Chronic obstructive pulmonary disease (COPD) is a progressive lung disorder in which patients are at high risk for both pulmonary and systemic complications of their disease. Medical nutrition therapy by a registered dietitian nutritionist can be an integral component of lifestyle treatment targeted at maintaining and improving outcomes, such as lung function, mortality, and quality of life. The Academy of Nutrition and Dietetics (Academy) convened an expert workgroup to conduct a systematic review to update the COPD Evidence-Based Nutrition Practice Guideline. This publication outlines the Academy's Evidence Analysis Library methods used to complete the systematic review and guideline and examines the recommendations and supporting evidence. A total of 14 recommendations were developed based on evidence from eight conclusions. Using the Nutrition Care Process as a framework for practice, recommendations rated as strong included assessing and monitoring and evaluating body weight and medical nutrition therapy by a registered dietitian nutritionist. Weak recommendations included predicting resting and total energy expenditure. All other recommendations were rated as fair. These included individualizing the calorie prescription and macronutrient composition of the diet; assessing and monitoring and evaluating energy intake, serum 25-hydroxyvitamin D levels, and frequency of exacerbations; and determining need for vitamin D supplementation. Fewer than one-third of the systematic review's conclusions could be used to support the recommendations due to conflicting results or limited or no evidence available. The Evidence Analysis Library 2019 COPD Evidence-Based Nutrition Practice Guideline is a valuable resource for registered dietitian nutritionists and other health care professionals caring for those with COPD.

中文翻译：

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慢性阻塞性肺疾病：2019 年证据分析中心循证实践指南

慢性阻塞性肺疾病 (COPD) 是一种进行性肺部疾病，患者出现肺部和全身并发症的风险很高。由注册营养师进行的医学营养治疗可以成为生活方式治疗的一个组成部分，旨在维持和改善结果，例如肺功能、死亡率和生活质量。营养与饮食学会（Academy）召集了一个专家工作组进行系统审查，以更新 COPD 循证营养实践指南。本出版物概述了学院用于完成系统评价和指南的证据分析库方法，并检查了建议和支持证据。根据八项结论的证据，共制定了 14 项建议。使用营养护理流程作为实践框架，被评为强的建议包括由注册营养师评估、监测和评估体重和医学营养治疗。弱建议包括预测静息和总能量消耗。所有其他建议都被评为公平。这些包括个性化饮食的卡路里处方和常量营养素组成；评估、监测和评估能量摄入、血清 25-羟基维生素 D 水平和恶化频率；并确定是否需要补充维生素 D。由于结果相互矛盾或证据有限或没有可用证据，只有不到三分之一的系统评价结论可用于支持建议。