Breathe Easy – COPD and Diet

Chronic Obstructive Pulmonary Disease (COPD) is the umbrella term for emphysema, chronic bronchitis, and refractory asthma, resulting from stiffening, inflammation, and damage of the airways, limiting airflow and making breathing much more difficult. Symptoms include shortness of breath, frequent coughing, excess production of phlegm, wheezing, and tightness in the chest.

COPD is one of those diseases that people assume diet can’t help; in fact, nutrition is an essential component of COPD care. Your lungs make oxygen available to your body and remove other gases, including carbon dioxide, when you exhale.

Following metabolism, carbohydrate, fat, and protein are all converted to carbon dioxide and water. Metabolism of carbohydrate produces much more carbon dioxide in relation to how much oxygen is produced. Fat produces much less carbon dioxide to produce the same amount of oxygen.  If too much carbon dioxide builds up in the body and can’t be exhaled, weakness and fatigue results. People with COPD should be advised to eat a diet that is lower in carbohydrate and higher in fat content.

Complex carbohydrates, such as whole-grain foods, fruits, and vegetables should be consumed instead of simple sugars, including candy, pastries, and regular soft drinks. Everyone, including individuals with COPD, should aim to consume about 30 grams of fiber each day. There is a positive association between vitamin C, which is found in many fruits and vegetables, and improved lung function. The antioxidants in fruits and vegetables can also decrease inflammation in the respiratory system.

The fat consumed should be the monounsaturated and polyunsaturated types – such as canola, safflower, sunflower, grapeseed, and olive oils. Trans fats and saturated fats should be avoided. These dangerous fats are found in butter, lard, poultry skin, fatty meat, fried foods, and packaged foods such as cookies and crackers.

Sodium can cause fluid retention (edema) and high blood pressure. Fluid retention can make breathing much more difficult. Most people should limit their sodium intake to 1500-2000 mg a day. Avoid foods that contain more than 300 mg of sodium, unless the food is your entire meal, in which case 500-600 mg is reasonable. High sodium foods are processed meats like salami and bologna, canned soups and vegetable juice, salted snacks, many frozen meals, processed cheeses, and condiments including ketchup and barbecue sauce.

If you have trouble breathing while eating, try eating more slowly, choosing soft foods, and eating several small meals rather than three larger meals each day. Wear your oxygen cannula while eating if you’ve been ordered continuous oxygen.

By drinking fluids in –between meals, instead of with your meals, you will leave more room in your stomach for food. When eating is tiring, it’s crucial to make every bite and sip count by choosing nutritious options that are high in calories and protein, such as cheese, peanut butter, avocado, poultry, lean meats, fish, eggs, milk, dried fruit, protein bars and shakes, yogurt, oatmeal, or healthy cereal such as raisin bran or shredded wheat. Add skim milk powder to foods including hot cereals, eggs, soups, pudding, ice cream and milkshakes, yogurt casseroles, and gravies to get a little extra protein and calcium. When adding the powder to hot foods, add it before heating to avoid clumping. You can even make “double strength” milk by adding one cup of powder to a quart of whole milk. It might be best to eat your biggest meal earlier in the day when your energy is usually highest.

Carbonated beverages cause gas and bloating, which can make breathing more difficult. Other foods that can cause gas and bloat include:

  • Fried and greasy foods
  • Spicy foods
  • Milk and milk products in individuals with lactose intolerance
  • Beans
  • Beer
  • Broccoli
  • Brussels sprouts
  • Cabbage
  • Cauliflower
  • Corn
  • Kale
  • Leeks
  • Lentils
  • Onion
  • Sauerkraut

There is some evidence that the nitrates in cured foods, including bacon hot dogs, ham, cold cuts, and sausage, can aggravate COPD.

Dairy foods do not increase the production of mucus but do have a thickening effect. It is not necessary for all people with COPD to avoid these foods, however. Drinking plenty of water and other fluids will thin mucus.

In addition to the loss of appetite, people with COPD often lose weight because the muscles used to breathe need ten times more calories in someone with COPD compared to someone with no breathing problems. It’s been estimated that someone with COPD needs an extra 430-720 calories a day to compensate for the increased work of breathing. Between 30 and 70% of patients with COPD have unintentional weight loss.

It’s important to relax before and during meals – try to rest for 30 minutes before eating, choose meals that are both appealing and easy to prepare, and listen to relaxing music and avoid stressful or upsetting conversations while eating.

Many people with COPD are prescribed steroids and should take calcium supplements to lessen the chances of developing osteoporosis that can be caused by these medications. Individuals with COPD generally have many other risk factors for bone loss, including malnutrition and decreased mobility, as well. If you take diuretics, you might need to increase or limit the potassium in your diet (ask your doctor). Foods that contain potassium include bananas, oranges, potatoes, winter squash, spinach, tomatoes, cantaloupe, milk and yogurt, and dried fruits including raisins, prunes, apricots, and dates.  Be aware that salt substitutes (“lite” salts) are very high in potassium. Caffeine can also interfere with some medicines used in the treatment of COPD.