Chronic obstructive pulmonary disease (COPD) is a progressive lung disease caused by damage and inflammation to the respiratory system. This can include having emphysema and chronic bronchitis. Some may experience tiredness and chronic cough, and this can lead to breathing difficulties due to restricted air flow (1).  

COPD is the second most common lung disease after asthma (2)

What are the symptoms/signs of COPD?

  • Increased breathlessness 
  • Tightness in the chest
  • Wheezing
  • Tiredness
  • Frequent chest infections
  • Chronic coughing (with or without mucus) 
  • Sarcopenia (loss of muscle mass & strength 

Symptoms will often worsen over time, making daily activities more difficult. There may be ‘flare ups’ where symptoms are particularly worse – this can happen particularly at winter (3).

More advanced COPD symptoms include:

  • Swollen ankles (fluid build up) 
  • Unintentional weight loss

How can nutrition help improve COPD outcomes?

A varied diet, high in fruits & vegetables, whole grains, legumes, nuts and fish can provide you with a wide range of nutrients, vitamins and minerals that can help your nutritional status. 

  • Try to have a source of protein with each meal – this includes meat, fish, beans and pulses, peas, nuts and seeds, soya products (tofu/tempeh) and plant based alternatives to meat.
  • A good fluid intake can help with easier mucus removal, as well as reducing constipation and keeping you well hydrated. Try to aim for 6-8 glasses, spread out throughout the day, unless otherwise advised. 
  • Be mindful of salt intake in your diet, as this can increase blood pressure and cause fluid retention, which may increase shortness of breath. Try not to add any salt to the table, and use other herbs/spices to add flavour to meals, instead of salt. 
  • You may require Vitamin D and calcium supplementation, especially if you have little exposure to sunlight or require steroid therapy (as this can increase calcium loss). Always speak to your GP first before supplementing. 

Risk of malnutrition with COPD

Being underweight with COPD can be a common concern, especially as those with COPD require extra calories each day due to the energy used for breathing! 

If you have been diagnosed with COPD and are underweight, here are a few ideas that may help you with increasing your calorie intake, to prevent any further weight loss (4)

  • Trying to eat smaller meals, 4-6 times a day instead of 3 large meals per day can allow your lungs to fill with air and empty out more easily. 
  • Eating more earlier in the morning can benefit those who get too tired later on in the day
  • Try to avoid any foods that lead to bloating or gas.
  • Eating slowly can also help prevent bloating. 
  • Fortifying your food with extra oil or butter can help increase energy intake without adding volume
  • Try smoothies/shakes with nut butter, milk/yoghurt (or non-dairy alternatives) and fruit, if you find it easier to drink than eat.
  • Limit liquids with meals, as these can be filling. Try to drink an hour before or after meals. 
  • You may need to consider a nutritional supplement if your health care provider is concerned with your weight loss, and you are struggling to meet your requirements through food alone. Please speak to a Registered Dietitian who will be able to advise accordingly. 

Meeting nutritional needs with COPD

  • For some, it can be difficult to meet your nutrient requirements if you struggle to prepare meals or experience shortness of breath when cooking. 
  • Trying to purchase pre-cut and ready prepared fruits and vegetables can help, as well as precooked meats, fish and frozen meals. 
  • Where possible, cooking extra of meals can help reduce cooking for the next day, or freezing extra portions for a time where you may be too tired, can be helpful. 
  • Meal or grocery delivery services may be something to consider. 

If you are overweight with COPD, this can put you at risk of developing other health conditions such as type 2 diabetes or high blood pressure. Being overweight can also put extra stress on your joints and increase your body’s demand for oxygen. Working with a Registered Dietitian can help you find a way to help reduce weight in a healthy and sustainable way, to reduce these risks (4).

What else can be done to slow down COPD progression?

  • Stopping smoking – this is the most effective way to prevent COPD from becoming worse, and to help preserve lung function (5)
  • Using inhalers or tablets to help with breathing
  • Pulmonary rehab – a specialised type of exercise and education to help improve muscle strength and emotional wellbeing

Please reach out to your doctor or GP if you have COPD or are concerned about any symptoms, before making any health of lifestyle changes. 

By Reema Patel, Dietitian, MSc

References

  1. COPD Foundation (2019). COPD Foundation. [online] Copdfoundation.org. Available at: https://www.copdfoundation.org/What-is-COPD/Understanding-COPD/What-is-COPD.aspx.
  2. British Lung Foundation (2017). Chronic Obstructive Pulmonary Disease (COPD) Statistics | British Lung Foundation. [online] Blf.org.uk. Available at: https://statistics.blf.org.uk/copd.
  3. NHS Choices (2019). Symptoms – Chronic obstructive pulmonary disease (COPD). [online] NHS. Available at: https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/symptoms/.
  4. Copdfoundation.org. (2019). COPD Foundation. [online] Available at: https://www.copdfoundation.org/Learn-More/I-am-a-Person-with-COPD/Nutrition-for-Someone-with-COPD.aspx.
  5. NHS (2019). Treatment – Chronic obstructive pulmonary disease (COPD). [online] NHS. Available at: https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/treatment/.
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