Comparative Efficacy of Nutritional Supplements in Modulating Lung Function and Exercise Capacity in COPD Patients: A Network Meta-Analysis

source extracted confidence: high 2026-04-09
#humans #pulmonary-disease-chronic-obstructive #dietary-supplements #exercise-tolerance #lung

Comparative Efficacy of Nutritional Supplements in Modulating Lung Function and Exercise Capacity in COPD Patients: A Network Meta-Analysis

Zeng et al., 2025 | Int J Chron Obstruct Pulmon Dis | Systematic Review

Citation

Zeng Yi, He Tian, ... Zhang Jing. Comparative Efficacy of Nutritional Supplements in Modulating Lung Function and Exercise Capacity in COPD Patients: A Network Meta-Analysis. Int J Chron Obstruct Pulmon Dis. 2025;20:1525-1541. doi:10.2147/COPD.S517252

Abstract

OBJECTIVE: To compare the effects of nutritional supplements on lung function and exercise tolerance in chronic obstructive pulmonary disease (COPD). METHODS: We searched PubMed, Embase, Cochrane Library, and Web of Science for randomized controlled trials (RCTs) on nutritional supplements in COPD patients, with the search ending December 31, 2023. Two authors independently screened studies, extracted data, and assessed quality using the Cochrane risk of bias tool. Data were analyzed using RevMan 5.4 and R 4.2.3. RESULTS: Forty-eight studies with 2481 COPD patients were included. Network meta-analysis showed six supplements significantly improved the 6-minute walk distance (6MWD) (all p<0.05), with the top three being: Coenzyme Q10+ Creatine [MD=63, 95% CI (36, 90)], L-carnitine [MD=53, 95% CI (24, 82)], and anabolic steroids [MD=44, 95% CI (7.1, 82)]. Four supplements improved FEV1%(all p<0.05): nanocurcumin [MD=13, 95% CI (7.7, 18)], Vitamin D [MD=7.5, 95% CI (5.1, 9.9)], probiotics [MD=7.1, 95% CI (5.2, 9.1)] and BSO [MD=4.9, 95% CI (1.6, 8.3)]. In pairwise comparisons, nanocurcumin outperformed BSO and Probiotics. Nanocurcumin [MD=12, 95% CI (4.6, 19), p<0.05] improved FEV1/FVC, and nitrate [MD=26, 95% CI (9.7, 42), p<0.05] was effective for the Incremental Shuttle Walk Test (ISWT). Traditional Chinese Medicine (TCM) products [MD=-1.3, 95% CI (-1.9, -0.67)], melatonin (MLT) [MD=-0.9, 95% CI (-1.6, -0.21)] and Calcitriol [MD=-0.66, 95% CI (-0.93, -0.39)] improved the modified Medical Research Council(mMRC) dyspnea score (all p<0.05), with comparable efficacy among them. CONCLUSION: Nutritional supplements improve lung function and exercise endurance in COPD. Coenzyme Q10+Creatine is most effective for endurance, while Nanocurcumin has the greatest impact on lung function.

Key Findings

Forty-eight studies with 2481 COPD patients were included. Network meta-analysis showed six supplements significantly improved the 6-minute walk distance (6MWD) (all p<0.05), with the top three being: Coenzyme Q10+ Creatine [MD=63, 95% CI (36, 90)], L-carnitine [MD=53, 95% CI (24, 82)], and anabolic steroids [MD=44, 95% CI (7.1, 82)]. Four supplements improved FEV1%(all p<0.05): nanocurcumin [MD=13, 95% CI (7.7, 18)], Vitamin D [MD=7.5, 95% CI (5.1, 9.9)], probiotics [MD=7.1, 95% CI (5.2, 9.1)]

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Pulmonary Disease, Chronic Obstructive
  • Dietary Supplements
  • Exercise Tolerance
  • Lung
  • Treatment Outcome
  • Recovery of Function
  • Aged
  • Walk Test
  • Middle Aged
  • Randomized Controlled Trials as Topic
  • Male
  • Female
  • Forced Expiratory Volume

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review, Network Meta-Analysis
  • Vertical: coq10

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09