Transcript Nutrition and COPD

Nutrition and COPD
All Things Considered
Primary Goals of Medical
Nutrition Therapy
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Preserve lean body mass
Prevent involuntary weight loss
Maintain nutritional status
Improve quality of life
Role of Nutrition
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Improves energy
Helps fight inflammation
Improves immune function
Helps retain muscle mass and strength
Helps retain bone mass
Helps slow progression of the disease
Nutrition Concerns
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Malnutrition
Weight status
Nutrient dense - Quality counts!
Adequate fluids (helps thin mucus)
Coping with COPD symptoms
Unplanned Weight Loss
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An individual without lung disease uses
about 100 calories per day expanding
and contracting the muscles involved
with breathing
Unplanned Weight Loss
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An individual with COPD could use
between 420 – 730 (or more) calories
per day for the work of breathing
Unplanned weight loss affects as many
as 40-70% of COPD patients
Malnutrition
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Studies report that in individuals with
COPD, the prevalence of lower BMI
(under 20 kg/m2) may be as high as
30% and the risk of COPD-related
death doubles with weight loss.
Body Composition
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In individuals with stable COPD, studies
report that even for the 70% of patients
with BMI greater that 20 kg/m2, body
composition differs from healthy
controls.
Fat-free (muscle) mass index and bone
mineral density are lower in individuals
with COPD.
COPD Symptoms Contribute
to Weight Loss
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Shortness of breath
Fatigue (too tired to cook)
Loss of appetite
Feeling bloated after eating
Food tastes different
Shortness of Breath
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CO2 retention associated with food comes
from eating excess calories in general.
Most individuals with COPD need smaller
nutrient-dense meals, more often
Digestion requires energy. Energy requires
oxygen. Smaller meals use less oxygen.
Learn to “graze” throughout day
Strategic snacking – no room for “junk”
Shortness of Breath
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Often difficult to chew, swallow, and
breathe at the same time
Try to rest for 30 minutes before meals
Good body posture at table
Easily prepared and easy to chew foods
Eat 6 small meals per day
If on continuous oxygen therapy, may
need to increase oxygen flow rate
during meals (Check with doctor first)
Fatigue
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Eat larger meals earlier in the day
6 small meals per day
Prepare greater amounts of food when
feeling “up”. Freeze to eat later.
Prepare simple foods and recipes
Enlist family, friends or community
agencies to help with meals
Feeling Bloated
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Factors: Swallowing air, not drinking enough
fluids, and not enough exercise
Try not to rush meals
Eat several small meals throughout day
Drink fluids 1 hour before or after meals
Avoid foods that cause gas and bloating
Eat less fried, fatty foods
Avoid constipation – gradually increase fiber
and fluid in diet and remember to move
If Individual is Underweight:
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May be more likely to get an infection
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May become weak and tired more often
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May weaken the muscles that control
breathing
Weight Gain or Maintenance
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Small meals and snacks throughout day
Nutrient-dense, High calorie, High
protein
Role of fat
Overall nutritional quality of foods
May use commercial nutrition
supplements (Not a meal replacement)
If Individual is Overweight:
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Heart and lungs must work harder
Increased weight increases oxygen needs
Breathing may become more difficult,
especially if weight is around middle
Weight may decrease ability to expand chest
well for breathing
Increased risk of developing other health
problems
Weight Loss Wizard
We wish we had a
magic wand!
Guidelines to Lose Weight
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Lose weight gradually and sensibly
Become more active
Eat fewer calories
Eat nutrient-dense, balanced diet
Follow healthy nutrition guidelines – such as
the DASH diet or Choose My Plate
Monitor or record food intake
DASH to Health
• Dietary Approaches
to Stop Hypertension
(DASH) eating plan is
balanced, nutrientdense, and fiber and
mineral-rich.
• DASH is consistently
ranked tops in
independent
comparisons of
nutrition and diet
plans.
Important Nutrition Guidelines
for COPD
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Protein
Fluids
Less Sodium
Calcium
Magnesium
Phosphorus
Potassium
Protein
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Most individuals with COPD have reduced
body muscle mass compared to normal
Protein is key component of muscle and
antibodies to help fight infection
Balanced diet is the real deal
Include protein source at every meal (fish,
poultry, meat, eggs, dairy products, legumes,
nuts, nut butters, soy products)
Tips to Increase Protein
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Snack on peanut butter, bean dips, nuts,
yogurt, boiled eggs, cheese or cottage
cheese, instant breakfast, puddings
Add skim milk powder to milk, cereals, cream
soups, casseroles, and sauces
Add cheese to sandwiches and vegetables
Add chopped meats, cheese, or legumes to
soups and casseroles
Fluids
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Helps thin and clear lung secretions
Helps prevent bloating and constipation
Oxygen therapy is drying
Choose caffeine-free, non-carbonated
beverages
Goal: at least 8 cups liquids per day
To reduce fullness at meals, drink more
between meals & sip throughout day
Reduce Sodium
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Fluid retention makes breathing difficult
Choose more fresh, unprocessed foods
Use less packaged, prepared foods
Read food labels for sodium values
Use more herbs, spices and salt-free
seasonings to add flavor
Calcium
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Helps with lung function, muscle
contraction, and blood clotting
Helps make bones strong
Important for healthy immune system
Helps transport nerve impulses
Corticosteroids may increase calcium
loss
Calcium Food Sources
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Dairy products are best source (milk,
yogurt, cheese, ice cream)
Other foods sources: tofu, almonds,
broccoli, leafy greens, legumes
Calcium-fortified foods
Vitamin D is essential for calcium
absorption
Magnesium
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Normal muscle and nerve function
Healthy immune system
Bone health
Energy metabolism
Protein synthesis
Heart rhythm
Normal blood pressure
Blood sugar and insulin regulation
Magnesium Food Sources
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Nuts
Dark green vegetables
Whole grains
Legumes (beans, peas, lentils, peanuts)
Soybeans and tofu
Some seafood
(Whole grains have about 80% more
magnesium than refined grains)
Potassium
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Protective effect against hypertension
(helps the body to excrete sodium)
Helps regulate water and mineral
balance throughout the body
Required for muscle contractions
Very important for the heart muscle
Diuretics decrease potassium
Potassium Food Sources
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Banana, kiwi, apricot, nectarine
Dried fruit (prunes, raisins, dates, figs)
Milk and yogurt
Potato (either white or sweet)
Tomato (raw or cooked)
Dried cooked beans (navy, black, lentil, limas, pinto,
black-eyed peas, etc.)
Leafy greens (spinach, kale, Swiss chard)
100% bran cereals
Fish: halibut, tuna, cod, snapper
What is the Role of Fat?
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Insulation, circulation, hormone balance
Helps meet increased energy needs (Fat
has twice the calories of protein or
carbohydrates)
Transports fat-soluble vitamins
Increases satiety
Unsaturated Fats are Healthy Fats
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Olive oil, canola oil, and other vegetable
oils
Nuts, seeds, nut butters
Fatty fish – salmon, mackerel, tuna,
sardines
Avocados
Olives
Good Carbs and Fiber
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Fiber only found in plant foods
Nutrient dense
Best sources: whole fruits and
vegetables, dried beans, whole grains,
nuts & seeds
Eating for color = Nutrient density
Whole grains – Try something different
Choose Your Plate
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5 - 6 small meals per day
Balance between carbs, proteins, and
fats
Simple and fresh
Nutrient dense
Variety of colors and textures
Drink plenty of fluids
Fill Your Plate With Color!