Summary
Chronic obstructive pulmonary disease (COPD) is a respiratory disease associated with airways inflammation and lung parenchyma fibrosis. The primary goals of COPD treatment are to reduce symptoms and risk of exacerbations, therefore pulmonary rehabilitation is considered the key component of managing COPD patients. Oxidative airway damage, inflammation and reduction of endogenous antioxidant enzymes are known to play a crucial role in the pathogenesis of COPD. Recently, also natural antioxidants have been considered as they play an important role in metabolism, DNA repair and fighting the effects of oxidative stress. In this paper we evaluated the response of 105 elderly COPD patients to pulmonary rehabilitation (PR), based on high or low vegetable consumption, by analyzing clinical parameters and biological measurements at baseline and after completion of the three weeks PR. We found that daily vegetable intake in normal diet, without any specific intervention, can increase the probability to successfully respond to rehabilitation (65.4% of responders ate vegetables daily vs. 40.0% of non-responders, p = 0.033). The association was especially evident in subjects ≥ 80 year of age (OR = 17.0; p < 0.019). Three weeks of pulmonary rehabilitation are probably too short to reveal a reduction of the oxidative stress and DNA damage, but are enough to show an improvement in the patient’s inflammatory state.

Relevance
This study, analyzed clinical and biological data to assess the response of older COPD patients to pulmonary rehabilitation based on high or low vegetable consumption. A respiratory condition called chronic obstructive pulmonary disease (COPD) is linked to lung parenchymal fibrosis and airway inflammation. It is well recognized that endogenous antioxidant enzymes are diminished, inflammation, and oxidative airway damage all play a significant part in the pathophysiology of COPD. This study discovered that regular vegetable consumption in a typical diet, without any special interventions, can raise the likelihood that a patient will respond favorably to rehabilitation. The relationship was particularly clear in those who were older. This is significant since chronic lung illness is more common in older people. This study demonstrates that a patient's inflammatory state may improve and oxidative stress and DNA damage may be reduced as a result of eating healthful foods.