Effect of supplementing a high-fat, low-carbohydrate enteral formula in COPD patients (Low Carb Helps!)

One of the goals in treating patients with chronic obstructive pulmonary disease (COPD) who suffer from hypoxemia, hypercapnia, and malnutrition is to correct the malnutrition without increasing the respiratory quotient and minimize the production of carbon dioxide. This 3-wk study evaluated the efficacy of feeding a high-fat, low-carbohydrate (CHO) nutritional supplement as opposed to a high-carbohydrate diet in COPD patients on parameters of pulmonary function.

Methods Sixty COPD patients with low body weight (<90% ideal body weight) were randomized to the control group, which received dietary counseling for a high-CHO diet (15% protein, 20% to 30% fat, and 60% to 70% CHO), or the experimental group, which received two to three cans (237 mL/can) of a high-fat, low-CHO oral supplement (16.7% protein, 55.1% fat, and 28.2% CHO) in the evening as part of the diet. Measurements of lung function (forced expiratory volume in 1 s or volume of air exhaled in 1 s of maximal expiration, minute ventilation, oxygen consumption per unit time, carbon dioxide production in unit time, and respiratory quotient) and blood gases (pH, arterial carbon dioxide tension, and arterial oxygen tension) were taken at baseline and after 3 wk.

Results Lung function measurements decreased significantly and forced expiratory volume increased significantly in the experimental group.

Conclusion This study demonstrates that pulmonary function in COPD patients can be significantly improved with a high-fat, low-CHO oral supplement as compared with the traditional high-CHO diet.

According to another journal article, the apparent reasoning for these results are as follows:

“A healthy diet for patients with COPD can lead to better breathing and possibly facilitate weaning from mechanical ventilation by providing the calories necessary to meet metabolic needs, restore FFM, and reduce hypercapnia. Carbon dioxide is a waste product of metabolism and is normally expelled via the lungs. However, patients with COPD who have limited and obstructed airflow have a compromised ability to take in oxygen and eliminate carbon dioxide. In patients with COPD, this impaired gas exchange increases patients’ ventilatory demands, as the lungs must work harder to clear excess carbon dioxide. In healthy individuals, increased carbon dioxide levels are easily eliminated.”

“The Importance of Proper Nutrition Proper nutrition can help reduce carbon dioxide levels and improve breathing. Specifically, it is important to focus on the percentages of total carbohydrate, fat, and protein that patients consume to see how their diet composition impacts their respiratory quotient (RQ), which is defined as the ratio of carbon dioxide produced to oxygen consumed. To put it simply, following metabolism, carbohydrate, fat, and protein are all converted to carbon dioxide and water in the presence of oxygen. However, the ratio of carbon dioxide produced to oxygen consumed differs per macronutrient; the RQ for carbohydrate is 1, fat is 0.7, and protein is 0.8. From a nutritional standpoint, this means that eating carbohydrates will yield the most carbon dioxide, while eating fats will yield the least carbon dioxide. That said, prescribing a high-fat, low-carbohydrate diet would reduce patient RQ levels and carbon dioxide production. In fact, patients who have difficulty increasing ventilation following a carbohydrate load or patients with severe dyspnea or hypercapnia may benefit from a high-fat diet.”

The link for this article will immediately follow.

LOW CARB / KETO PING!!!

Thanks ConservativeMind for finding this.

The Carb levels are still significantly above the Keto range, but even so, one can see the benefit of simply reducing carbs, even if they don’t make it all the way down to Ketosis. Assuming that CHO is actually 100% carbs, their low-carb diet still has an intake of about 130 grams of carbs, versus a goal of 20 grams for Keto, and a recommended (LOL) intake of about 275 grams...so they’ve cut half of their carbs out, which is very easy to do, and still got excellent results!

Here are a couple of (unrelated) tips provided to me a few days ago:

Dr Peter Ballerstede:
https://www.youtube.com/watch?v=cRmwobXCc4c

Low Carb Down Under has hours and hours of good info
https://www.youtube.com/user/lowcarbdownunder/videos

[p.s., anyone wanting to join, or leave, my Low-Carb ping list, just let me know, privately or publicly]

This study was done before all of the recent Keto/Low Carb “hype.” It only took three weeks to see huge positive changes in lung use. I’m sorry, but the full study is behind Elsivier’s pay wall (it was in an expensive journal).

There is an open access option offshore at 6 different locations. Just cut and paste the article title in the search field. If an I am not a bot word pops up in Russian, enter it. You can read the PDF or click save to download to desktop. It is a safe website to get around the publication mafias.

Sci-Hub

Complete article: Effect of Supplementing a High-Fat, Low- Carbohydrate Enteral Formula in COPD Patients

Open Access is being pushed by President Trump for any paper receiving federal funds. Many authors are also now publishing on line pre-publications or with Research Gate to stop the share blocking of their work by groups such as Elsevier.

Authors and research institutions do not receive a penny in royalties from groups such as Elsevier.

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