Targeted Nutrient Supplement in COPD (NUTRECOVER-trial)

Subjects will wear an activPAL accelerometer for 1 week to assess physical activity.

The EQ-5D is a generic classification system used to characterize current health states of patients. It consists of 5 domains (mobility; self-care; usual activity; pain/discomfort; anxiety/depression) and a visual analogue scale (EQ-VAS). The domains have a scale from 1-3 and the VAS-scale from 0-100 in which higher values represent a better outcome.

The investigators will use the Motor Screening Task, Reaction Time Task, Paired Associates Learning, Delayed Matching-to-Sample, Spatial Working Memory and Stop Signal Task. The higher the score on these tasks, the better the cognitive function.

The DASS-21 measures 3 related states of depression, anxiety and stress. The DASS-21 consists of 21 negative emotional symptoms and subjects will be asked to extent to which have experienced each symptom over the past week, on a 4-point severity/frequency scale. The total score will range from 0-66 in which a higher score means more susceptibility to depression.

The HADS will allow the investigators to measure domain-specific quality of life. This is a 14-item instrument designed to detect the presence and severity of mild degrees of mood disorder, anxiety and depression in hospital and community setting and outside. Per scale (anxiety and depression) a maximum of 21 points can be scored, in which a higher score means worse outcome.

The PSS is a measure of the degree to which situations in one's life are appraised as stressful. Individual scores on the PSS can range from 0 to 40 with higher scores indicating higher perceived stress.

The SECPT asks the participant to immerse their right hand up to and including the writs into ice water for a maximum of 3 minutes. Blood pressure will be measured before and after the test.

The SECPT asks the participant to immerse their right hand up to and including the writs into ice water for a maximum of 3 minutes. Cortisol in the saliva will be measured before and after the test.

Cortisol level in hair is a biomarker of chronic stress.

Three manoeuvres will be performed: the balance test, the gait speed test and the chair stand test. Each individual can score 0-12 points in which a higher score means a better physical performance.

Handgrip strength is measured in the dominant hand using a hydraulic grip strength dynamometer.

The mouth pressure will be measured using the MicroRPM monitor.

Subjects will be instructed to walk as fast as possible for 6 minutes. The distance walked during these 6 minutes will be measured.

Using the DEXA-scan three compartments of the body composition (lean mass, fat mass, bone mass) will be measured.

Weight will be measured in kg.

Height will be measured in cm.

Markers include high-sensitive C-reactive protein, procalcitonin, interleukin-6, interleukin-8 and leucocyte levels.

Markers include vitamin E, vitamin D, poly unsaturated fatty acids, amino acids (tryptophan), and homocysteine.

Markers include tryptophan, kynurenine and kynurenic acid.

The CIS is a 20-item self-report questionnaire that measures several aspects of fatigue: fatigue severity, concentration, motivation and physical activity. Individual scores can range from 20-140 in which higher scores mean fatigue problems.

Pain will be assessed by the VAS range from 0-100, in which a higher score means more pain experience.

The PSQI is a self-report questionnaire to assess sleep quality. It consists of 19 individual items, creating 7 components that produce one global score (0-21, in which higher scores indicate worse sleep quality).

IFABP is a marker for intestinal integrity.

IFABP is a marker for intestinal integrity.

Several analysis will be performed after completion of the study. The exact markers of the microbiome will be determined.

Measured by spirometry within 3 previous months.

Measured by spirometry within 3 previous months.

Measured by body plethysmography within 3 previous months

Measured by body plethysmography within 3 previous months

measured within 3 previous months

The CAT score ranges from 0-40, in which a higher score means worse outcome.

The CCQ is a 10-item questionnaire and individual scores range from 0-6 in which a higher score means worse health status

The MRC-scale ranges from 0-5 in which a higher score means more breathlessness.

All medications used by participants will be reported to determine difference in medication use between groups.

Comorbidities will be extracted from the medical history

3-day 24h food diary

retrieved from medical records

Viral or bacterial infection based on medical records

from the medical records

from the medical records

To determine difference between COPD patients and healthy controls in gut microbiome composition, 30 healthy controls will sample stool at baseline which will be compared to a subgroup of 30 COPD patients.

To ascertain that healthy controls have no obstructive lung disease, a baseline lung function measurement will be performed in the 30 healthy controls and compared to a subgroup of 30 COPD patients.

To determine difference between COPD patients and healthy controls in systemic inflammation, blood samples will be obtained at baseline from 30 healthy controls and compared to a subgroup of 30 COPD patients.

To determine difference between COPD patients and healthy controls in food intake, a 3-day 24h food diary will be obtained at baseline from 30 healthy controls and compared to a subgroup of 30 COPD patients.

To determine difference between COPD patients and healthy controls in medication use, all medications used by the 30 healthy controls will be reported at baseline and compared to a subgroup of 30 COPD patients.