Nutrition, Strength, and Function in Elderly Individuals With Chronic Obstructive Pulmonary Disease

PURPOSE: Individuals with severe chronic obstructive pulmonary disease are frequently characterized as cachectic and suffering from generalized weight loss and muscle wasting. Loss of body mass is associated with disability and premature mortality, and body mass index (BMI) has been used as a marker for nutritional status and to predict survival. This cross-sectional study evaluated the association between BMI (kg/m(2)), nutritional intake, strength, and function in 19 elderly (70 +/- 1 years) men and women (BMI = 27.8 +/- 1.1 kg/m(2)) enrolled in a pulmonary rehabilitation program. METHODS: Three-day prospective diet records were collected and analyzed using Food Processor software. Upper and lower body strength was measured using 1 repetition maximum testing for chest and leg press. Function (endurance, strength, and power) was assessed using the Senior Fitness Test battery (6-minute walk, up-and-go, chair stand, arm curl). RESULTS: BMI was positively associated with upper (P < .05) and lower (P < .01) body strength but was not related to nutrition or function. Total daily caloric (kcal/d), protein (g/d), and carbohydrate (g/d) intakes were positively related to upper body strength (P < .01, P < .01, and P < .05, respectively) and lower body strength (P < .05, P < .05, and P < .05, respectively) and 6-minute walk (P < .05). Fat intake (g/d) was positively related to upper body strength (P < 0.05) alone. CONCLUSIONS: Despite health concerns regarding obesity and overweight, clinicians should consider the impact of BMI and dietary intake before initiating weight loss interventions in patients with chronic obstructive pulmonary disease.