Patients diagnosed with idiopathic pulmonary fibrosis (IPF) may present with early signs of nutritional and physical performance impairments, according to a new study published in ERJ Open Research.

The study assessed the nutritional status of 87 patients with IPF. The mean body mass index was 27.6±4.0 kg/m2. Most patients were in the overweight (44.8%) and the nonsarcopenic obesity classes (27.6%), about a quarter of patients (27.6%) had normal weight, and none were underweight.

The evaluation of the primary outcome revealed that normonourished was the most prevalent nutritional phenotype at the first nutritional visit (67.8%, 95% CI, 58.6%-77.7%). Most normally nourished patients showed early signs of impairment in nutritional and physical performances, including body mass index ≥30 kg/m2 in 3.4% of cases, history of weight loss ≥5% in the prior 3 months in 11.9% of patients, and reduction in gait speed and handgrip strength in 11.9% and 35.6% of cases, respectively.

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Normonourished phenotype was followed by nonsarcopenic 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%) phenotypes.

The authors observed no difference in nutritional phenotypes and main nutritional variables between patients with IPF who received oral steroids and those who did not. However, they did find that patients with IPF who received oral steroids showed poorer physical status (indicated by lower handgrip strength and slower 4-m gait speed) than those who did not.

“Our results suggest two crucial considerations: first, the importance of an early and comprehensive nutritional
screening in patients with IPF, in order to promptly initiate nutritional and rehabilitation programmes that may reduce nutritional and physical performance impairment; secondly, the importance of an early IPF diagnosis, as the introduction of a rehabilitation programme or lifestyle modifications when the disease is already in a moderate-to-severe stage may be difficult and potentially worthless,” the authors concluded.


Faverio P, Fumagalli A, Conti S, et al. Nutritional assessment in idiopathic pulmonary fibrosis: a prospective multicentre study. ERJ Open Res. 2022;8(1):00443-02021. doi:10.1183/23120541.00443-2021