Nutritional assessment in idiopathic pulmonary fibrosis: a prospective multicentre study

Background Nutritional status (NS) impacts on quality of life and prognosis of patients with respiratory diseases including idiopathic pulmonary fibrosis (IPF). However, there is a lack of studies performing an extensive nutritional assessment of IPF patients. This study aims to investigate the NS and to identify nutritional phenotypes in a cohort of IPF patients at diagnosis. Methods Patients underwent a thorough pulmonary and nutritional evaluation including questionnaires on NS and physical activity, anthropometry, body impedence, dynamometry, 4-meter gait speed and blood tests. Results 90 IPF patients (78.9% males, mean age 72.7 years) were enrolled. The majority of patients were classified as Gender-Age-Physiology Index stage 2 (47, 52.2%) with an inactive lifestyle according to International Physical Activity Questionnaire score (39, 43.3%) and had mean forced vital capacity and diffusing capacity for carbon monoxide 86.5% and 54.2%, respectively. In regards to nutritional phenotypes, the majority of patients were normally nourished (67.8%, 95% Confidence Interval (CI):58.6–77.7), followed by non-sarcopenic obese (25.3%, 95%CI:16.1–35.2), sarcopenic (4.6%, 95%CI:0.0–14.5) and sarcopenic obese (2.3%, 95%CI:0.0–12.2). Among normally nourished, 49.2% showed early signs of nutritional and physical performance alterations, including body mass index≥ 30 in 4.3%, history of weight loss≥ 5% in 11.9%, reduction of gait speed and hand grip strength in 11.9% and 35.6%, respectively. Low vitamin D values were observed in 56.3% of cases. Conclusions IPF patients at diagnosis are mainly normally nourished and obese, but early signs of nutritional and physical performance impairment can already be identified at this stage.