JPEN J Parenter Enteral Nutr. 2022 Apr 19. doi: 10.1002/jpen.2385. Online ahead of print.
ABSTRACT
BACKGROUND: Macronutrients can differently affect respiratory function markers such as VO2 , VCO2 , PaO2 , PaCO2 and respiratory quotients (RQ), but systematic appraisal of the evidence on randomized clinical trials (RCTs) is lacking.
OBJECTIVE: To compare the response of respiratory function markers to high-carbohydrate and high-fat intake in patients with lung diseases.
METHODS: Systematic review conducted according to Cochrane Collaboration recommendations, reported following PRISMA 2020. PubMed, EMBASE, Scopus, and Cochrane CENTRAL were searched up to July/2021. Two reviewers selected the RCTs and extracted the data. Risk of bias and the certainty of evidence were assessed by RoB 2 and GRADE, respectively. Statistical and graphical data guided the publication bias investigation. Meta-analyses were conducted.
RESULTS: We included 14 RCTs (362 participants), four of which were parallel. Most studies included patients with COPD. High-fat intake decreased VCO2 [MD = -35.89(95%CI -45.24; -26.21) ml/min; I²=0%], VO2 [MD= -29.30(95% CI -40.94, -17.66) ml/min; I² = 0%], PaCO2 [MD = -4.62(95%CI -7.67; -1.58) mmHg; I²=84%], and RQ [MD = -0.08(95%CI -0.09; -0.06); I² = 0%] in the subset of parallel RCTs. In crossover RCTs, there was generally no evidence of effect except for a greater decrease in RQ [MD = -0.09(95%CI -0.12; -0.02); I² = 96%] in favor of high fat intake.
CONCLUSION: High-fat intake resulted in greater reductions of VCO2 , VO2 , PaCO2 , and RQ in adult patients with lung diseases. The certainty of the evidence is very low/ low, and it precludes a specific recommendation on macronutrients contribution to energy intake of these patients. This article is protected by copyright. All rights reserved.
PMID:35437762 | DOI:10.1002/jpen.2385
