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Nutrition and Exercise Tolerance in Chronic Diseases and Sport: From Basic Research to Clinical Trials

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: 25 August 2026 | Viewed by 252

Editor


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Guest Editor
Department of Pulmonology, Semmelweis University, 1083 Budapest, Hungary
Interests: cytokines; lung; respiratory; lung diseases; asthma; physiotherapy; physical education; respiratory physiology; plasma; exercise science; chronic heart failure; nutrition
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Special Issue Information

Dear Colleagues,

Sarcopenia and frailty are prevalent yet under-recognized contributors to disability, reduced quality of life, and adverse outcomes in chronic respiratory and heart diseases. Body composition, including lean body mass and muscle type, are crucial to improving exercise tolerance in athletes. Shared mechanisms, including systemic inflammation, hormonal imbalance, malnutrition, and inactivity, make these syndromes potential targets for multimodal intervention. Combining exercise, targeted nutrition, and selected pharmacological or adjunctive interventions offers the best potential for mitigating sarcopenia and frailty in chronic respiratory and heart diseases. The combined effect of exercise training and nutrition is crucial in sport. This Special Issue will focus on using biomarkers to understand pathophysiological mechanisms. We solicit manuscripts on this topic that take the form of basic research, clinical trials, or reviews.

Dr. Janos T. Varga
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • nutrition
  • exercise tolerance
  • sarcopenia
  • frailty
  • chronic respiratory and heart diseases
  • exercise training
  • biomarkers
  • basic research
  • clinical trials

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Published Papers (1 paper)

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Review

39 pages, 1005 KB  
Review
Sarcopenia and Frailty in COPD: Mechanisms, Relationship with Malnutrition and Potential Therapeutic Interventions
by Saoussen Naas, Mónika Fekete, Riad Bejta, Regina Bakos, Borbála Szalai and János Tamás Varga
Nutrients 2026, 18(12), 2003; https://doi.org/10.3390/nu18122003 (registering DOI) - 20 Jun 2026
Abstract
Background: Sarcopenia and frailty are highly prevalent extrapulmonary manifestations of chronic obstructive pulmonary disease (COPD) and are strongly associated with reduced exercise tolerance, exacerbation risk, hospitalizations, and mortality. Beyond inflammation, oxidative stress, and physical inactivity, emerging evidence highlights nutrition as a major modifiable [...] Read more.
Background: Sarcopenia and frailty are highly prevalent extrapulmonary manifestations of chronic obstructive pulmonary disease (COPD) and are strongly associated with reduced exercise tolerance, exacerbation risk, hospitalizations, and mortality. Beyond inflammation, oxidative stress, and physical inactivity, emerging evidence highlights nutrition as a major modifiable driver of muscle deterioration in COPD. Nutritional deficits impair anabolic signaling, exacerbate proteolysis, worsen mitochondrial dysfunction, and contribute to frailty progression. Methods: This narrative review synthesizes evidence from PubMed, Embase, Scopus, and Web of Science up to 2025, integrating mechanistic, metabolic, nutritional, and biomarker-related pathways underlying muscle dysfunction in COPD. Studies examining inflammation, hypoxemia, oxidative stress, hormonal imbalance, nutrition, and emerging biomarkers were included. Results: COPD-related sarcopenia results from converging inflammatory (TNF-α, IL-6), catabolic (FOXO, UPS), metabolic, and vascular mechanisms, compounded by energy deficiency, protein insufficiency, and micronutrient deficits. Inadequate intake of protein, vitamin D, antioxidants, and omega-3 fatty acids increase anabolic resistance, enhance muscle catabolism, and worsen frailty. Nutritional interventions, particularly high-protein supplementation, leucine-enriched formulas, vitamin D repletion, omega-3 fatty acids, and multimodal nutrition–exercise programs, demonstrate benefits in muscle mass, strength, and physical performance. Biomarkers such as GDF-15, CAF22, and specific microRNAs reflect nutritional status and correlate with muscle health in COPD. Conclusions: Sarcopenia and frailty in COPD arise from a complex interplay of inflammatory, metabolic, nutritional, and lifestyle-related factors. Integrating nutritional assessment and targeted dietary interventions with exercise and pulmonary rehabilitation is essential to counteract anabolic resistance and improve functional outcomes. Advances in biomarker research may support earlier diagnosis and personalized nutrition-based therapeutic strategies. Full article
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