Nutrition

Maintaining a Healthy Lifestyle
Maintaining a healthy lifestyle is a good idea for everyone. But as one of more than 12.1 million Americans who have chronic obstructive pulmonary disease, or COPD, you need to be especially aware of the ways in which your lifestyle, including your diet, affects your health. The proper diet, along with the physical activity recommended by your health care team, will keep your arm, chest, and leg muscles strong and your heart and lungs well supplied with oxygen.

Eating Right
Most people are surprised to learn that the food they eat may affect their breathing. Your body uses food as fuel for all of its activities. The process of changing food to fuel in the body is called metabolism. Oxygen and food are the raw materials of the process, and energy and carbon dioxide are the finished products. Carbon dioxide is a waste product and is exhaled. Your body uses the energy to function. The right mix of nutrients in your diet can help you breathe easier. No single food will supply all the nutrients you need. A healthy diet has lots of variety. You and your health care team will work out a meal plan just for you. Be sure to tell your team:

  • What foods you like
  • What foods you don't like and won't eat
  • Your daily schedule, including your exercise
  • Other health problems or special dietary needs you have

Food Plan
Foods contain three major sources of energy: carbohydrates, protein, and fat. The metabolism of each requires a different amount of oxygen and produces a different amount of carbon dioxide. Metabolism of carbohydrates produces the most carbon dioxide for the amount of oxygen used; metabolism of fat produces the least. For some people with COPD, eating a diet with less carbohydrates and more fat helps them to breathe easier.

You should talk with a registered dietitian nutritionist (RDN) who specializes in COPD. An RDN can work with you to develop a food plan you can live with; provide tips on reading food labels, grocery shopping, cooking and baking, and eating away from home; and recommend cookbooks and other materials. An RDN can also review your medications and discuss any possible drug-food interactions with you.

You can find an RDN who specializes in COPD by asking your doctor, or by visiting the Academy of Nutrition and Dietetics at www.eatright.org.

An RDN will consider these factors when designing your food plan:

Calorie intake to meet energy needs
A diet with the amount of calories your body needs will give you energy to help you do the things you want to do. Your body may be using more calories than you think. A person with COPD can burn 10 times as many calories breathing as a healthy person does. Some people with COPD find that they lose weight without trying. Others find they become overweight easily.

Carbohydrate intake
Carbohydrates are the major sources of fuel for the body. Simple carbohydrates, also called sugar, are a main component of foods such as table sugar, candy, cake, and regular soft drinks. Complex carbohydrates, such as those in breads, pastas, and vegetables, are a good source of vitamins, minerals, and fiber. Dietary fiber, which comes mainly from foods high in complex carbohydrates, is an important part of the diet, especially for older people. Health care experts recommend 20 to 35 grams of fiber a day to help maintain bowel function.

Protein intake
Muscle and other body tissues are composed of protein. Experts believe the need for protein may increase as we age. It is important that people with COPD eat good source of protein at least twice a day to help maintain strong respiratory muscles. The best sources of protein are milk, eggs, cheese, meat, fish, poultry, nuts, and dried beans or peas.

Fat intake
Fat is a rich source of energy. It also produces the least carbon dioxide when it is metabolized. More fat can be eaten if gaining weight is important. Less fat can be included in the diet if your goal is to lose weight.

There are several different types of fats. Generally, saturated fat and trans fat are bad for your health. Mono- and polyunsaturated fats are better for your health.

Saturated fats often are solid at room temperature and come mainly from animal sources - butter, lard, fat, and skin fat of meat and poultry - and from palm, coconut, and hydrogenated vegetable oils. Limit sources of animal fats and try to cut down on the amount of visibly fatty meats that you eat.

Mono- and polyunsaturated fats do not contain cholesterol. These fats are often liquid at room temperature and come from plant sources - canola, safflower, and corn oils. If your RD tells you to increase the fat in your diet, make it the polyunsaturated kind. Use liquid vegetable oils, soft margarines, and mayonnaise made from plant oils. The need to follow a diet low in cholesterol and saturated fat varies from person to person. Be sure to discuss the role of fat in your diet with your doctor and RDN.

Trans fat is made when vegetable oils are hardened into shortening and margarine. It is also found in fried foods such as fried chicken and french fries. Many cookies, crackers, doughnuts, and pastries contain trans fat. Read the label on food packages and limit foods that contain trans fat.

Vitamin and mineral intake
Many people find taking a general-purpose multivitamin helpful. Often, people with COPD take steroids. Long-term use of steroids may increase your need for calcium. Consider taking calcium supplements. Look for one that includes vitamin D. Calcium carbonate or calcium citrate are good sources of calcium. Before adding any vitamins to your daily routine, be sure to discuss with your doctor.

Sodium intake
Too much sodium may cause edema (swelling) that may increase blood pressure. If edema or high blood pressure are health problems for you, talk with your doctor about how much sodium you should be eating each day. Ask your RD about the use of spices and herbs in seasoning your food and other ways you can decrease your sodium intake.

Fluid intake
Fluids are important because two thirds of our body is water. A good intake of water is important to help keep mucus thin for easier removal. Talk with your doctor about your water intake. A good goal for many people is 6 to 8 glasses (8 fluid ounces each) daily. Don't try to drink this much fluid at once; spread it out over the entire day. Some people find it helpful to fill a water pitcher every morning with all the water they are supposed to drink in one day. They then refill their glass from that pitcher and keep track of their progress during the course of the day. Remember, any healthy fluid counts toward your fluid goal, and most foods contribute a substantial amount of fluid, as well.

Timing of meals
Eating several small meals a day instead of two or three large ones can help you eat well and not feel uncomfortable. Here's why: Your organs aren't packed tightly inside your body. A muscular membrane, the diaphragm, is in the space between the lungs and the stomach. The diaphragm moves down and up as you breathe in and out. A full stomach presses up into the space below the diaphragm. This keeps the diaphragm from moving as far down as it should when you breathe in and your lungs don't fill completely.

Try dividing your day's food into 4 to 6 small meals. You can eat a small breakfast, lunch, and dinner. Then get the rest of your nutritional needs for the day by eating two or three between-meal snacks.

Another idea to help you feel more comfortable after eating is to limit foods that may produce gas. For some people, these foods include broccoli, cauliflower, beans, and carbonated beverages. You may want to try using Beano®, if you would still like to eat some of those vegetables.

In addition, try not to rush through your meal. Eat slowly in a relaxed manner. Sometimes if you try to eat very quickly, you may accidentally swallow air. This results in more air in your stomach and greater discomfort.

Checking your weight
Get in the habit of weighing yourself regularly. The scale will alert you to weight loss or gain. You should see your doctor or dietitian if you continue to lose weight or see a weight gain while following the recommended diet. You can be too thin! A well-nourished body is better able to handle infections. When people with COPD get an infection, it can become serious quickly and result in hospitalization. Good nutrition can help prevent that from happening. If illness does occur, a well-nourished body can respond better to treatment.

Using Medical Nutritional Products
You may find it difficult to meet your nutritional needs with regular foods, especially if you need a lot of calories every day. Also, if your RDN has suggested that you get more of your calories from fat the polyunsaturated, monounsaturated, and low-cholesterol variety — you may not be able to meet this goal easily with ordinary foods. So, your RDN or doctor may suggest you drink a liquid called a medical nutritional product. Many people who need extra calories and nutrients add a medical nutritional product to their diet. Some of these products can be used as a complete diet by people who can't eat ordinary foods, or they can be added to regular meals by people who can't eat enough food.

Diet Hints
Here are some ways you can help yourself eat meals that provide your body with the nutrients it needs. If you have certain favorite foods you're not sure about, ask your dietitian if they are high in carbohydrates. Your dietitian may suggest ways that other foods can be used to balance the carbohydrates in those foods you most enjoy.

  • Choose foods that are easy to prepare. If you use all your energy to cook, you won't have enough left to eat.
  • Ask a family member or friend to help with grocery shopping or cooking if you are too short of breath to do these tasks. 
  • Rest just before eating.
  • Eat more food early in the morning if you're usually too tired to eat later in the day.
  • Avoid foods that cause gas or bloating. They tend to make breathing more difficult.
  • Eat 4 to 6 small meals a day. This enables your diaphragm to move freely and lets your lungs fill with air and empty out more easily
  • Use water-packed fruit, or fruit with no added sugar. Fresh fruit is also a good choice.
  • Add margarine or other sources of fat to breads and vegetables. If high cholesterol levels are a problem for you, use mono- or polyunsaturated fats, oils, and margarines.
  • If drinking liquids with meals makes you feel too full to eat, limit liquids with meals; drink an hour after meals.
  • Use artificially sweetened jams, jellies, and hard candies.