- National Emphysema Foundation (NEF)
- Nutrition and COPD
- How Does Food Relate to Breathing?
- Nutritional Guidelines
- Diet Hints
- Dietary intake of patients with moderate to severe COPD in relation to fat-free mass index: a cross-sectional study
- Nutrition screening in patients with COPD
Nutritional Guidelines for People with COPD
- If you have COPD, why is good nutrition so important?
- If you are often too tired to eat later in the day, here are some guidelines:
- Tips for improving your appetite
- Tips for gaining weight
- High-calorie recipes to promote weight gain
- Calorie Boosters
- Meal Planning
- Which foods are good for people with COPD?
- Which foods should COPD patients avoid?
- How to Create a Healthy COPD Diet in 5 Easy Steps
- 5. Stock Up on Protein for a Healthy COPD Diet
- 4. You Need Vitamin D
- 3. Take a Note from the Japanese, and Eat More Fish
- 2. Drink More Water
- 1. Avoid Bad Foods as Much as Possible
- Looking to What’s Next
- Foods to eat with COPD: The Benefits of The Mediterranean Diet
- Feb 26, 2019 Foods to eat with COPD: The Benefits of The Mediterranean Diet
- The Mediterranean Diet
National Emphysema Foundation (NEF)
To that end, Zhukovskaya recommends that patients focus on including more fruits and vegetables into their diet, as these will provide the body with the nutrients it needs to help fight infection and inflammation. Fruits and vegetables also take the least amount of energy to digest and give the body the most energy to function.
Included in this diet should be dark, leafy greens such as kale and collard greens and foods rich in vitamin A or C such as sweet potatoes, mangoes, bell peppers and oranges.
“You want to get the most nutrition out of the least volume of food, and fruits and veggies are key to doing this,” said Zhukovskaya. “Juicing is also great because you get all of the vitamins and minerals in liquid form, so the body can absorb these nutrients more quickly.”
By juicing just once a day, and incorporating more life-giving foods such as fruits and vegetables into their diet, COPD and other lung condition patients will see improvements in their breathing.
“One thing that I tell chronic lung patients is to avoid drinking soda,” said Zhukovskaya. “Soda is essentially carbonated water and as a result it is full of carbon, or the waste of our breathing process. When people drink carbonated beverages, they put a lot of waste back into their body. For COPD patients who already have trouble breathing, this can negatively impact their ability to breathe.”
In addition, soda is full of sugar and sugar substitutes, which have been found to cause inflammation, as do processed proteins such as hamburger meat.
“I have talked to people who have implemented these dietary improvements and they have seen huge improvements in their breathing,” said Zhukovskaya. “The key is learning what is bad and what is good and learning how to incorporate these changes into your daily life.”
Nutrition and COPD
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 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 healthcare team will work out a meal plan just for you. Meeting with a registered dietitian nutritionist (RDN) will help you get on track. Find an RDN who specializes in COPD by asking your doctor or visiting the Academy of Nutrition and Dietetics at EatRight.org.
Be sure to mention:
- 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
How Does Food Relate to Breathing?
The right mix of nutrients in your diet can help you breathe easier.
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 that we exhale.
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 fewer carbohydrates and more fat helps them breathe easier.
Check 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 if you gain weight while following the recommended diet. There are health complications that can result from being underweight or overweight. 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.
Choose complex carbohydrates, such as whole-grain bread and pasta, fresh fruits and vegetables.
- To lose weight: Opt for fresh fruits and veggies over bread and pasta for the majority of your complex carbohydrates.
- To gain weight: Eat a variety of whole-grain carbohydrates and fresh fruits and vegetables.
Limit simple carbohydrates, including table sugar, candy, cake and regular soft drinks.
Eat 20 to 30 grams of fiber each day, from items such as bread, pasta, nuts, seeds, fruits and vegetables. Eat a good source of protein at least twice a day to help maintain strong respiratory muscles. Good choices include milk, eggs, cheese, meat, fish, poultry, nuts and dried beans or peas.
- To lose weight: Choose low-fat sources of protein such as lean meats and low-fat dairy products.
- To gain weight: Choose protein with a higher fat content, such as whole milk, whole milk cheese and yogurt.
Choose mono- and poly-unsaturated fats, which do not contain cholesterol. These are fats that are often liquid at room temperature and come from plant sources, such as canola, safflower and corn oils.
- To lose weight: Limit your intake of these fats.
- To gain weight: Add these types of fats to your meals.
Limit foods that contain trans fats and saturated fat. For example, butter, lard, fat and skin from meat, hydrogenated vegetable oils, shortening, fried foods, cookies, crackers and pastries.
Note: These are general nutritional guidelines for people living with COPD. Each person’s needs are different, so talk to your doctor or RDN before you make changes to your diet.
What Else Is Important to Know about My Diet?
Vitamins and minerals
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.
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 RDN about the use of spices and herbs in seasoning your food and other ways you can decrease your sodium intake.
Drinking plenty of water is important not only to keep you hydrated, but also 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 caffeine-free fluid counts toward your fluid goal, and most foods contribute a substantial amount of fluid, as well.
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. Your RDN or doctor may suggest you drink a liquid called a medical nutritional product (supplement). 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.
offer to help your loved one with grocery shopping or cooking. Choose foods that are easy to prepare. If you use all your energy to cook, you won’t have enough left to eat.
- 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
- If drinking liquids with meals makes you feel too full to eat, limit liquids with meals; drink an hour after meals.
- Consider adding a nutritional supplement at night time to avoid feeling full during the day
Dietary intake of patients with moderate to severe COPD in relation to fat-free mass index: a cross-sectional study
The present study which included male COPD patients with moderate to severe airway obstruction showed that dietary intake and habitual food consumption differ in relation to fat-free mass index. The link between aging and the pathogenesis of COPD is strongly supported and longer duration of the disease since diagnose in severe COPD patients in our study can be explained by the progressive nature of the disease . Cigarette smoking is the most important environmental risk factor for the development of COPD . In our study the mean age for starting to smoke corresponded to adolescence, similar to the findings of a recent study by Kim et al. , who found the mean initiation age of smoking of COPD patients as 16.4 ± 4.8 years.
In the current study 18.5% of patients were characterized by a low FFMI. Similarly, a study among 72 COPD outpatients suffering from a moderate degree of airflow obstruction showed that prevalance of fat-free mass depletion was 18% in male patients . In another study, among moderate to severe COPD patients the prevalance of fat free mass depletion was 20.3% in male patients . A recent study by Van de Bool et al. showed that almost 25% of moderate to severe COPD patients who were eligible for pulmonary rehabilitation were characterized by a low FFMI. These little discrepancies may be explained by different inclusion criteria of the studies. On the other hand, in a cross-sectional study among male COPD patients, depletion of fat-free mass based on fat-free mass index was about 42% . This discrepancy can be due to more severe COPD being present in the study as they mentioned that the prevalance of low FFMI was high among severe to very severe (stage IV) COPD patients.
Increased BMI does not protect against fat-free mass depletion in COPD, since there is a preferential loss of muscle tissue in this disease . In our study 8% of the patients had low FFMI despite a BMI ≥21 kg/m2. A study by Pirabbasi et al. showed that among 271 male COPD patients 11.1% had a low FFMI (<16 kg/m2) despite a normal BMI (≥21 kg/m2). In the study by Vermeeren et al. , the prevalence of being underweight was 17% whereas prevalence of FFM depletion was 42%. It should be noted however that in their study they used <18.5 kg/m2 as the BMI cutoff for being underweight.
Nutritional intake and habitual food consumption
In the current study, mean daily energy intakes of COPD patients was 1906 kcal similarly to a group of 275 moderate to severe COPD patients (93% male) in Spain, whose mean daily energy intake was 2033 kcal . According to Turkey Health and Nutrition Survey-2010, mean energy intake of Turkish individuals was 1918 kcal in the 51–64 years age group and 1706 kcal in the 65–74 year age group . A study in Malaysia with 149 COPD patients showed that dietary energy intake of patients (assessed by one day or two days record) was below Malaysian RNI . Compared to the Malaysian sample, in our study prevalance of patients with energy intake below RNI is lower yet clinically significant (93% vs 75%, respectively). A recent study by Van de Bool et al., which is the only study to evaluate dietary intake of COPD patients in relation to body composition until now, showed that COPD patients with low FFMI reported higher energy intake than patients with normal FFMI . On the contrary, in the current study mean energy intake of patients in the low FFMI group was lower than normal FFMI group (1770 ± 338 and 1937 ± 606 kcal, respectively).
Selective wasting of fat-free mass is suggesting a disturbed protein balance in COPD patients ; hence, protein intake of depleted COPD patients is recommended to exceed 1.5 g/kg/day . Increased protein intake and physical activity, in the form of resistance training, stimulate muscle protein synthesis in the elderly . In the study of Van de Bool et al. , COPD pateints with low FFMI reported significantly higher protein intake per kg body weight. In the current study, protein intake of patients did not differ between low and normal FFMI groups. However, daily consumptions of dairy products and red meat were significantly low in the low FFMI group. This finding is considerable since high-quality protein sources such as whey protein, milk, and beef have been shown to improve protein synthetic response in the elderly .
In the current study, majority of patients’ daily milk and yogurt consumption was below RNI and this finding was more marked in the patients with low FFMI. Milk proteins (casein and whey) are known for their high branched-chain amino acid (BCAA) content, which include leucine (LEU), isoleucine (ILE) and valine (VAL) . Since skeletal muscle is a major site of (BCAA) catabolism in disease state, they are used for maintenance of protein quality and repair process of tissues . Plasma levels of BCAAs, particularly leucine, are reduced in patients with COPD and a significant association was found between low levels of BCAAs and depletion of FFM . Engelen et al. showed an elevated anabolic response to sip feeding of a casein protein meal in patients with COPD . All of these findings make milk proteins an important preventive approach to conserve muscle mass in COPD.
In this study, a vast majority (92%) of the COPD patients could not meet RNI for fruits and vegetables with mean daily consumption of fruits being significantly lower in the low FFMI group compared to normal FFMI group. This finding is concerning since cross-sectional studies have showed a significant positive association between fruit and vegetable (FV) intake and forced expiratory volume in 1 s (FEV1), with stronger evidence for fruit consumption . Data from the MORGEN study showed that higher intakes of antioxidants such as vitamin C, beta-carotene and flavonoids are associated with higher FEV1 values, compared with low intakes . Moreover, Walda et al. demonstrated an inverse association between fruit intake and 20 yr COPD mortality.
The major deficiencies were assessed in magnesium and calcium intakes in the current study. Mean magnesium intake of COPD patients was 239.3 ± 89.3 mg in our study. According to National Turkish Health and Nutrition Survey (NTHNS) 2010, mean magnesium intake was 290.8 mg in the 51–64 year old group, 271.3 mg in the 65–74 year old group and 241.7 mg in 75 years and older . Mean magnesium intake of COPD patients in our study was lower than all of the age groups in the national survey. Low consumption of dark leafy vegetables, nuts and seeds due to chewing problems , or legumes due to gastrointestinal disturbances might be the reason of low magnesium intake in our group of COPD patients.
Mean calcium intake in the current study was 740.2 ± 310.2 mg and 92% of the patients’ intake could not meet RNI. Calcium intake in the NTHNS-2010 was 712.7 mg in the 51–64 year olds, 677.2 mg in the 65–74 year olds and 592.6 mg in 75 years and older . In the study by Van de Bool et al. which evaluated the dietary intake of COPD patients assessed by using a cross-check dietary history in in Netherlands, calcium intake was reported as “too low” since 72% of the patients’ dietary intake could not meet the RNI . In the COPD patients in this study, the reported percentage of patients with calcium intake below recommendations was remarkably higher. In a Spanish group of 275 moderate to severe COPD patients, prevalence of complience with recommendations was 31% for magnesium and 49% for calcium and similar to our study magnesium was the major mineral deficieny .
We did not find any significant differences in daily macro- and micronutrient intakes between patients with low FFMI and normal FFMI. Unlikely to our study, Van de Bool et al. recently showed that intakes of calcium and vitamin A in COPD patients with low FFMI were significantly higher . The consumption of legumes, dairy products, fruits and vegetables were lowest as majority of the patients’ intakes did not comply with the recommendations in our sample. In a Spanish group of 275 moderate to severe COPD patients daily legume consumption was 31 ± 21 g while in our study it is 8.9 ± 5.6 g. This difference may be attributed to cultural differences between the countries.
Anthropometric measurements, body composition and physical activity level
In the present study mean weight, height, waist circumference (WC), mid-upper arm circumference (MUAC), fat mass and fat-free mass were significantly lower in patients with low FFMI. Mid-upper arm circumference correlate with total muscle mass and is therefore used to predict changes in the protein nutritional status . Accordingly, in the present study mean MUAC of patients with low FFMI was significantly low.
Patients with COPD have a significantly reduced duration, intensity, and counts of daily physical activity when compared to healthy control subjects . Low fat-free mass has been shown to impair exercise performance in COPD patients . A recent study by Andersson et al. showed that COPD patients who were more physically active were characterized not only by better pulmonary function but also higher BMI and FFMI. In the current study, mean total daily energy expenditure of patients with low FFMI was significantly low. Additionally, mean physical activity levels was lower in the low FFMI group, but the difference was not statistically significant.
Serum albumin is synthesized in the liver and is a marker of nutritional status. Data suggest that low serum albumin is associated with low appendicular skeletal muscle mass in elderly women and men. Reduced protein metabolism with aging may occur concurrently in the liver and muscle causing similar decrements in both serum albumin and muscle mass . Although in our study mean serum albumin levels were not markedly different between low and normal FFMI groups, there was a positive weak correlation between FFMI and serum albumin.
Cesari et al. showed in their study that hemoglobin levels were associated with muscle and fat mass changes, and that decreased muscular strength occured in the presence of anemia in individuals who were 65 years and older . Similarly to these findings, in our study patients with low FFMI had significantly low hemoglobin and hematocrit levels.
Some shortcomings of the current study need to be considered. First, no healthy control group could be included in the present analyses in order to compare the nutritional intake between COPD patients and healthy subjects. Nevertheless, results were compared with general findings in general older Turkish adults from the Natonal Turkish Nutrition and Health Survey-2010 . Second, loss of FFM seems to be more frequent in patients with emphysema-type COPD than in patients with chronic bronchitis. Unfortunately, we were unable to differentiate COPD subtypes in our study. Third, the assessment of dietary intake of fat might be underestimated in food frequency questionnaire. The food frequency method is generally applied in order to assess the quality of dietary intake because it is able to provide data about particular food groups. While there is concern that food frequency questionnaires can be prone to measurement error , they have been shown to identify similar patterns of diet as other dietary methods .
Fourth, in the current study physical activity was assessed by a 24-h recall questionnaire. It has been reported that COPD patients overestimate the time spent walking and underestimate time spent standing. Therefore, using a multisensor armband or an accelerometer to assess physical activity would be more reliable .
Nutrition screening in patients with COPD
Patients with COPD are therefore at high risk of malnutrition, according to the following definition: “Malnutrition is a state of nutrition in which a deficiency or excess (or imbalance) of energy, protein and other nutrients causes measurable adverse effects on tissue/body form (body shape, size and composition) and function, and clinical outcome” (British Association for Parenteral and Enteral Nutrition, 2011).
Importance of screening
Nutritional screening of patients with COPD should be carried out regularly,
even in those who seem to be generally well; they may begin to experience exacerbations more frequently and this can have a negative effect on nutrition. NICE (2010) recommended that BMI should be calculated; those with abnormal (high or low) BMI, or one that changes over time, should be referred for dietetic advice.
Early nutritional intervention is important as it is easier to maintain weight than regain lost weight. It is also important to use a validated screening tool; probably the most widely used is the Malnutrition Universal Screening Tool (MUST) (BAPEN, 2003; updated). Velasco et al (2011) compared MUST with other European tools and showed it to be reliable. MUST includes recommendations for action depending on the “score” achieved, which is extremely valuable. Whichever screening tool is used, it is vital that prompt action is taken to correct any nutritional problems.
Being underweight, especially when this is linked to having less muscle, is independently associated with a poor prognosis in COPD (Anker et al, 2006). It is also associated with impaired pulmonary status, reduced diaphragmatic mass, lower exercise capacity and a higher mortality rate in people with COPD (Ferreira et al, 2000).
Once patients have been screened and identified as being at nutritional risk, it is important that they are supported to make dietary changes to improve their nutritional status as soon as possible. In this group, it is common to see gradual weight reduction over the years, and this often seems to follow a pattern of weight loss during exacerbations followed by an inability to regain lost weight on recovery.
Encouraging underweight patients to make dietary changes to reduce the weight lost during an exacerbation and changes to encourage weight gain after recovery can help to prevent this downward spiral. Research supports this, as Prescott et al (2002) found the best survival in underweight patients was in those who gained weight, while Weekes et al (2009) found significant improvement can be made by dietary counselling and food fortification. Box 1 contains dietary advice for patients during exacerbations and after recovery.
It is vital to monitor patients’ progress with the dietary changes recommended. If a patient is still losing weight despite these changes, consider making a referral to a registered dietitian. The dietitian will be able to assess nutritional requirements and compare these with intake, and may be able to suggest further changes or nutritional supplements, including advice for prescribers on the most appropriate number and type of supplement.
BOX 1. DIETARY ADVICE DURING AND AFTER COPD EXACERBATIONS
During exacerbations, advise patients to:
- Eat small amounts, frequently throughout the day
- Choose soft, easy-to-eat foods that do not need much chewing, such as soup, omelette, fish pie, shepherd’s pie, pasta with sauce, milk pudding, sponge and custard, yoghurt, trifle and mousses
- Have nutritious drinks regularly through the day such as malted milk drinks, drinking chocolate, milky
- coffee and milkshakes, all made using fortified milk made from milk with 2-4 tablespoons milk powder added per pint
- Use nutritional supplements such as Build Up and Complan to boost intake during exacerbations. Ideally, make these up with full-fat milk. Keep these in the store cupboard
After recovery, advise them to:
- Eat smaller meals more often and, if they become full or breathless, delay desserts for 30-60 minutes after the main course
- Supplement with snacks and milky drinks between meals
- Continue to increase protein, by fortifying milk with milk powder, and using this on cereals, in cooking and in drinks
- Increase protein by adding cheese to soups and mashed potatoes, and evaporated milk to cereals and desserts
- Increase energy intake by adding double cream, butter, margarine, sugar, jams, honey and syrup to foods as appropriate
- Continue to exercise as nutritional support is more effective if accompanied by exercise (Anker et al, 2006)
COPD-related swallowing issues are a developing area of research. This issue should be considered, especially in patients who experience recurrent back-to-back chest infections, which may be caused by silent aspiration (Ilsley, 2011).
Swallowing difficulties can make eating and drinking difficult and often result in patients losing weight if no support is given. They often need to have softer foods but manage normal fluids. Altering the texture of foods to make them softer can result in diluted nutrients so it is often necessary to fortify foods.
Managing obesity and overnutrition
Despite many patients with COPD having undernutrition and a low BMI, increasing numbers are presenting with a high BMI. Research supports the fact that obesity carries not only risk factors for heart disease but also leads to pulmonary problems (Rabec et al, 2011). It causes difficulties in thoracic cage expansion and diaphragm movement. Ventilatory work is increased, arterial hypoxaemia is frequently altered and obstructive sleep apnoea is more common in obese people.
However, the decision over whether to treat obesity in patients with COPD poses a dilemma. Prescott et al (2002) identified the best outcomes for overweight and obese patients was when they maintained their weight, while Landbo et al (1999) found mortality decreased with increasing BMI in severe COPD. At BreathingSpace we decided to advise only obese patients to lose weight (those with a BMI of 30kg/m2 or higher) and to aim to do so slowly and steadily, with a conservative 5-10% weight loss target.
Dietary advice for obese patients with COPD is as follows:
- Eat three regular meals and reduce snacking;
- Fill up on vegetables at meals and, if very hungry between, snack on fruit;
- Eat a balanced diet according to the “eatwell plate” model (DH, 2011);
- Reduce intake of fatty and sugary foods;
- Increase physical activity;
- Make changes gradually, one step at a time;
- Avoid strict or crash diets;
- Aim to prevent further weight gain or lose 0.5kg (1lb) per week;
- Make dietary changes permanent.
Comorbidities affecting nutrition
COPD rarely exists in patients as the only condition. They may also have ischaemic heart disease, heart failure, osteoporosis, anaemia, lung cancer, depression, diabetes or cataracts (Barnes and Celli, 2009; Soriano et al, 2005).
Some of their comorbidities may be related to COPD while others may exist independently. This may mean that dietary management of nutritional problems is more difficult as it is necessary to take into account dietary advice for other conditions as well, which can sometimes conflict.
If nutritional screening identifies problems in patients with multiple comorbidities, consider asking advice from or referring them to a registered dietitian, who will be able to balance the dietary prescriptions required for the different diseases and come to an appropriate compromise.
COPD is a chronic progressive condition. Although nutrition is a significant factor at all stages of the disease, the risk of patient malnutrition increases as the disease progresses.
It is important to identify nutritional issues early by regular screening, allowing prompt and appropriate actions to be taken to improve nutritional status, thus improving quality of life and prognosis for people with COPD.
- Patients with COPD should be encouraged to eat a variety of fruit and vegetables every day and a portion of oily fish every week
- They should also be encouraged to eat 2-3 portions of dairy products every day
- COPD patients should have regular nutritional screening to ensure early identification of problems and prompt treatment
- Referral to a speech and language therapist should be considered if swallowing difficulties are suspected
- If screening reveals problems in patients with comorbidities, advice from a dietitian should be considered
Anker SD et al (2006) ESPEN guidelines on enteral nutrition: cardiology and pulmonology. Clinical Nutrition; 25: 2, 311-318.
Barnes PJ, Celli BR (2009) Systemic manifestations and comorbidities of COPD. European Respiratory Journal; 33: 5, 1165-1185.
British Association for Parenteral and Enteral Nutrition (2011) The ‘MUST’ Explanatory Booklet.
British Association for Parenteral and Enteral Nutrition (2003; update undated) The ‘MUST’ Itself.
Department of Health (2011) The Eatwell Plate.
Ferreira IM et al (2000) Nutritional support for patients with COPD. A meta analysis. Chest; 117: 3, 672-678.
Ilsley E (2011) Dysphagia and chronic obstructive pulmonary disease. Bulletin; February 2011; 13-14.
Ionescu AA, Schoon E (2003) Osteoporosis in chronic obstructive pulmonary disease. European Respiratory Journal; 22: 46, suppl 64s-75s.
Keranis E et al (2010) Impact of dietary shift to higher-antioxidant foods in COPD: a randomised trial. European Respiratory Journal; 36: 4, 774-780.
Landbo C et al (1999) Prognostic value of nutritional status in chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine; 160: 6, 1856-1861.
National Institute for Health and Clinical Excellence (2010) Management of Chronic Obstructive Pulmonary Disease in Adults in Primary and Secondary Care. London: NICE.
Parenteral and Enteral Nutrition Group (2011) A Pocket Guide to Clinical Nutrition. Birmingham: British Dietetic Association.
Prescott E et al (2002) Prognostic value of weight change in chronic obstructive pulmonary disease: results from the Copenhagen City Heart Study. European Respiratory Journal; 20: 3, 539-544.
Rabec C et al (2011) Respiratory complications of obesity. Archivos de Bronchoneumología; 47: 5, 252-261
Shahar E et al (1999) Docosahexaenoic acid and smoking-related chronic obstructive pulmonary disease. The Atherosclerosis Risk in Communities Study Investigators. American Journal of Respiratory and Critical Care Medicine; 159: 6, 1780-1785.
Soriano JB et al (2005) Patterns of comorbidities in newly diagnosed COPD and asthma in primary care. Chest; 128: 4, 2099-2107.
Tabak C et al (2001) Chronic obstructive pulmonary disease and intake of catechins, flavonols and flavones. The MORGEN study. American Journal of Respiratory and Critical Care Medicine; 164: 1, 61-64.
Velasco C et al (2011) Comparison of four nutritional screening tools to detect nutritional risk in hospitalised patients: a multicentre study. European Journal of Clinical Nutrition; 65: 2, 269-274.
Watson L et al (2002) The association between diet and chronic obstructive pulmonary disease in subjects selected from general practice. European Respiratory Journal; 20: 2, 313-318.
Weekes CE et al (2008) Dietary counselling and food fortification in stable COPD: a randomised trial. Thorax; 64: 326-331.
Nutritional Guidelines for People with COPD
If you have COPD, why is good nutrition so important?
Food is the fuel your body needs to perform all activities, including breathing. Your body uses food for energy as part of a process called metabolism. During metabolism, food and oxygen are changed into energy and carbon dioxide. You use energy for all of your activities – from sleeping to exercising.
Food provides your body with nutrients (carbohydrates, fat, and protein) that affect how much energy you will have and how much carbon dioxide is produced. Carbon dioxide is a waste product that leaves your body when you breathe out (exhale). If there is too much carbon dioxide in your body, you might feel weak.
Breathing requires more energy for people with chronic obstructive pulmonary disease (COPD). The muscles used in breathing might require 10 times more calories than those of a person without COPD.
Good nutrition helps the body fight infections. Chest infections are illnesses that often lead to hospitalization for people with COPD, so it is important to reduce your risk of infection by following a healthy diet.
Maintain a healthy body weight. Ask your healthcare provider or registered dietitian what your “goal” weight should be and how many calories you should consume per day.
If you are overweight, your heart and lungs have to work harder, making breathing more difficult. In addition, the extra weight might demand more oxygen. To achieve your ideal body weight, exercise regularly and limit your total daily calories.
In contrast, being underweight might make you feel weak and tired, and might make you more likely to get an infection. People with COPD use more energy while breathing than the average person. Therefore, the pulmonary (breathing) muscles in someone with COPD might require up to 10 times the calories needed by a person without COPD. It is important for you to consume enough calories to produce energy in order to prevent wasting or weakening of the diaphragm and other pulmonary muscles.
Monitor your weight. Weigh yourself once or twice a week, unless your doctor recommends weighing yourself more often. If you are taking diuretics (water pills) or steroids, such as prednisone, you should weigh yourself daily since your weight might change. If you have an unexplained weight gain or loss (2 pounds in one day or 5 pounds in one week), contact your doctor. He or she might want to change your food or fluid intake to better manage your condition.
Drink plenty of fluids. You should drink at least 6 to 8 glasses (eight ounces each glass) of non-caffeinated beverages each day to keep mucus thin and easier to cough up. Limit caffeine (contained in coffee; tea; several carbonated beverages such as cola and Mountain Dew; and chocolate) as it might interfere with some of your medicines.
Some people with COPD who also have heart problems might need to limit their fluids, so be sure to follow your doctor’s guidelines.
Include high-fiber foods — such as vegetables, fruits, cooked dried peas and beans (legumes), whole-grain cereals, pasta, and rice. Fiber is the indigestible part of plant food. Fiber helps move food along the digestive tract, better controls blood glucose levels, and might reduce the level of cholesterol in the blood.
The goal for everyone is to consume 20 to 35 grams of fiber each day. An example of what to eat in one day to help you get enough fiber includes: eating 1 cup of all-bran cereal for breakfast, a sandwich with two slices of whole-grain bread and 1 medium apple for lunch, and 1 cup of peas, dried beans, or lentils at dinner.
Control the sodium (salt) in your diet. Eating too much salt causes the body to keep or retain too much water, causing breathing to be more difficult. In addition to removing the salt shaker from your table:
- Use herbs or no-salt spices to flavor your food.
- Don’t add salt to foods when cooking.
- Read food labels and avoid foods with more than 300 mg sodium/serving.
- Before using a salt substitute check with your doctor. Salt substitutes might contain other ingredients that can be just as harmful as salt.
Make sure you are getting enough calcium and Vitamin D to keep your bones healthy. Good sources of these nutrients are foods made from milk (milk, cheese, yogurt, ice cream, and pudding) and foods fortified with calcium and Vitamin D. You may need to take calcium and Vitamin D supplements. Maintaining a healthy weight and exercising will also help with keeping bones healthy.
Wear your cannula while eating if continuous oxygen is prescribed. Since eating and digestion require energy, your body will need the oxygen.
Avoid overeating and foods that cause gas or bloating. A full stomach or bloated abdomen might make breathing uncomfortable. Avoid the foods that cause gas or bloating. Some foods that cause gas for some people include:
- Carbonated beverages
- Fried, greasy, or heavily spiced foods
- Apples, avocados, and melons
- Beans, broccoli, Brussels sprouts, cabbage, cauliflower, corn, cucumbers, leeks, lentils, onions, peas, peppers, pimentos, radishes, scallions, shallots, and soybeans
Follow your doctor’s other dietary guidelines. If you take diuretics (water pills), you might also need to increase your potassium intake. Some foods high in potassium include oranges, bananas, potatoes, asparagus, and tomatoes.
If you are short of breath while eating or right after meals, try these tips:
- Clear your airways at least one hour before eating.
- Eat more slowly. Take small bites and chew your food slowly, breathing deeply while chewing. Try putting your utensils down between bites.
- Choose foods that are easy to chew.
- Try eating five or six small meals a day instead of three large meals. This will keep your stomach from filling up too much so your lungs have more room to expand.
- Try drinking liquids at the end of your meal. Drinking before or during the meal might make you feel full or bloated.
- Eat while sitting up to ease the pressure on your lungs.
- Use pursed-lip breathing.
Eat a variety of foods from all the food groups to get the nutrients you need. The recommended number of servings per day are listed below. These guidelines are for a 2,000-calorie diet. To find out more about the amounts that are right for you, go to www.ChooseMyPlate.gov.
- Eat whole-grain cereals, breads, crackers, rice, or pasta every day.
- 1 oz. is about 1 slice of bread, 1 cup of cereal, or a half cup of cooked rice, cereal, or pasta.
- Eat 6 oz daily.
- Eat more dark green veggies like broccoli and more orange veggies like carrots.
- Eat more dry beans and peas like pinto beans and lentils.
- Eat 2.5 cups daily.
- Eat a variety of fresh fruit.
- Choose fresh, frozen, canned or dried fruit.
- Go easy on fruit juices.
- Eat 2 cups daily.
- Choose low-fat or fat-free milk, yogurt, and other milk products.
- If you don’t or can’t consume milk, choose lactose-free products or calcium-fortified foods or beverages.
- Have 3 cups daily.
Meat and Beans
If you are often too tired to eat later in the day, here are some guidelines:
- Choose foods that are easy to prepare. Save your energy for eating, otherwise you might be too tired to eat.
- Ask your family to help with meal preparations.
- Check to see if you are eligible to participate in your local Meals on Wheels program.
- Freeze extra portions of what you cook so you have a quick meal when you’re too tired.
- Rest before eating so you can enjoy your meal.
- Try eating your main meal early in the day so you have enough energy to last you for the day.
Tips for improving your appetite
- Talk to your doctor. Sometimes, poor appetite is due to depression, which can be treated. Your appetite is likely to improve after depression is treated.
- Avoid non-nutritious beverages such as black coffee and tea.
- Try to eat more protein and fat, and less simple sugars.
- Eat small, frequent meals and snacks.
- Walk or participate in light activity to stimulate your appetite.
- Keep food visible and within easy reach.
- Drink beverages after a meal instead of before or during a meal so that you do not feel as full.
- Plan meals to include your favorite foods.
- Try eating the high-calorie foods in your meal first.
- Use your imagination to increase the variety of food you’re eating.
- Don’t waste your energy eating foods that provide little or no nutritional value (such as potato chips, candy bars, colas, and other snack foods).
- Choose high-protein and high-calorie snacks.
- Keep non-perishable snacks visible and within easy reach.
- Make food preparation an easy task. Choose foods that are easy to prepare and eat.
- Make eating a pleasurable experience, not a chore.
- Liven up your meals by using colorful place settings.
- Play background music during meals.
- Eat with others. Invite a guest to share your meal or go out to dinner.
- Use colorful garnishes such as parsley and red or yellow peppers, to make food look more appealing and appetizing.
Ask your doctor for specific guidelines regarding alcohol. Your doctor might tell you to avoid or limit alcoholic beverages. Alcoholic beverages do not have much nutritional value and can interact with the medicines you are taking, especially oral steroids. Too much alcohol might slow your breathing and make it difficult for you to cough up mucus.
Tips for gaining weight
- Drink milk or try one of the “High Calorie Recipes” listed below instead of drinking low-calorie beverages.
- Ask your doctor or dietitian about nutritional supplements. Sometimes, supplements in the form of snacks, drinks (such as Ensure or Boost) or vitamins might be prescribed to eat between meals. These supplements help you increase your calories and get the right amount of nutrients every day. The combination of exercise and these supplements can help you gain weight.
Note: Do not use supplements in place of your meals.
- Avoid low-fat or low-calorie products unless you have been given other dietary guidelines. Use whole milk, whole milk cheese, and yogurt.
- Use the “Calorie Boosters” listed in this article to add calories to your favorite foods.
- Adding fresh or frozen fruit to your shakes can give you different consistencies and more variety.
- Ice cream
- Granola bars
- Nachos with cheese
- Crackers with peanut butter
- Bagels with peanut butter or cream cheese
- Cereal with half and half
- Fruit or vegetables with dips
- Yogurt with granola
- Popcorn with margarine and parmesan cheese
- Bread sticks with cheese sauce
Eat a variety of foods from all the food groups to get all the nutrients you need.
High-calorie recipes to promote weight gain
If you are having difficulty maintaining a healthy weight, try some of these “Calorie Boosters.”
- 1 cup whole milk
- 1 cup ice cream (1-2 scoops)
- 1 package Carnation Instant Breakfast
Directions – Pour all ingredients into a blender. Mix well. Makes one serving; 550 calories per serving.
Chocolate Peanut Butter Shake
- 1/2 cup heavy whipping cream
- 3 tablespoons creamy peanut butter
- 3 tablespoons chocolate syrup
- 1-1/2 cups chocolate ice cream
Directions – Pour all ingredients into a blender. Mix well. Makes one serving; 1090 calories per serving.
- 2 cups whole milk
- 2 tablespoons vegetable oil
- 1 package instant pudding
- 3/4 cup non-fat, dry milk powder
Directions – Blend milk and oil. Add pudding mix and mix well. Pour into dishes (1/2 cup servings). Makes four 1/2 cup servings; 250 calories per serving.
Great Grape Slush
- 2 grape juice bars
- 1/2 cup grape juice or 7-up
- 2 tablespoons corn syrup
- 1 tablespoon corn oil
Directions – Pour all ingredients into a blender. Mix well. Makes one serving; 490 calories per serving.
If you are having difficulty maintaining a healthy weight, try some of these calorie boosters:
Food Item: Egg yolk or whole egg
- Suggested Use: Before cooking, add egg yolk or whole egg to foods such as meat loaf, rice pudding, or macaroni and cheese. (To prevent illness, avoid the use of uncooked eggs.)
Food Item: Non-fat powdered milk or undiluted evaporated milk
Food Item: Cream cheese or shredded, melted, sliced, cubed, or grated cheese
Food Item: Vegetable oils, mayonnaise, butter, margarine, or sour cream
- Suggested Use: Add margarine or mayonnaise to sandwiches; add any of these items to bread, casseroles, soups, eggs, cooked cereals, pasta, potatoes, rice, vegetables, pudding.
Food Item: Peanut butter (creamy or crunchy)
- Suggested Use: Spread on bread, crackers, apples, bananas, or celery. Or add to cereal, custard, cookies, or milk shakes.
Food Item: Nut dust (grind any type of nuts in a blender or food processor)
- Suggested Use: Add to puddings, gravy, mashed potatoes, casseroles, salads, yogurt, cereals.
Food item: Miscellaneous foods (limit to one serving per day)
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For patients with chronic obstructive pulmonary disease (COPD), meal planning can help to make sure that they are consuming enough of the right kinds of nutrients to power the body’s functions.
Some COPD patients find that they become breathless while they eat, or right after they eat. This can make eating uncomfortable and can make patients more likely to skip meals and avoid eating. But there are ways that COPD patients can avoid or lessen this problem, such as:
- Clearing mucus from the airways an hour before eating
- Taking small bites, and chewing food slowly
- Drinking liquids after the meal, instead of during it
- Eating while sitting up
- Using breathing strategies, such as pursed-lip breathing
- Using oxygen therapy while eating, if prescribed
COPD patients are also usually advised to eat 5-6 small meals per day, rather than 3 large meals. Smaller meals require less effort to eat, which can help COPD patients conserve their energy. Having a very full stomach can put pressure on the lungs and breathing muscles, which can make it harder to breathe. Eating smaller meals can also reduce the risk of heartburn and indigestion.1,2
Which foods are good for people with COPD?
Foods that are high in fiber are helpful for patients with COPD. Fiber helps food to move though the digestive system, and can help control blood sugar and cholesterol levels. High-fiber foods include:
- Whole grains
- Peas and beans
Foods made with milk contain calcium and Vitamin D that can help to keep bones healthy. Many people with COPD have bones that become weak and brittle, and consuming enough calcium in addition to exercising can help prevent that problem.
High-protein foods can provide energy as well as helping to fight off infections. COPD patients should try to include protein in every meal. Good sources of protein include:
- Lean meats
- Cottage cheese
- Peanut butter, or other nut butters
- Protein powders, which can be added to foods and drinks
Fresh fruits and vegetables contain important vitamins, minerals, and nutrients that COPD patients need. Starchy vegetables are good choices, such as:
Phosphorus is a mineral that plays an important role in nutrition, including getting the best out of a person’s lung function. Up to half of COPD patients may have phosphorus levels that are too low. This can be caused by certain types of COPD medications, as well as by poor nutrition. To make sure that they are getting enough phosphorus, COPD patients should include these foods in their diets:
Magnesium is another important mineral that helps to keep breathing muscles strong. Foods high in magnesium include:
- Dark green vegetables
- Whole grains
- Beans, peas and lentils
COPD patients who need to gain weight should plan a diet that includes high calorie foods and drinks, such as shakes. COPD patients who need to lose weight should try to eat smaller portions of nutritious foods.1,2,3
Which foods should COPD patients avoid?
Some foods are more likely to cause gas and bloating, which can increase breathlessness. These include soft drinks and foods that are fried, greasy and spicy. Certain fruits and vegetables can also cause gas for some people, such as:
Eating too much salt can also cause breathing problems, because it can make the body retain water. Patients can lower their salt intake by:
- Not adding salt to their food when cooking or eating
- Using herbs or salt substitutes in recipes in place of salt
- Reading the labels of processed food carefully, to check for salt content
Patients with COPD should also avoid food and drinks that contain:
- Alcohol – such as beer, wine, and liquor
- Caffeine – such as coffee, tea, chocolate, and certain soft drinks
- Food additives
Alcohol and caffeine can both interact badly with some types of COPD medications. Drinking alcohol can also slow down a person’s breathing, which may be harmful for people with COPD.
“Food additives” are chemicals or substances that are added to processed food. They are often added to make food look or taste better, or to preserve food so that it lasts longer. However, these food additives can cause inflammation for some COPD patients.1,2
How to Create a Healthy COPD Diet in 5 Easy Steps
3 Apr 2017 | Under COPD, Diet and Nutrition, Lifestyle, Tips | Posted by |
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Diet is key in addressing COPD symptoms. Here’s how to set up a COPD diet plan that works.
Chronic obstructive pulmonary disease (COPD) can make life for those who have it very difficult. And in short, to say that the diseases’ symptoms can have a significant effect on the quality of life for a patient is an understatement. For more than 15 million Americans, chronic respiratory issues related to shortness of breath, fatigue, and limited mobility continue to make even the simplest of daily activities nearly impossible. Whether it’s the act of cleaning up around the house, getting mail from the mailbox or having the energy needed to play with your grandchildren, COPD and other chronic lung diseases can dramatically limit your ability to engage in a normal life.
Although there are many beneficial and traditional treatment options available such as inhalers, inhaled corticosteroids and supplemental oxygen—including some natural and emerging alternatives—in managing one’s respiratory health, it’s important to start from the ground up.
It’s important to start by improving your general health as much as possible in addition to the use of medication, pills, and surgery. To do this, the key is to address your COPD diet first.
With your health in mind, the Lung Institute is here to give you a blue print on how to do just that and explain just How to Create a Healthy COPD Diet in 5 Easy Steps.
5. Stock Up on Protein for a Healthy COPD Diet
So, what’s the big deal about protein?
Protein is vital. In essence, it’s one of the most important nutrients your body can receive, allowing it to heal itself, build muscle and create antibodies that fight infection. As a crucial chemical within our food, the bonus is that protein is found in a large variety of differing foods and substances. For those looking to increase their protein intake, lean meats—particularly chicken—can be a great source of protein intake. Just make sure it’s all-white meat chicken though, so leave the McNuggets at the window. Instead, look for simple foods like grilled chicken breast with lemon. Grilling the chicken with olive oil can keep down the trans and saturated fat, and the lemon may help open airways and ease breathing.
If grilling, pan-frying or baking is too strenuous, you can get your necessary protein intake through simple foods like eggs, beans (specifically black beans) and nuts. So, fry an omelet in the morning with mushrooms, spinach and cheddar cheese. Create a plate of grilled chicken, black beans and white rice. Or if you just want to relax a little bit after a long day, make a peanut butter and honey sandwich. Your body will get all the nutrients it needs, and you’ll save more money than if you ate out or bought pre-prepared meals (frozen dinners).
4. You Need Vitamin D
Although many patients with lung disease believe that milk causes phlegm and should therefore be avoided, this fact is only half-true. In truth, drinking milk does not cause phlegm production; however, what it does do is allow current phlegm within the throat to become thicker. So how do you get the vital nutrients of vitamin D and calcium without producing more phlegm.
For starters, you could eat cheese. Cheese is loaded with vitamin D, calcium and protein. And for those that are above the age of 50, Vitamin D is critical to keeping aging bones healthy and strong. The added effect of Vitamin D is that it also has been shown to improve respiratory health in those with COPD. Other products that can be packed with Vitamin D and other nutrients are yogurt, soy-milk, fish, tofu, cereals and certain shellfish like oysters.
3. Take a Note from the Japanese, and Eat More Fish
Did you know that the Japanese have one of the healthiest diets in the world?
They also have one of the longest life expectancies. The reason behind this is because of how they portion their food. For starters, their diets are high in certain carbs (rice), vegetables, fruits, as well as fish and meat. It’s low in saturated fats, and they have few processed foods. They also prefer tea and water on a cultural level (but more on water later). Since the times of ancient Japan, the Japanese have been a people that have structured their meals thusly:
- A staple food: Typically, white rice
- Steamed or grilled vegetables
- Occasionally, a meat such as seafood, sometimes poultry, and rarely red meat
Because the country of Japan is an island nation, they have taken full advantage of the abundancy of seafood that surrounds them. Although even before the proliferation of Buddhism in the country, eating four-legged land animals was seen as being unclean and avoided by personal choice.
Eating fish in abundance in favor of traditional American meats (red meat specifically) can be incredibly beneficial to overall health and life expectancy outcomes. Due to fish’s essential vitamins and oils (vitamin D and omega-3s), while being low in cholesterol and fat, fish can be a great way to lose weight while giving your body the vitamins and nutrients it needs to thrive. Just try not to eat them fried as much as you eat them grilled.
Preferred fish: Salmon, Mackerel and Sardines.
2. Drink More Water
We’ve said it before, and we’ll say it again: water is everything. Our bodies not only need it to survive, but in truth, our bodies are mostly water themselves. Despite these facts and how badly our body needs water to thrive, most Americans are chronically dehydrated. In general, the average American should be drinking at least half a gallon of water a day. A red solo cup is about 16 fluid ounces which means you’d need to drink four of these to equal the minimum amount of required water for the day. That might sound like a lot, but the effects are well worth the inconvenience of drinking that much water. So, add water to your COPD diet.
Improved water intake has been linked better sleep, reduced headaches, reduced phlegm, increased energy levels, and a general ease of breathing.
1. Avoid Bad Foods as Much as Possible
This list wouldn’t be complete if we didn’t give you a complete list of the foods you need to avoid. And it starts with:
Cut Out the Cold Cuts and Cured Meats
As we mentioned above, red meat should be eaten sparingly in favor of fish and chicken. So, when it comes to American favorites such as bacon, burgers, cold cut deli sandwiches and hot dogs, these meats tend to be all flavor (mostly salt) without the nutritional benefit.
Foods with Excessive Salt
Drop the salt and vinegar potato chips. Excessive sodium intake can lead to heart and respiratory problems. Salty snacks like fries and popcorn may taste delicious, but be wary of how much you’re taking in.
Cruciferous Vegetables are your sprout vegetables like broccoli, cauliflower and Brussel sprouts. These are great sources of vitamin C, A and fiber, but can also cause excessive bloating and gas, ultimately creating an atmosphere that makes it more difficult to breathe.
Fried Foods and Sodas
Yes, these are certainly among life’s simple pleasures; however, they’re devoid of any real nutrition or positive health value. Instead of getting a coke with your meal, just get a water. The carbonation will cause bloating and hiccupping which will only make obstructed breathing that much worse. Eat these foods as rarely as possible, if at all, and you’ll be surprised how much better you end up feeling once you get past the initial Pepsi withdrawals.
See the full list of foods to avoid here.
Looking to What’s Next
Creating a COPD diet that works for your health doesn’t have to be difficult, and taking the small steps to change your lifestyle can have a dramatic effect on your day-to-day energy and quality of life. Although we always recommend quitting smoking first as the first step to better health, the second is often to address your general health through simple diet and exercise.
And with these behavioral changes, it’s possible to greatly affect the pronouncement of symptoms within those with COPD, emphysema and pulmonary fibrosis. However, when lifestyle changes fail to improve your quality of life in the way that you may expect, it may be time to consider cellular therapy. Rather than addressing the symptoms of lung disease, cellular therapy may directly affect disease progression and may improve quality of life.
For more information on cellular therapy and what it could mean for your life moving forward, contact us today or call us at 888-745-6697. Our patient coordinators will walk you through our available treatment options, talk through your current health and medical history and determine a qualifying treatment plan that works best for you.
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Foods to eat with COPD: The Benefits of The Mediterranean Diet
Feb 26, 2019 Foods to eat with COPD: The Benefits of The Mediterranean Diet
What you eat has a big impact on your overall health. No, there aren’t special foods to eat with COPD or a special diet for lung disease, as we have often been asked, but anything that maintains your weight and health is very important. When you weigh too much, that extra weight you have to carry around all day long can make you more fatigued and shorter of breath, so you tend to avoid exercise, which also contributes to weight gain. So, what do you do?
- You exercise anyway. Our laboratory was one of the first in the world to show that exercise is one of the best things you can do to help your respiratory condition.
- You watch what you eat. Remember, a “beer belly” can compress your diaphragm and make it harder for you to breathe. On the other extreme, being too thin is also unhealthy, as you can lack energy or get into trouble if you have a COPD flare-up.
The Mediterranean Diet
One diet that we recommend is the Mediterranean Diet. While many popular diets are only fads or actually unhealthy for you in the long run, this diet has proved itself to be the best diet out there. According to U.S. News & World Report’s panel of health experts, the Mediterranean Diet is easy to follow, nutritious, safe, effective for weight loss, and protective against diabetes and heart disease.
This heart-healthy diet is inspired by the typical eating habits and recipes of Mediterranean-style cooking. This eating plan offers benefits beyond weight loss, such as:
- Lowering “bad” cholesterol levels.
- Decreasing the risk of cancer, including breast cancer.
- Reducing the risk of Parkinson’s and Alzheimer’s diseases.
Foods To Eat
In addition to all of those benefits, the Mediterranean diet allows you to eat well. The basic outline of the plan emphasizes plant-based foods, such as fruits and vegetables, legumes, nuts, and whole grains. These foods are good to eat with COPD because they help you maintain a healthy weight and prevent further health problems. Instead of deprivation, the plan simply shifts the focus. For example, this diet replaces butter with healthier fats like olive oil and canola oil and encourages you to use herbs and spices instead of salt to flavor your foods. Other characteristics of this diet include:
- Limiting red meat to no more than a few times a month.
- Eating fish and poultry at least twice a week.
- Drinking red wine – in moderation, of course!
Lifestyle and Exercise
Going beyond the meal plan, the diet encourages you to enjoy your meal with family and friends. Positioning food as a social interaction helps you stay healthy and gives more enjoyment to eating. You’re also encouraged to stay active and get plenty of exercise. There’s lots we could say about this diet but remember: a good diet is something you can do to help yourself feel better.
The Mayo Clinic wrote an excellent article on the Mediterranean Diet. We encourage you to read it if you’re interested in learning more about it.