Nutrition & Dietetic Department
Pulmonary Rehabilitation
Food choices for people with
Lung Disease (COPD)
Diet and Lung Disease
Eating well when you have lung disease (COPD) can help you
to feel better. Breathing may require more energy for people
with lung disease. The muscles used in breathing may require
more calories than those of a person without lung disease.
NOTES
Being overweight, your heart and lungs have to work harder,
making breathing more difficult. In contrast, being underweight
might make you feel tired and more prone to infections.
The treatments of lung disease can lead to either an increase
or a decrease in your appetite, both of which have their own
individual problems.
Steroids
If you are taking steroids, possible side effects may include
weight gain due to an increased appetite, high blood pressure
and possibly diabetes. By following a sensible healthy eating
pattern you could help reduce some of the symptoms
associated with these problems.
Carrying excess weight will make your breathing more difficult
and reduce your level of activity, which makes breathing even
more difficult.
Diabetes
High doses of steroids can cause diabetes. Diabetes is where
the body cannot control the level of sugar in the blood, leading
to raised blood sugar. This can cause symptoms such as
feeling thirsty, passing urine more often and feeling tired.
Maintaining a healthy weight and following a healthy eating
pattern will help to relieve symptoms.
Produced by the Dietitians at Bedford Hospital
01234 792171
Or email
dietetics@bedfordhospital.nhs.uk
Further information on diabetes is available from the Dietitians.
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Where do you store the cartons?
Calcium and Osteoporosis
Choose a cool place, not next to a heater or radiator.
Once opened keep at room temperature for no more than 4
hours.
Open cartons can be kept in the fridge for 24 hours.
Osteoporosis or thinning of the bones can occur if you take
steroids for a long time. To help prevent this it is important to
eat enough foods that are high in calcium. Fill in the calcium
score to check your intake.
If you cannot manage the supplement contact the person who
recommended them, for advice.
Good sources of Calcium are:
Further information on Calcium in foods is available from the
Dietitians.
Why not try some homemade or shop bought
high protein, high calorie drinks
-Milk
-Cheese
Use your fortified milk to make hot chocolate, Horlicks or
coffee.
Double cream can be added to a hot milky drink.
Milkshakes made with cordials, fruit juice, milk shake
syrup or powder. Add a scoop of ice cream for extra
nourishment.
Fizzy drinks e.g., Lucozade, Appetizer, Schloer,
Lemonade, and Coca Cola. Try to avoid ‘low calorie’
and ‘diet’ options.
-Yoghurt
-White bread
-Calcium fortified soya milk
-Sardines (including the
bones)
-Green vegetables
Food Choices
Dietary advice will be discussed under the following headings:
Health Eating – for those who want to maintain or lose
weight
A high protein, high calorie diet (with or without
supplements) is only temporary until your breathing and
your weight improve. Once you achieve this, you should
return to following a healthy eating pattern again.
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High Calorie / High Protein Diet – for those who are
underweight and need to gain weight or are losing weight
unintentionally.
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Healthy Eating
Having a healthy diet can help maintain a healthy weight,
blood pressure and, help control blood sugar levels if you have
diabetes. Good nutrition helps prevent infections. Chest
infections may lead to hospitalisation for people with lung
disease. So it is important to reduce your risk of infection by
following a healthy diet.
The principles of a healthy diet are:
Eat a variety of different foods
Eat plenty of fruit and vegetables
Have less salt, sugar and fat
Have more fibre
Drink enough fluids
The following picture illustrates what a healthy, balanced diet
looks like. Include foods from each of the five groups
How much should you take?
The person recommending the supplement will suggest how
much to take each day.
How should you take the supplement?
Take between or after meals or before bedtime so it does
not affect your appetite.
Sip slowly to avoid feeling overfull.
If the whole carton is too much to take in one go, have
small amounts regularly, storing the open carton in
the fridge.
Chilled supplements may be nicer so it may be worth
keeping some in the fridge.
You can warm supplements drinks. Do not warm in the
carton and do not boil.
Mix juice style cartons with lemonade or soda for a
refreshing drink, or freeze as ice-lollies.
Can you use the supplements in cooking?
Try freezing them to make an ice cream or fruit ice.
Whip a milk based supplement with equal amounts of
whipped cream and freeze to make a softer dairy ice
cream.
Use a fruit juice supplement to make up a jelly.
Use a milk based supplement to make up an instant
whip.
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High Calorie Foods
Add sugar to drinks, puddings, breakfast, cereals,
etc. Do not choose low calorie or diet products.
Fatty and fried foods are a good, concentrated energy
source.
Use butter or margarine (not low fat spread) on bread,
crackers, vegetables and potatoes.
Add cream to soups, puddings, sauces, fruit, breakfast
cereals, etc.
Avoid drinking with meals as this may fill you up and spoil
your appetite.
Try not to get out of the habit of eating. You actually need
to stimulate your appetite.
tips Have less fat
Avoid all fried foods. Grill, bake, poach, steam, microwave
or instead.
Avoid eating fat from meat and chicken skin.
Reduce meat portions to 2 – 3oz (60 – 90g) lean
meat.
4 – 5 oz (120 – 150g) fish or chicken per
serving.
Use low fat products e.g. low fat spread, semi-skimmed or
skimmed milk.
Supplement Drinks
Have less fatty foods like chocolate, cakes, biscuits, pastries and pies.
If you are losing weight you will need extra nourishment. If you
are taking a high calorie diet but still struggle to gain weight you
may be advised to take nutritional supplements.
There are many different types available:
Avoid adding lots of fat (e.g. spreads, oil) to foods.
Non-prescribable – for example Build-Up or Complan, these
come in both sweet and savour flavours and are made up
with milk or water. They are widely available in
supermarkets and chemists.
Prescribable – these can be divided into:
Milk based, eg Ensure Plus, Fortisip, Scandishake
Yoghurt style, eg Ensure Plus Yoghurt style
Fruit juice based, eg Enlive Plus, Provide Xtra, Fortijuce
Mousse type, eg, Clinutren desserts, Forticreme
Others, eg Calogen (taken as a medicine). Maxijul (added
into foods)
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.Healthy eating
Have less sugar
Choose diet or sugar-free drinks and products.
Cut down on sweets, chocolates, biscuits, and
puddings. Avoid adding sugar to foods – use sweeteners
instead.
Increase the amount of fibre in your diet
Choose wholemeal or whole wheat
products.
Include plenty of fruit and
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vegetables.
Increase your fluid intake when increasing your fibre.
Watch your salt intake
Use less salt in cooking.
Avoid adding salt at the table.
There is no benefit from using salt substitutes
Use alternatives like herbs and spices to flavour foods
By opting for a healthier eating plan you should still be able to
include some of the foods that you enjoy, but less frequently.
Do not worry if you have a “bad day”; continue with the
healthier options after.
Weight loss
If you need to lose weight, ideal weight loss is around 1 – 2 lbs
per week. If you lose it slowly you are more likely to keep it off.
Unplanned weight loss leads to a loss of muscle mass,
which can have a negative effect. If you lose a lot of
weight quickly, which maybe unplanned, it is advisable to
see a Dietitian.
High Calorie, High Protein Diet
Sometimes breathlessness can make it difficult for people to
maintain or gain weight.
Breathing problems can lead to unplanned weight loss. You
may find if difficult to eat your usual amount of food due to
increased breathlessness. The condition may also mean you
need more calories than normal.
For whatever reason, if you need to gain weight, then following
a high protein, high calorie diet can help achieve this.
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If you are not eating as well as you would normally, the following
tips may help you to eat more:
Continue to have a balanced diet as explained in the
healthy eating section, and include fruit, vegetables and
fruit juices. As these foods are low in calories, try not to
fill up on them.
Small, frequent meals or snacks will be easier for you to
manage than 3 large meals and can be equally nutritious
e.g., every 2-3 hours.
Include milky puddings daily.
Try not to spend too long preparing
meals. Tinned, packet or readymade meals such as canned milk
puddings, creamy thick yoghurts,
soups, etc are ideal.
Protein foods
Include foods that are high in protein with every meal
Have 1 pint of full cream milk every day. You can fortify this
by adding 4 tablespoons of milk powder, such as ‘marvel’ or
‘5 pints’. Use it as normal in cooking and drinks.
Meat, fish, chicken, eggs, cheese, nuts, beans, peas and
other pulses are all good sources of protein. Include in your
meals and snacks.
Cheese is useful to melt into sauces, soups, omelettes,
vegetables etc, to increase both protein and energy.
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