{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T21:01:11Z","timestamp":1788210071564,"version":"build-2803163510"},"reference-count":35,"publisher":"BMJ","issue":"1","funder":[{"name":"Eimskip University Fund","award":["HI17040070"],"award-info":[{"award-number":["HI17040070"]}]},{"name":"MS Iceland Dairies"},{"name":"Nutricia"},{"name":"Icelandic Research Fund of the Icelandic Centre for Research","award":["141216-051"],"award-info":[{"award-number":["141216-051"]}]},{"name":"Landspitali University Hospital Research Fund"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2018,11,27]]},"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Intervention studies have mainly used oral nutritional supplements (ONS) for the management of patients with chronic obstructive pulmonary disease (COPD) identified as at nutritional risk. In this 12-month randomised feasibility trial, we assessed the (1) feasibility of the recruitment, retention and provision of two interventions: ONS and between-meal snacks (snacks) and (2) the potential impact of the provision of snacks and ONS on body weight and quality of life in patients with COPD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods\u00a0<\/jats:title>\n                  <jats:p>Hospitalised patients with COPD, at nutritional risk, were randomised to ONS (n=19) or snacks (n=15) providing 600 kcal and 22 g protein a day in addition to regular daily diet. The intervention started in hospital and was continued for 12 months after discharge from the hospital.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results\u00a0<\/jats:title>\n                  <jats:p>Study recruitment rate was n=34 (45%) and retention rate at 12 months was similar for both groups: n=13 (68%) in the ONS group and n=10 (67%) in the Snacks group. Both groups gained weight from baseline to 12 months (2.3\u00b14.6 kg (p=0.060) in the ONS group and 4.4\u00b16.4 kg (p=0.030) in the Snacks group). The St George\u2019s Respiratory Questionnaire total score improved from baseline to 12 months in both groups (score 3.9\u00b111.0 (p=0.176) in the ONS group and score 8.9\u00b114.1 (p=0.041) in the Snacks group).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion\u00a0<\/jats:title>\n                  <jats:p>In patients with COPD who are at nutritional risk snacks are at least as feasible and effective as ONS, however, adequately powered trials that take account of the difficulties in recruiting this patient group are required to confirm this effect.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjresp-2018-000349","type":"journal-article","created":{"date-parts":[[2019,1,4]],"date-time":"2019-01-04T05:17:05Z","timestamp":1546579025000},"page":"e000349","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Oral nutrition supplements and between-meal snacks for nutrition therapy in patients with COPD identified as at nutritional risk: a randomised feasibility trial"],"prefix":"10.1136","volume":"6","clinical-trial-number":[{"clinical-trial-number":"nct02251496","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02251496","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4593-3739","authenticated-orcid":false,"given":"Arora Ros","family":"Ingadottir","sequence":"first","affiliation":[{"name":"Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland"},{"name":"Department of Clinical Nutrition, Landspitali University Hospital, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Marie","family":"Beck","sequence":"additional","affiliation":[{"name":"Faculty of Health, Copenhagen University College, Copenhagen, Denmark"},{"name":"Research Unit for Nutrition, Herlev and Gentofte Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Baldwin","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences, King's College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine Elizabeth","family":"Weekes","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences, King's College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olof Gudny","family":"Geirsdottir","sequence":"additional","affiliation":[{"name":"Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland"},{"name":"The Icelandic Gerontological Research Institute, Landspitali University Hospital and University of Iceland, Reykjavik, 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