{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T08:06:29Z","timestamp":1792483589591,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,6,12]],"date-time":"2017-06-12T00:00:00Z","timestamp":1497225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001720","name":"Nutricia Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001720","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Evidence regarding the efficacy of nutritional supplementation to enhance exercise training responses in COPD patients with low muscle mass is limited.<\/jats:p><jats:p>The objective was to study if nutritional supplementation targeting muscle derangements enhances outcome of exercise training in COPD patients with low muscle mass.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighty\u2010one COPD patients with low muscle mass, admitted to out\u2010patient pulmonary rehabilitation, randomly received oral nutritional supplementation, enriched with leucine, vitamin D, and omega\u20103 fatty acids (NUTRITION) or PLACEBO as adjunct to 4\u00a0months supervised high intensity exercise training.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study population (51% males, aged 43\u201380) showed moderate airflow limitation, low diffusion capacity, normal protein intake, low plasma vitamin D, and docosahexaenoic acid. Intention\u2010to\u2010treat analysis revealed significant differences after 4\u00a0months favouring NUTRITION for body mass (mean difference\u00a0\u00b1\u00a0SEM) (+1<jats:styled-content>.<\/jats:styled-content>5\u00a0\u00b1\u00a00<jats:styled-content>.<\/jats:styled-content>6\u00a0kg, <jats:italic>P<\/jats:italic>\u00a0=\u00a00<jats:styled-content>.<\/jats:styled-content>01), plasma vitamin D (+24%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00<jats:styled-content>.<\/jats:styled-content>004), eicosapentaenoic acid (+91%,<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00<jats:styled-content>.<\/jats:styled-content>001), docosahexaenoic acid (+31%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00<jats:styled-content>.<\/jats:styled-content>001), and steps\/day (+24%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00<jats:styled-content>.<\/jats:styled-content>048). After 4\u00a0months, both groups improved skeletal muscle mass (+0<jats:styled-content>.<\/jats:styled-content>4\u00a0\u00b1\u00a00<jats:styled-content>.<\/jats:styled-content>1\u00a0kg, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00<jats:styled-content>.<\/jats:styled-content>001), quadriceps muscle strength (+12<jats:styled-content>.<\/jats:styled-content>3\u00a0\u00b1\u00a02<jats:styled-content>.<\/jats:styled-content>3\u00a0Nm,<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00<jats:styled-content>.<\/jats:styled-content>001), and cycle endurance time (+191<jats:styled-content>.<\/jats:styled-content>4\u00a0\u00b1\u00a034<jats:styled-content>.<\/jats:styled-content>3\u00a0s, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00<jats:styled-content>.<\/jats:styled-content>001). Inspiratory muscle strength only improved in NUTRITION (+0<jats:styled-content>.<\/jats:styled-content>5\u00a0\u00b1\u00a00<jats:styled-content>.<\/jats:styled-content>1\u00a0kPa, <jats:italic>P<\/jats:italic>\u00a0=\u00a00<jats:styled-content>.<\/jats:styled-content>001) and steps\/day declined in PLACEBO (\u221218%,<jats:italic>P<\/jats:italic>\u00a0=\u00a00<jats:styled-content>.<\/jats:styled-content>005).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High intensity exercise training is effective in improving lower limb muscle strength and exercise performance in COPD patients with low muscle mass and moderate airflow obstruction. Specific nutritional supplementation had additional effects on nutritional status, inspiratory muscle strength, and physical activity compared with placebo.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12219","type":"journal-article","created":{"date-parts":[[2017,6,13]],"date-time":"2017-06-13T02:42:40Z","timestamp":1497321760000},"page":"748-758","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":133,"title":["A randomized clinical trial investigating the efficacy of targeted nutrition as adjunct to exercise training in COPD"],"prefix":"10.1002","volume":"8","author":[{"given":"Coby","family":"van de Bool","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht University Medical Center+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica P.A.","family":"Rutten","sequence":"additional","affiliation":[{"name":"Department of Research and Education CIRO+ Horn  Haelen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ardy","family":"van Helvoort","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht University Medical Center+  Maastricht The Netherlands"},{"name":"Nutricia Research, Nutricia Advanced Medical Nutrition  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frits M.E.","family":"Franssen","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht University Medical Center+  Maastricht The Netherlands"},{"name":"Department of Research and Education CIRO+ Horn  Haelen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emiel F.M.","family":"Wouters","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht University Medical Center+  Maastricht The Netherlands"},{"name":"On behalf of the CIRO network"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemie M.W.J.","family":"Schols","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht University Medical Center+  Maastricht The 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