Motivational regulations and lifestyle in muscle-wasted COPD patients undergoing pulmonary rehabilitation

M. van Beers; J. J.M. Meis; C. van de Bool; A. M.W.J. Schols; S. P.J. Kremers

doi:10.1016/j.nutos.2021.10.003

Motivational regulations and lifestyle in muscle-wasted COPD patients undergoing pulmonary rehabilitation

M. van Beers, J. J.M. Meis, C. van de Bool, A. M.W.J. Schols, S. P.J. Kremers^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background & Aims: Low physical activity (PA) levels and a poor-quality diet are common in chronic obstructive pulmonary disease (COPD) patients eligible for pulmonary rehabilitation (PR). PR may improve short-term nutritional status and exercise capacity but generally not long-term lifestyle outcomes. We hypothesized that healthy lifestyle motivation is related to PA levels and dietary quality before PR and the responsiveness thereof after PR. Methods: Before and after standardized outpatient PR, 81 COPD patients with low muscle mass completed validated motivational regulation self-reports. Physical (in)activity was assessed before and after PR through 7-day accelerometry (GT3X Actigraph). Dietary quality was assessed using a validated cross-check dietary history before and after PR and quantified as the Mean Adequacy Ratio (MAR). Results: Patients' baseline motivational profile was unrelated to dietary quality or PA. Baseline integrated motivation and its change during PR significantly predicted MAR change during PR and its levels after PR. Baseline introjected motivation and its change during PR significantly predicted PA change during PR and its levels after PR. Conclusions: Specific motivational regulations predict dietary quality and PA improvements of patients with COPD admitted to PR. Therefore, targeting integrated and introjected motivation may be key to achieving lasting behavior change after PR. Registry site: Maastricht University Medical Centre+. Clinical trial identifier number: NCT01344135.

Original language	English
Pages (from-to)	89-101
Number of pages	13
Journal	Clinical Nutrition Open Science
Volume	40
DOIs	https://doi.org/10.1016/j.nutos.2021.10.003
Publication status	Published - 1 Dec 2021

Keywords

Chronic obstructive pulmonary disease
Diet
Motivation
Physical activity
Pulmonary rehabilitation
Self-determination theory

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10.1016/j.nutos.2021.10.003Licence: CC BY-NC-ND

Cite this

@article{fe754a869560476f87ae513ab8244d4b,

title = "Motivational regulations and lifestyle in muscle-wasted COPD patients undergoing pulmonary rehabilitation",

abstract = "Background & Aims: Low physical activity (PA) levels and a poor-quality diet are common in chronic obstructive pulmonary disease (COPD) patients eligible for pulmonary rehabilitation (PR). PR may improve short-term nutritional status and exercise capacity but generally not long-term lifestyle outcomes. We hypothesized that healthy lifestyle motivation is related to PA levels and dietary quality before PR and the responsiveness thereof after PR. Methods: Before and after standardized outpatient PR, 81 COPD patients with low muscle mass completed validated motivational regulation self-reports. Physical (in)activity was assessed before and after PR through 7-day accelerometry (GT3X Actigraph). Dietary quality was assessed using a validated cross-check dietary history before and after PR and quantified as the Mean Adequacy Ratio (MAR). Results: Patients' baseline motivational profile was unrelated to dietary quality or PA. Baseline integrated motivation and its change during PR significantly predicted MAR change during PR and its levels after PR. Baseline introjected motivation and its change during PR significantly predicted PA change during PR and its levels after PR. Conclusions: Specific motivational regulations predict dietary quality and PA improvements of patients with COPD admitted to PR. Therefore, targeting integrated and introjected motivation may be key to achieving lasting behavior change after PR. Registry site: Maastricht University Medical Centre+. Clinical trial identifier number: NCT01344135.",

keywords = "Chronic obstructive pulmonary disease, Diet, Motivation, Physical activity, Pulmonary rehabilitation, Self-determination theory",

author = "{van Beers}, M. and Meis, {J. J.M.} and {van de Bool}, C. and Schols, {A. M.W.J.} and Kremers, {S. P.J.}",

note = "Funding Information: This work was supported by the Lung Foundation Netherlands [grant number 3.4.09.003 ], ZonMW [JPI-HDHL NutriCog-Ambrosiac] and Nutricia Advanced Medical Nutrition. These funders had no involvement in the study design; the collection, analysis and interpretation of data; the writing of the report; or the decision to submit the article for publication. Publisher Copyright: {\textcopyright} 2021",

year = "2021",

month = dec,

day = "1",

doi = "10.1016/j.nutos.2021.10.003",

language = "English",

volume = "40",

pages = "89--101",

journal = "Clinical Nutrition Open Science",

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TY - JOUR

T1 - Motivational regulations and lifestyle in muscle-wasted COPD patients undergoing pulmonary rehabilitation

AU - van Beers, M.

AU - Meis, J. J.M.

AU - van de Bool, C.

AU - Schols, A. M.W.J.

AU - Kremers, S. P.J.

N1 - Funding Information: This work was supported by the Lung Foundation Netherlands [grant number 3.4.09.003 ], ZonMW [JPI-HDHL NutriCog-Ambrosiac] and Nutricia Advanced Medical Nutrition. These funders had no involvement in the study design; the collection, analysis and interpretation of data; the writing of the report; or the decision to submit the article for publication. Publisher Copyright: © 2021

PY - 2021/12/1

Y1 - 2021/12/1

N2 - Background & Aims: Low physical activity (PA) levels and a poor-quality diet are common in chronic obstructive pulmonary disease (COPD) patients eligible for pulmonary rehabilitation (PR). PR may improve short-term nutritional status and exercise capacity but generally not long-term lifestyle outcomes. We hypothesized that healthy lifestyle motivation is related to PA levels and dietary quality before PR and the responsiveness thereof after PR. Methods: Before and after standardized outpatient PR, 81 COPD patients with low muscle mass completed validated motivational regulation self-reports. Physical (in)activity was assessed before and after PR through 7-day accelerometry (GT3X Actigraph). Dietary quality was assessed using a validated cross-check dietary history before and after PR and quantified as the Mean Adequacy Ratio (MAR). Results: Patients' baseline motivational profile was unrelated to dietary quality or PA. Baseline integrated motivation and its change during PR significantly predicted MAR change during PR and its levels after PR. Baseline introjected motivation and its change during PR significantly predicted PA change during PR and its levels after PR. Conclusions: Specific motivational regulations predict dietary quality and PA improvements of patients with COPD admitted to PR. Therefore, targeting integrated and introjected motivation may be key to achieving lasting behavior change after PR. Registry site: Maastricht University Medical Centre+. Clinical trial identifier number: NCT01344135.

AB - Background & Aims: Low physical activity (PA) levels and a poor-quality diet are common in chronic obstructive pulmonary disease (COPD) patients eligible for pulmonary rehabilitation (PR). PR may improve short-term nutritional status and exercise capacity but generally not long-term lifestyle outcomes. We hypothesized that healthy lifestyle motivation is related to PA levels and dietary quality before PR and the responsiveness thereof after PR. Methods: Before and after standardized outpatient PR, 81 COPD patients with low muscle mass completed validated motivational regulation self-reports. Physical (in)activity was assessed before and after PR through 7-day accelerometry (GT3X Actigraph). Dietary quality was assessed using a validated cross-check dietary history before and after PR and quantified as the Mean Adequacy Ratio (MAR). Results: Patients' baseline motivational profile was unrelated to dietary quality or PA. Baseline integrated motivation and its change during PR significantly predicted MAR change during PR and its levels after PR. Baseline introjected motivation and its change during PR significantly predicted PA change during PR and its levels after PR. Conclusions: Specific motivational regulations predict dietary quality and PA improvements of patients with COPD admitted to PR. Therefore, targeting integrated and introjected motivation may be key to achieving lasting behavior change after PR. Registry site: Maastricht University Medical Centre+. Clinical trial identifier number: NCT01344135.

KW - Chronic obstructive pulmonary disease

KW - Diet

KW - Motivation

KW - Physical activity

KW - Pulmonary rehabilitation

KW - Self-determination theory

U2 - 10.1016/j.nutos.2021.10.003

DO - 10.1016/j.nutos.2021.10.003

M3 - Article

SN - 2667-2685

VL - 40

SP - 89

EP - 101

JO - Clinical Nutrition Open Science

JF - Clinical Nutrition Open Science

ER -