What to eat when you have COPD?

KATHMANDU: Nutrition matters for everyone. A healthy diet can help your body keep up with the demands of life and help keep you healthier, longer.

But when you’re living with chronic obstructive pulmonary disease (COPD), it can be surprising to hear just how much what you eat matters to your health.

After all, COPD is a lung disease. And does your diet affect your lungs all that much?

Yes, says registered dietitian Krista Mielnik, RD, LD.

Maintaining a healthy weight can go a long way toward managing COPD.

“The goal of a healthy diet for people with COPD is to optimize your health, not cure your condition,” Mielnik clarifies. “But following a diet that’s healthy for you and meets your nutritional goals is one more tool to help you stay healthier.”

In other words, there is no COPD diet that will make your condition go away. But a proper diet can help you fight off infections, maintain your strength and lower your risk of developing other conditions that can cause complications.

We talked with Mielnik about what a healthy COPD diet looks like and how the foods you eat can help manage the challenges of living with the condition.

COPD and diet

COPD can have a big impact on weight. And vice versa: Your weight can make a big difference on the impact of COPD on your life. So, what you eat can affect how your condition affects you.

For starters, people with COPD can be at a higher risk for developing severe chest infections that lead to hospitalization. Proper nutrition helps your body fight infections.

What’s more, people living with a healthy weight (BMI between 19 and 24) are less likely to face the most severe complications of living with COPD.

“People with COPD can unintentionally lose significant weight because of their condition,” Mielnik shares. “And on the flip side, people with COPD who have overweight or obesity benefit greatly from reaching a healthy weight to reduce their risk for developing other conditions that complicate their health.”

Let’s take a closer look at the relationship between COPD and weight.

COPD weight loss

Our bodies require energy from the foods we eat to carry out all the activities we do. That energy comes from the calories we take in.

It takes calories to do things like walking and exercising, sure. But even the act of breathing takes energy.

When you’re living with a lung condition like COPD, it takes your body more calories to breathe. The American Lung Association says people with COPD may use up about 10 times more calories breathing than people who don’t live with lung disease.

“That high energy expenditure can cause unhealthy weight loss, muscle wasting and frailty. And having underweight (a BMI below 18.5) can put you at higher risk for infection,” Mielnik explains. “So, nutrition becomes very important to helping people fight off infection and also maintaining strength and helping their lung function overall.”

What’s more: Some medications for COPD may also be associated with weight loss for some people. They may make you feel nauseated or decrease your appetite. And it can be tough to eat enough when you’re not feeling well.

It’s a recipe for significant weight loss, especially for people who are living with advanced COPD.

Overweight, obesity and COPD

A COPD-friendly diet can also help people who are carrying extra weight. If you’re living with overweight (BMI between 25 and 29) or obesity (BMI of 30 or greater), your lungs may have to work even harder to keep up.

Having overweight or obesity can also increase your risk for conditions like diabetes, high cholesterol, high blood pressure and more.

“If you have overweight or obesity, losing weight can help to manage your risk for comorbidities that can pile on top of your COPD and complicate your health,” Mielnik states. “Losing weight and following a healthy diet can also promote a strong immune system to protect you from infection.”

What to eat when you have COPD

Because getting to a healthy weight (or maintaining a healthy weight) is so important to managing COPD, you’ll want to be thoughtful about sticking to a healthy COPD diet.

Consider your diet one more arrow in your quiver of managing COPD.

But what should you eat? What should you avoid?

Mielnik says it’s all about fueling your body with good energy and cutting down on empty calories. And that’s true whether your goal is to gain weight, lose weight or maintain weight.

It’s worth noting, too, that even when you’re living with COPD, getting adequate exercise is still an important part of a healthy lifestyle and managing your weight.

“Exercise activity is hugely important for lung health, even if you have any kind of lung disease,” Mielnik reminds us. “It really helps to keep the lung function that you have, and even improve it in some cases.”

Participating in a pulmonary rehabilitation program can be an especially helpful way to make sure you’re exercising safely and effectively with COPD.

Let’s take a look at what foods should be part of a COPD-friendly diet.

Go Mediterranean

Mielnik recommends that people with COPD follow the Mediterranean diet. That is, an eating style that emphasizes plant-based foods and healthy fats.

“The Mediterranean diet is a good starting place for just about anyone looking for a healthy, balanced diet,” Mielnik notes. “And it can be customized to meet your nutritional needs and your goals.”

Following the Mediterranean diet means eating less prepackaged foods and instead increasing your intake of whole foods, like:

• Fruits.
• Vegetables.
• Lean proteins (like fish, chicken and turkey).
• Whole grains.
• Legumes.
• Healthy fats (like fatty fish, nuts, avocados and olive oil).

But how you incorporate these foods varies a bit depending on your goals.

To lose weight or maintain a healthy weight

One of the benefits of following the Mediterranean diet for COPD is that it ups your intake of high-fiber foods, which can help support weight loss.

Fiber is the indigestible part of plant food. It helps move food along your digestive tract, manages blood glucose levels and can reduce the level of cholesterol in your blood. Fiber also helps you to stay fuller longer. So, it helps manage your food intake in a healthy way.

Foods high in fiber include:

• Lentils.
• Split peas.
• Black beans.
• Raspberries.
• Whole-wheat pasts.
• Almonds.
• Apples.

In addition to getting more fiber, be sure to eat lean protein to help speed up your metabolism. And opt for low-fat dairy products, like skim milk and low-fat yogurt.

To gain weight

Gaining weight in a healthy way is important for staying on top of managing COPD.

“Adding calories can be done in a healthy way. It’s not about eating candy and fast food,” Mielnik emphasizes. “Filling up on empty calories isn’t going to give your body the fuel it needs to become stronger and healthier. And it won’t benefit your immune system.”

What’s more, many less-than-healthy choices can be very high in sodium, which can cause trouble for people with COPD. More on that in a bit.

People with COPD who would benefit from gaining weight should opt for full-fat dairy products, like whole milk and full-fat yogurt.

Remember, too, that fruits and vegetables can be very filling. That’s because plant-based foods often contain a lot of fiber, a natural appetite-suppressant. While the benefits of fruits and veggies are significant, people who need to gain weight may be better off focusing first on filling up with protein and healthy fats. Save the produce for the end of your meal to help keep you from filling up too fast.

Eating small meals frequently throughout the day can help as well.

“People with COPD who have a harder time breathing tend to fill up quickly. And large meals can make breathing even harder,” Mielnik says. “We recommend people who need to gain weight aim to eat five to seven small meals a day. That might look like eating every two or three hours.”

Bone-builders

People who take steroids for COPD may need more calcium. Especially if you take steroids long term. Researchers say that’s because corticosteroids can keep your body from absorbing calcium.

Calcium works in tandem with vitamin D to help keep your bones healthy and strong, lessening your risk for osteoporosis and bone fractures.

Good sources of calcium and vitamin D include foods made from milk (like milk, cheese, yogurt and pudding) and foods fortified with calcium and vitamin D.

If you’re concerned about your intake of these vitamins, talk with a healthcare provider. They may recommend supplements to make sure you’re getting the nutrients you need.

Immunity-boosters

Respiratory infections like RSV, flu and COVID-19 can be more severe for people with COPD. That means more time spent in the hospital and, studies suggest, a lower quality of life.

A COPD diet that includes a variety of foods with healthy vitamins and minerals can help to build your immunity. Known immunity-boosting foods include foods like:

• Fatty fish (think salmon, trout and mackerel).
• Citrus fruits (like oranges and grapefruit).
• Garlic.
• Ginger.
• Spinach.
• Bell peppers.

Again, it’s not that eating a pepper a day is a magic potion to staying infection-free. But an eating pattern that keeps immunity-helping vitamins flowing through your system can help to lower your risk for severe illness.

Limit sodium

Eating too much salt can cause your body to keep or retain too much water. And it can raise your blood pressure. When you’re living with COPD, that all adds up to making breathing even more difficult.

Follow these tips to keep your sodium intake low:

• Remove the saltshaker from your table.
• Don’t add salt to foods when cooking. Instead, use herbs or no-salt spices to flavor your food.
• Cut down on packaged foods when possible. And read food labels and avoid foods with more than 300 milligrams of sodium per serving.
• When eating at restaurants, ask for your food to be prepared without salt and order dressings and condiments on the side so you can manage how much you consume.
• Limit your intake of salty foods, like canned soup, popcorn, pickles and olives.

If you’re concerned about how the foods you eat and your weight are affecting your life with COPD, talk with a healthcare provider, like a dietitian or a pulmonologist. They can help you develop an eating pattern that will help you achieve a healthy weight and avoid serious complications from COPD.

-Health Essentials