March is National Nutrition Month, and a great time to consider how your diet is affecting your life. For patients with chronic lung disease, specifically lung cancer, it is actually a greater factor in treatment and management than people may know. “The data we have about nutrition supports the fact patients have better outcomes and increased chance of survival if they maintain a healthy diet and exercise during chemotherapy,” said Amit Mahajan MD, FCCP, DAABIP, Medical Director, Interventional Pulmonology for Inova Health System and American Lung Association National Spokesperson. He offered some expert insight into this important topic.

Q: Why is nutrition so important for lung disease patients? 

There are a couple of factors we look at when seeking to restore health in patients dealing with chronic diseases. Patients who have a history of, for example, lung cancer or emphysema, use a lot of extra energy to breathe, and as their condition progresses, they continue to work even harder. So, to prevent these patients from losing weight, we focus on nutrition. This is especially important for patients preparing for treatment like chemotherapy or immunotherapy where common side effects are loss of appetite or nausea. Data shows that losing weight when combating cancer leads to poor outcomes, mainly because patients are working harder to breathe, and are more susceptible to infections. So, even though they may not have much of an appetite, we want to make sure our patients are eating enough.

Q: Are there certain diets that can improve outcomes and why? 

A lot of respiratory illnesses are related not only to the underlying lung function but even more related to the amount of muscle strength they're required to exert because of the disease. For example, patients with emphysema are not using their diaphragm as effectively, so they must use other muscles to make up for the work of breathing. That is why it is absolutely essential for these patients to be on a daily vitamin.

Secondly, a protein rich diet is encouraged because patients need to build that extra muscle. There are other issues for chronic lung patients, like those with emphysema or asthma, if their underlying disease is not controlled. They tend to lose weight because they're metabolizing more fat, more muscle because they're working so hard.

Q: Does the type of food matter or can patients just eat whatever they want to gain weight? 

We don’t encourage patients to eat junk food, like super sugary foods or fatty foods, we want them to maintain weight in a healthy way. We try and push a good balance of fruits, vegetables, and carbohydrates, but what is even more crucial for lung disease patients is protein rich meals because it helps develop more muscle. We hope this will be stored in the body so that if they’re not eating as much during treatment, they still have stored energy that can be used during cancer treatments.

This can be hard because even though we are telling our patients how important it is not to lose weight, a protein rich diet that is low in sugar and carbohydrates isn’t necessarily appealing. It’s not easy to sustain. We ask patients to avoid those fatty foods because, though we don’t want them to lose weight, we don’t want them to gain significant weight either. When lung health patients gain more abdominal weight, it can, in turn push down on their chest. This causes more restriction or more pressure on the chest wall making it harder to take bigger breaths.

It's a really fine balance and that's why we suggest protein rich foods, because it's not going to add empty pounds and allows patients to continue exercising. It’s not an easy task but it is so essential. So that is why we also encourage patients to work with a nutritionist to help them maintain this delicate balance. Your other health care providers can also be great resources as they have experience working with similar patients and can advise you on what has worked for others with similar diagnoses.

To learn more about nutrition and lung health visit our website.
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