TY - JOUR T1 - Nutritional rehabilitation: from pulmonary cachexia to sarcoPD JF - European Respiratory Journal JO - Eur Respir J SP - 949 LP - 950 DO - 10.1183/09031936.00011209 VL - 33 IS - 5 AU - A. M. W. J. Schols Y1 - 2009/05/01 UR - http://erj.ersjournals.com/content/33/5/949.abstract N2 - Evidence is accumulating that disease burden in chronic obstructive pulmonary disease (COPD) is determined by not only pulmonary impairment but the fact that skeletal muscle pathology and cardiovascular disease also contribute to decreased physical performance and increased mortality. An integrated view of the decline in function of multiple organs as a disturbed homeostatic network resulting from smoking, suboptimal diet, inactivity and disease susceptibility has not yet been conceptualised in COPD management but could lead to a shift in clinical medicine and public health towards personalised lifestyle. Research into the pathogenesis and treatment of skeletal muscle pathology in pulmonary cachexia to alleviate progressive disability has been the subject of intensive research during the past decade. While the anabolic and metabolic potential of multimodal nutritional rehabilitation strategies, including exercise, protein-calorie supplementation, polyunsaturated fatty acids and/or anabolic agents, has been demonstrated in the short-term 1–3, efficacy in pulmonary cachexia is limited by the absence of long-term strategies to maintain physical fitness in advanced disease and by adverse effects of persistent inflammation on … ER -