Nutrition for Someone with COPD

Even having mild COPD can increase your chance of being underweight.

When the number of calories you are taking in is too few to meet your energy needs, your body breaks down fat and muscle. This causes muscles to become weak. This also causes weight loss. A bad cycle begins. The muscles used to breathe are weakened. This causes shortness of breath. This causes a decrease in appetite. This causes more weight loss. And the cycle continues.

If you are underweight, you should increase the number of calories you eat each day.

To add more calories to your diet:

• Mix a teaspoon of olive oil into hot foods.
• Use peanut butter in sandwiches and snacks.
• Use honey or date syrup for sweetening food and beverages.
• Drink smoothies made with nut butters and fruits. Try adding protein powder or egg substitutes for more protein and added calories.
• Keep high-calorie snacks around: olives, walnuts, raw almonds, and dried fruits.
• Add flaxseed oil or olive oil to cottage cheese or non-dairy cream cheese with fruit.

Other Causes of Weight Loss

The most common reason people with COPD lose weight is that they lose their appetite. Some say they eat less because food does not taste as good as it used to. Others say they get too tired to make meals. For some, chewing, swallowing, and breathing all at the same time is just too much work. Chewing and swallowing adds to the feeling of shortness of breath.

Feeling bloated from swallowing air and not getting enough exercise can make you feel like not eating. Sometimes medicine side effects cause loss of appetite. Some medicines can cause problems with your body absorbing nutrients from food.

To improve your appetite:

• Make mealtime as pleasant as possible. Listen to relaxing music.
• Do not talk about stressful topics at the table.
• Eat healthy snacks throughout the day. Keep them handy.
• When you know you should eat but are not hungry, eat some of your favorite foods.

The best way to lose weight and keep it off is to do it little by little. Extreme dieting is not healthy and can be hard to maintain. It can also be harmful by not giving you important nutrients you would get in a balanced diet.

Eating fewer calories will help you lose weight. This is easier to do when eating six small meals each day. By eating every few hours, the smaller meals will help fight hunger and cravings.

Increase your activity level. People with moderate to severe COPD can exercise effectively. You can learn about this in pulmonary rehabilitation (pull-mon-air-ree re-ha-bill-ii-tay-shun).

Protein is important for people with COPD. It produces antibodies (ant-tee-bodies) that fight infection. The main sources of protein are beans, peas, nuts, soy products (such as tofu, tempeh), eggs, dairy, fish, and animal meat.

To Get More Protein in Your Diet:

• Add skim milk or non-dairy calcium rich protein powder to hot beverages, cereal, eggs, soups, casseroles, gravies, and ground meat or legume dishes. This will add extra protein and calcium to your diet.
• Add chopped, high-protein foods (nuts, legumes/beans, poultry, meats, or cheese) to soups, casseroles, and vegetables.
• Blend finely chopped hard-boiled egg or egg substitute into a sauce, gravy, or soup.
• Include high protein snacks such as pasteurized eggnog, instant breakfast, and puddings in your diet.
• Have nut butter, bean dips, nuts, cottage cheese, or other cheese as snacks to add additional protein and calories.

Drinking enough fluids is important for people with COPD. Fluids help thin and clear out lung secretions. Fluids keep you hydrated and prevent constipation. Water may be the best fluid for your health, but fruit juices, decaffeinated coffee, and tea are also good choices. Milk provides needed nutrients.

A Fluid-Restricted Diet:

Your health care provider may put you on a fluids-restricted diet. Ask your health care provider or dietitian to help you plan what to eat and drink. Fluid retention can be caused by medicines. It can also be caused by your COPD, and sometimes it is caused by eating too much salt.

Too much salt in your diet can cause you to retain fluids. It can also increase your blood pressure and shortness of breath.

To Reduce Salt in Your Diet:

• Do not add salt while making food or to food served at the table.
• Read labels and ingredients on all foods. Avoid those that contain salt.
• Read the sodium content on food labels. Look for products with less than 140 mg sodium per serving or labeled "low sodium."
• Avoid:
  • Cured, smoked, and canned meats, bologna, frankfurters, ham, and salami
  • Regular canned vegetables, soups, and vegetable juices
  • Salted snacks (nuts, pretzels, chips)
  • Regular frozen meals
  • Foods in brine (pickles, olives, sauerkraut, feta cheese)
  • Regular processed cheeses
  • Seasoned salt, meat tenderizer, MSG, soy sauce, barbeque sauce

Calcium (cal-see-um) helps with lung function, muscle contraction and blood clotting. Calcium also plays an important role in keeping your bones strong, helping the immune system, and transporting nerve impulses.

Many people with COPD take corticosteroid (kort-tee-coe-stair-royd) drugs. These drugs can speed up the loss of calcium in both men and women. Osteoporosis (ah-stee-oh-pah-row-sis), a condition of weak bones, can occur. Talk with your health care provider about the risk of osteoporosis.

Dairy products, dark green leafy vegetables (broccoli, kale, cabbage and watercress), dried fruits, nuts, seeds, pulses (peas, beans and lentils) are all good sources of calcium. Calcium is not easily absorbed. Vitamin D helps. Make sure your diet includes good sources of Vitamin D.

Dairy and Symptoms of Mucus Production

Many people believe that drinking cow’s milk will create extra mucus in their nose, throat, and lungs. This is not entirely true. The fats in milk can leave a soft, filmy coating in your throat and mouth. This may make you feel like you have extra mucus in your throat. Milk is an important part of a good diet. It contains calcium, protein, vitamins A, D, and B-12 and riboflavin. We do not know enough about COPD and dairy but there are numerous alternatives to dairy foods that provide the important nutrients found in milk.

Based on recent literature and studies primarily in asthmatics, there is some evidence that a dairy-free diet reduces mucus production.

A 2018 reference for non-dairy diet in asthma is Frosh A, Cruz C, Wellsted D, Stephens J. Larnyngoscope.2019;129(1):13-17. doi: https://doi.org/10.1002/lary.27287.

Magnesium (mag-knee-zee-um) is the “fuel” that makes muscles work. It is also an important mineral that is involved in blood clotting, muscle contraction, and protein production. A low level of magnesium weakens the muscles, including the breathing muscles.

Dark green vegetables are rich natural sources of magnesium. Magnesium may also be found in whole grains, beans, peas, lentils, tofu, and some seafood. Chocolate contains some magnesium. Foods made from refined flours (like white bread) have 80 percent less magnesium than whole grain flours.

Potassium (poe-taa-see-um) is required for muscle contractions. It is very important for the heart muscle. High or low levels of potassium can cause an irregular heartbeat. Foods high in potassium include milk, yogurt, winter squash, tomatoes, apricots, cantaloupe, bananas, oranges, prunes, carrots, potatoes, raisins, spinach, and dates.