Nutrition & COPD

Post created by the Upper Grand Family Health Team Registered Dietitians

Have you wondered how nutrition and food choices impact your breathing when managing your COPD? Although each person’s needs are different and unique, it is important to talk to your Doctor or Nurse Practitioner before you make significant changes to your diet.  You may also request a referral to a Registered Dietitian that supports your primary care provider at your local Family Health Team for additional support.

Breathing and digesting food takes an enormous amount of energy when you have COPD and if you can’t eat enough calories and protein to keep your body running, your immune system can breakdown, making you more prone to lung infections, such as pneumonia.

What do my food choices have to do with my breathing?

Digesting food can have a significant impact on your breathing.  Lung muscles used for breathing may need 10X more calories in someone with COPD than someone without. Our bodies require a lot of oxygen to digest food so if you are using oxygen, keep it on while you eat because you need more support during this time than when you are at rest and not eating.

Oxygen + Food = Carbon Dioxide  →  that we need to breath out!

The digestion of carbohydrates generates the most carbon dioxide and fat produces the least, so when you reduce the carbohydrates in your diet and increase the fat, you may find it easier to breathe.  We also need an adequate amount of protein with each meal to keep our lung muscles strong.

General Guidelines:

1. Choose complex carbohydrates (whole grains like oatmeal or whole grain breads rather than boxed cereals or white breads/crackers) & whole foods. Discontinue use of added sugars (juices, sugar in coffee/tea, sweets, cake/candy/cookies etc) and processed foods as much as possible.
2. Aim for 20-30gm of fibre/day – whole grains, nuts/seeds, fruits, vegetables, or added fibre supplements after meals ( eg Metamucil, Benefibre, etc
3. Have a source of protein with each meal- fish, meat, nuts/nut butters, beans/lentils, eggs, cheese, etc
4. Choose healthy fats (avoid deep fried foods)- use olive/canola oil, nuts/seeds, olives, avocadoes, fatty fish (salmon, herring, mackerel). Avoid processed foods with added fat (crackers, cookies, baked goods, shortening, etc)
5. Drink plenty of water (6-8 glasses) to keep you hydrated and to keep mucous thin so it is easier to clear.
6. Avoid adding salt or eating processed foods that are high in sodium to prevent swelling and fluid accumulation. Try using lemon juice, herbs/spices to flavor food

What if I need extra calories?

Try to eat every 3-4 hours, eating 5-6 smaller meals a day. Add high protein/high fat snacks such as a 5-10% Milk Fat (MF) Greek yogurt, toast + peanut butter, scrambled eggs and toast, snack on cheese, olives, nuts.  Drinking a meal replacement shake such as Boost/Ensure can be helpful between meals or as a drink after a meal.

1. Use whole milk, condensed milk or added skim milk powder and use it to replace water in cooking- make oatmeal with milk instead of water, add it to soups/stews. You can add skim milk powder (2-4 tbsp) to your regular milk or yogurt for added calories and protein. Use puddings for snacks
2. Dried fruit for snacks provides a lot of nutrition
3. Plan your biggest meal at the time of day when you have the most energy. You can have “supper” for breakfast, or “breakfast” for supper
4. Add shredded cheese on top of meals such as stews, chili, toast, eggs, or on top of vegetables
5. Drizzle pesto sauce or olive oil on top of vegetables
6. Drink water/liquids after meals to make sure you don’t fill up before eating food
7. Aim for a good source of protein with each meal ( e.g. eggs, nut butters, canned tuna/salmon, meat, tofu, beans/lentils, milk/cheese/yogurt)
8. If you enjoy boxed cereal- choose granolas, high protein options with nuts/seeds

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.
• Rest before a meal if too fatigued
• Eat larger meal earlier in the day when you have more energy
• 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

Easy Meal/Snack Ideas

• Frozen, canned or dried fruits
• Granola bars or fruit bars
• Milk, yogurt, ice cream, and puddings
• Whole grain breads, cereals, crackers and pasta
• Cheese
• Eggs
• Canned meats or fish
• Pre-cooked meats
• Quick sandwiches can make a meal
• Liquid nutrition supplements for meals and snacks
• Peanut butter or cream cheese on crackers or breads
• Frozen dinners from the grocery store (be selective as many brands contain increased amounts of fat and sodium)
• Oatmeal cooked with milk and dried fruit
• Whole wheat toast, peanut butter and fresh fruit
• Hard-cooked egg, toast and a glass of milk
• Blend together fruit and yogurt or milk to make a smoothie or milkshake
• English muffin with cheese or a poached egg
• Yogurt with fresh or canned fruit, a muffin and cheese
• Meat slices on whole grain bread with cheese and a glass of tomato juice
• Canned fish mixed with mayonnaise on rye bread, raw vegetables and a glass of milk
• Cottage cheese, fruit salad, a wholegrain bun
• Vegetable soup, cheese and crackers
• Chili on a whole grain bun, salad and a glass of milk
• Scrambled eggs, tomatoes, whole grain toast and fresh fruit
• Peanut butter, toast and banana with a glass of milk
• Pasta and meatballs or sauce, stir-fried vegetables and fresh fruit

For more information about any of the free services offered by the Upper Grand Family Health Team, visit our website at www.uppergrandfht.org or call our Fergus office at 519-843-3947. Like us on Facebook (UpperGrandFHT) or follow us on Instagram (uppergrandfht) for tips and information on upcoming programs and events in the area!

References:

Canadian Lung Association- Living with COPD Handout

American Lung Association- Nutrition and COPD https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/living-with-copd/nutrition

Health Link BC: https://www.healthlinkbc.ca/illnesses-conditions/copd/copd-keeping-your-diet-healthy