Nutrition and Chronic
Obstructive Pulmonary Disease (C.O.P.D.)
Pulmonary Rehabilitation-Toronto Western Hospital
Kathy Conway Registered Dietitian
Dianne Johnson Respiratory Therapist, Meeran Manji Pulmonary
Nurse
Maintaining a desirable body weight while being
well nourished is very important for patients with C.O.P.D. This will contribute
to increasing energy levels, i mproving exercise tolerance, improving
resistance to infections, aiding in fighting infections, reducing
hospitalizations and improving general physical and emotional well being.
Eat a Well-Balanced Diet
It is important to eat a well-balanced
diet to nourish the body providing vitamins, minerals, antioxidants, protein,
carbohydrate, fat and fibre.
Choosing a variety of foods from each of the Four Food Groups, which
includes Fruit and Vegetables, Grain Products, Milk and Milk Products and Meat
and Alternates helps to achieve optimal nutritional status. A registered dietitian can provide a
personalized meal plan to help meet individual protein and energy requirements.
Maintain a Desirable Body Weight
Overweight
Excess abdominal fat makes it more
difficult for the lungs to fully expand, which makes breathing difficult. The
heart and lungs have an increased workload when supplying oxygen to all parts
of the body. Achieving a desirable
body weight with a gradual weight loss is desirable. This will contribute to an
improvement in breathing and general health.
Underweight
Factors limiting intake can result in
malnutrition and may include; early satiety, anorexia, bloating, issues with
meal production and difficulty breathing (dyspnea). It can be difficult to meet increased energy requirements
resulting from increased workload on the lungs for breathing which can
contribute to malnutrition.
Recommendations from a Registered Dietitian for the addition of
nutritional supplements into a healthy meal plan may be indicated to contribute
to meeting caloric requirements. A gradual weight increase is desirable and
will result in improved respiratory function, exercise tolerance, resistance to
infection and energy level.
A Registered
Dietitian can help you achieve your desirable body weight, whether you are
overweight or underweight.
Eat Smaller more Frequent
Meals
Eating 5 to 6 small meals a day instead of
3 large ones will help with energy conservation. Fatigue experienced results
from the stomach filling up too much and causing shortness of breath. When the
stomach is not as full, the lungs have more room to expand, increasing the
ability to breathe better.
Limit Salt Intake
Too
much sodium can cause fluid retention and may interfere with breathing.
Limiting salt intake by not adding it at the table and limiting intake of
processed and prepared foods are ideal. Using salt-free spices
and herbs can provide flavour to foods without the added sodium.
Relax and Enjoy your Food
Eating in a relaxing and enjoyable
atmosphere is best. Conserve energy by
choosing meals that are easy to prepare, resting prior to eating and taking
adequate time to eat without rushing.
Avoid Bloating
Eating slowly and chewing food well and
swallowing as little air as possible will reduce discomfort resulting from
bloating. Limit intake of carbonated beverages and gum chewing. Certain foods
may cause bloating. Examples may include raw apples, beans (kidney, black, navy
etc.) cabbage, raw onion, radishes, broccoli or other foods. Using trial and error to detect and
eliminate bloating foods is useful.
Incorporate Calcium
Foods
This
mineral has several important functions in the body. These include building and
maintaining strong bones and teeth, involvement in blood pressure maintenance,
blood clotting, contraction and relaxation of all muscles including lung and
heart and supporting nerve function.
Best
sources are the following low fat dairy products; milk, yogurt and cheese.
Lactose reduced products are also available. Other sources include kale, bok
choy, collard greens, broccoli, sardines and canned salmon with bones,
fortified soy beverage and tofu made with calcium sulfate.
A
Registered Dietitian can recommend the number of servings required for your
individual needs. Your physician or Registered Dietitian may recommend a
calcium and vitamin D supplementation during a consultation.
Long-term use of ingested steroid
medication can increase the risk of osteoporosis. This makes an individual more
susceptible to fracture. Adequate
intake of calcium and vitamin D is very important. Reducing sodium and caffeine
intake will reduce calcium loss in urine.
Adequate Fluid Intake
Drink at least 8 glasses of water daily.
Milk and unsweetened juice are also beneficial fluid sources, however, a
Registered Dietitian can suggest an appropriate number of servings. Intake of these fluids will promote adequate
hydration and help thin out mucus secretions, making it easier to cough up and
expectorate.
It
is important to limit caffeinated beverages and alcohol as they increase the
need for fluids.
A diet low in fibre, fluids and a lack of physical activity usually cause constipation, however, other factors may be involved. Constipation can cause shortness of breath. Incorporating foods that are a good source of fibre into the diet, increasing fluid intake and increasing activity as tolerated can contribute to improving elimination and breathing.
Eating too many sweets and desserts
produce more carbon dioxide
than other foods. Breathing is more difficult, as the lungs must work harder.
Limiting intake of these foods will help you breathe better.
For
more information please contact the Cardiac/Pulmonary Wellness Centre
Tel.
416-603-5890, fax 416-603-5854
E
mail:Kathy.conway@uhn.on.ca
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