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Dyspnoea was measured with Medical Research Council and BORG scales. Exercise capacity was measured through 6-min walk test and shuttle tests; [http://en.wikipedia.org/wiki/Vatalanib Vatalanib (PTK787) 2HCl] health-related quality of life was assessed with St. George's Respiratory Questionnaire. Psychological status was measured with Hospital Anxiety and Depression Scale. Body weight and body mass indexes (BMI) were also evaluated. Fat-free mass was measured through bioelectrical impedance analyser. The CSA of quadriceps was calculated in mid-level of the thigh with magnetic resonance imaging. Dyspnoea and total scores of St. George's Respiratory Questionnaire improved in both groups (P?[http://www.selleckchem.com/products/Docetaxel(Taxotere).html Docetaxel] in lean body mass and mid-thigh CSA. This study suggests combining NS with PR in reversing weight loss and muscle wasting in COPD. Chronic obstructive pulmonary [http://www.selleckchem.com/products/EX-527.html EX 527 clinical trial] disease (COPD) is a systemic disease. Nutritional depletion commonly occurs in patients with COPD, causing muscle wasting and impaired function that are reported in between 20% and 35% of COPD cases.[1-4] Negative protein balance caused by inflammation cannot be treated by nutritional supplementation (NS) alone and therefore Schols[5] recommends that NS should be combined with exercise training (pulmonary rehabilitation (PR)) in order to improve muscle function and exercise performance. Other studies also recommend to encourage COPD patients to participate in a PR program in order to augment the effects of any nutritional supplement.[6, 7] Efthimiou et?al.[8] found significant improvements in body weight, triceps skinfold thickness and mid-arm circumference with NS. Therefore, ongoing research is required to find the optimal method for these interventions. In our study; we aimed to determine the effects of oral NS incorporated into an 8-week PR primarily on body composition, mid-thigh cross-sectional area (CSA). Dyspnoea, exercise capacity, health-related quality of life and psychological status (anxiety, depression) were also evaluated in depleted advanced COPD patients in comparison with PR and control COPD patients. The study group consisted of patients from Ege University Hospital outpatient clinic who were admitted to the PR unit.