04 May Key Nutrients for COPD
Peter Kendall, a reader of our blog who hails from Australia, posted a comment to our post, “Nutrition and COPD: 5 Types of Food to Avoid,” asking what are the key nutrients for COPD?
We thought it a very good question, and turned it over to board member Mary Burns, RN, BS, who wrote this response:
Unfortunately there is no specific diet for preventing or improving pulmonary disease that I have ever heard of. The basic Mediterranean diet is usually suggested along with watching sodium intake. However, modifications are needed for individual problems. In severe emphysema, the lungs are enlarged by air trapping, and the diaphragm is flattened. A full stomach further impedes breathing and causes increased shortness of breath. Five small meals a day are recommended with small snacks in between. Gas-forming foods and beverages should be avoided. Avoiding large snacks at bedtime is also recommended because the food added to the stomach late at night is not lowered by gravity as it is during the day, and so the stomach ends up compressing the diaphragm. If a patient is obese, weight loss will help too, of course. Extra weight makes exercise more difficult and that, in itself, can cause more shortness of breath than what has already been caused by lung damage.
For the very thin patient with a poor appetite, we often recommend high calorie nutritional drinks to sip between meals. We give them lists of high calorie foods they may like. They often don’t have the energy to prepare things for themselves, so that limitation must be considered. We also discuss between-meal snacks like trail mix and nuts, that are easy to carry around in a baggie.
Patients with severe bronchitis or bronchiectasis may produce large amounts of sputum, often triggered by the smell of food. Their coughing at meals, as well as the production of large amounts of sputum, is embarrassing as well as deleterious to nutrition. This can be helped with various techniques and discussions with them concerning what most often triggers these problems.
With all patients you have to take into account food preferences of various nationalities and consider this when recommending a diet.
In rehabititation, all patients fill out a food diary so we have a better idea of what they are eating on a daily basis. We have a class on nutrition taught by a dietician and also do individual counseling as needed. I always had patients weigh themselves every time they came to class so we could also alert them to sudden weight gain of 5 pounds or more and the need to check their ankles for swelling.
You can see why this subject requires a lot of discussion in a rehabilitation program, even if there is no particular diet specific for COPD. Patients with severe weight problems can often get a recommendation from their physician for a dietary consultation if they don’t have a good rehabilitation program to go to.
Hope this helps.