Nutrition

Fueling Your body and mind: Nutrition Tips for COPD

People with COPD use 700 extra calories to breathe each day. Nutrition is key to manage COPD disease

Chronic obstructive pulmonary disease (COPD) makes breathing more difficult, so making sure that you get the right nutrients can not only support your lung health but also your overall quality of life. Attention to nutrition can also help manage the weight disturbances that are often caused by COPD since this disease can cause people to unintentionally gain or lose weight.

There are a variety of reasons why COPD affects appetite, nutrition requirements, and weight.

• Dyspnea, or shortness of breath, can make it hard to eat.

• People may be too tired or fatigued to eat.

• Food may not taste or smell as good.

• People may have dry mucous membranes in their mouth and nose, making it difficult or unpleasant to eat.

• People with COPD may feel full after only eating a little.

As a result, many may lose weight over time, and about one-third of people with COPD experience malnutrition. Additionally, due to the increased work to breathe many people with COPD face, it can be a challenge to get enough calories, as on average, people with COPD use 700 extra calories to breathe each day.
On the other hand, some people with COPD eat more as a result of feeling bored or anxious, causing them to gain weight. Some become less active as a result of shortness of breath and lack of energy, which can lead to weight changes. Prednisone, a common medication used to manage COPD flare-ups, can also cause weight gain.
If you have COPD, proper nutrition can make a significant difference in living with and managing your condition. A well-balanced diet rich in complex carbohydrates, fibre, protein, and healthy fats has been shown to reduce lung inflammation, maintain and improve muscle strength, improve lung function, and lower the risk of metabolic and heart disease.

 

Your health care team can help. You can ask your doctor to help you find a registered dietitian (RD) to make the best meal plan for you—based on the foods you like and don’t like, your schedule, your income, your energy, and any other health conditions or dietary needs you may have. Learning about nutrition from an experienced professional is a great way to help you feel better.

Foods to focus on

Everyone’s dietary needs will be different, but for people with COPD, there are specific foods that are known to help maintain a good quality of life. Here’s what to look for.

Complex carbohydrates

Complex carbohydrates can be found in foods like whole-grain bread and pasta and fresh fruits and vegetables. Carbohydrates are broken down into the energy that is required by all of the cells in the body.

Fibre-rich foods

Foods like beans and lentils, fruits, vegetables such as asparagus, nuts and seeds, and whole grains are great sources of fibre. A person with COPD should consume around 20–30 grams of fibre every day. Fibre helps us feel full longer and have regular bowel movements.

Mono- and poly-unsaturated fats

Mono- and poly-unsaturated fats are liquid when stored at room temperature and often come from plants. Olive and avocado oil, salmon, avocados, nuts, and seeds are all examples of mono- and poly-unsaturated fats. Fats are a calorie-dense food, which means a little can go a long way. The body uses them for energy, storage of vitamins, and as building blocks for many of its vital structures.

Protein

Meat and poultry, fish, tofu, edamame, eggs, nuts and seeds, cheese, cottage cheese, and milk are all excellent sources of protein. Protein can also be found in powdered form that can be added to drinks, shakes, smoothies, and other recipes. Protein can help build and repair muscle and can add balance to a carbohydrate-dominant meal or snack to help you feel fuller longer.

Fluids

Drinking plenty of water not only keeps you hydrated but also keeps your airways hydrated, which can help loosen sticky, stubborn mucus. A good goal for most people is to drink about 8 glasses (8 fluid ounces or 250 mL each) of water a day. This varies from person to person and can depend on many things like how active you are, your age, what you eat, and the medications you take. Tea, coffee, milk, shakes, fruit, and other beverages will also keep you hydrated. Be wary of alcohol, however, as it dehydrates you. Many people add lemon, fruit, herbs, or other flavourings to their water to make it more appealing. Some people may be on a fluid-restricted diet due to a condition like heart failure. In that case, talk to your doctor about how much fluid you should be consuming each day.

Ways to increase calorie intake

For some people with COPD, especially those with malnutrition, it is essential to increase the number of calories they take in every day. This can help preserve strength and prevent muscle wasting and excessive weight loss. People often feel better too!

High-fat supplements

A high-fat diet is one of the best ways for people with COPD and malnutrition to take in more calories. Studies are still ongoing, but what we know so far is that upping the fats (rather than the carbohydrates) in the diet is a good way to get nutrition efficiently and even improve oxygen levels. Omega-3 fatty acids have also been shown to help improve lung function in people with COPD.

Calorie-dense supplement drinks

Foods like beans and lentils, fruits, vegetables such as asparagus, nuts and seeds, and whole grains are great sources of fibre. A person with COPD should consume around 20–30 grams of fibre every day. Fibre helps us feel full longer and have regular bowel movements.

Add exercise

Studies have shown that people with COPD can optimize their muscle mass, weight, strength, and lung function by combining nutritional supplement drinks with pulmonary rehabilitation exercises.

Amino acids

Amino acids are the building blocks of proteins and help the body to build and repair muscle tissue. Amino acids can be taken in supplement form as EAAs (essential amino acids) or BCAAs (branched-chain amino acids). Adding these muscle building blocks can help people with COPD feel significantly better in their daily lives with better muscle strength and mental functioning.

Vitamins and minerals

People with COPD are often found to be low in vitamin D. Taking a daily multivitamin can also help ensure that levels of antioxidants, vitamins, and minerals are optimal.

Foods that are good in moderation

It’s important to strike a balance when it comes to nutrition. Try to focus on balanced meals and snacks that include complex carbohydrates, fibre, protein, and fats. Here are some of the foods that are traditionally advised to be eaten in moderation. But remember, there are many factors that go into what we eat. Culture, cost, convenience, texture, taste…and the list goes on!

Trans fats and saturated fat

Many high-fat foods are nutritious, but some should be eaten in moderation. To promote overall health, people with COPD should limit highly processed foods that contain trans fats and saturated fats. These foods include bacon and other processed meats, fast food, butter, fried food, ice cream, and sugary pastries, among others.

Simple carbohydrates

Simple carbohydrates provide fewer nutrients than complex carbohydrates. They can be filling at first, but often do not keep us satisfied or full for very long. A good rule of thumb is to eat simple carbohydrates in moderation and for a more balanced snack or meal, combine them with sources of protein, fibre, and fat. Simple carbohydrates include chocolate and candy, table sugar, cakes and other sugary desserts, sugary drinks, as well as white bread and pasta.

Sodium

Sodium can cause edema, also known as swelling, and may increase blood pressure. If a person with COPD has edema or high blood pressure, they should talk to their doctor about how much sodium they should be eating every day.

Example meal plan

Breakfast: Oatmeal with fruit and peanut or almond butter
Snack: Fresh sliced vegetables and a boiled egg
Lunch: Green salad with grilled chicken breast and rice
Snack: Mixed nuts
Dinner: Grilled salmon with quinoa and roasted vegetables
Dessert: Greek yogourt with fruit

Cooking tips

Cooking food can consume a lot of energy for people with COPD, making it a challenge to maintain a balanced, home-cooked diet. However, there are steps that people with COPD can take to make cooking meals easier and more sustainable:

• Try batch cooking. Batch cooking, or meal prepping, allows you to prepare food for multiple meals at once. Extra portions can be frozen or eaten throughout the week. This way, you can get a large amount of cooking done so that you won’t have to worry about cooking for a longer period of time.

• Consider meal prepping with a family member or friend to share the work and get double the meals.

• Use a crock pot or Instant Pot®. These handy devices can speed up the cooking process, or limit the amount of work required to cook certain recipes.

• Follow easy recipes. Choosing recipes with minimal ingredients that take 30 minutes or less to make will make cooking much less strenuous.

• Use pre-cut fruit and vegetables. This will help you save energy and time when preparing food.

• Try a meal kit subscription service.

• Ask a friend or use a service to help with grocery shopping to conserve energy. (Bonus: You can use the time saved from going to the grocery to prepare some delicious meals.)

• Use a meal delivery service like Meals on Wheels.

How can I avoid shortness of breath while eating?

Aside from cooking, some people with COPD struggle when eating food. This is largely due to the shortness of breath that often happens while eating. To minimize discomfort, try to:

• Take smaller bites.

• Take your time while eating, chewing slowly.

• Eat small meals instead of large ones. This prevents your stomach from pushing on your diaphragm and interfering with your breathing.

• Rest before eating if eating makes you feel tired or short of breath.

• Try using your bronchodilator puffer (like Ventolin) before a meal.

• Try to cough up excess mucus before you eat.

• Remove pressure on your lungs by eating while sitting up.

• Avoid foods that are difficult to chew.

• Drink liquids after your meal.

• Limit talking and conversations during a meal.

• Try pursed-lip breathing if you feel short of breath.

 

Nutrition plays a major role in the maintenance of COPD, and it’s important to eat foods that will supply your body with all of the nutrients it needs. In addition to good nutrition, exercise is also an essential part of COPD management. To learn more about exercise and COPD, read this article.

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