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Good Nutrition for COPD Patients: Bigger and Better
Doctors increasingly understand COPD as a pervasive, widely-affecting, "systemic" disease and not just a respiratory one. There is the patient's labored breathing to treat, but also the related weakness and chronic weight loss that cannot be ignored either. Precisely for this reason, proper nutrition is coming into focus as an essential part of COPD treatment.
When discussing COPD and nutritional concerns, the singlemost pressing issue is unchecked weight loss. Doctors believe this weight loss happens because of a "metabolic and mechanical inefficiency" possibly involving an imbalance in the protein synthesis/breakdown process. In other words, COPD creates a nutritional deficit between smaller amounts of energy available from patients' dietary intake and patients' larger energy requirements. Patients with moderate to severe COPD often go undernourished, both losing muscle mass and muscle endurance and experiencing dangerously low energy levels. In turn, low energy levels and depleted muscle mass translate to poor mobility and poor quality of life, but also mean the body has to work harder to get the oxygen it needs (mostly because of a weakened diaphragm and other pulmonary muscles). The Cleveland Clinic estimates COPD patients burn ten times more calories just in act of breathing, exacerbated by the fact that they don't eat well and they don't eat enough. Systemic disease indeed.
There are several ways to combat this nutritional deficit and its resultant weight loss, but the most important way appears to be a full and balanced diet. In certain ways, the suggested diet is not far from the diet suggested for most people: the same Cleveland Clinic recommends a diet rich in fiber (like most vegetables and whole grains) and protein (like fish and whole milk) but lower in sodium and saturated fats. Yet specific to COPD--and because of the disease's chronic undernourishment--the clinic stresses patients consume enough calories everyday--"full" calories of nutritional value and not just "empty" ones like potato chips. Of course, full calories from healthful foods can still be tasty: eggs, custard and buttered popcorn are included in the clinic's list of high calorie snacks. But always with balance in mind, the clinic isn't suggesting patients gorge themselves on custard. Eat to the point of satisfaction, but don't overeat; enjoy meats and cheeses, but also make sure to have enough fruits and vegetables.
Past the organizing principle of dietary balance, the clinic suggests avoiding all foods that can cause gas; upon digestion the resultant bloating can put pressure on the diaphragm, make breathing difficult and make the entire eating experience uncomfortable. (Such foods include beans, broccoli, melons, fried foods and heavily spiced foods.) The clinic also suggests patients prescribed a cannula actually wear it during their meals--after all, eating and digesting require energy that can be supplemented by oxygen therapy.
In addition to a healthier, larger diet, studies have found that nutritional supplements can help as well. For example, one 2003 study used 85 patients in a double-blind, randomized, controlled trial of carbohydrate supplementation. Researchers measured exercise performance using shuttle walk tests, body weight, body composition and overall health status. Not surprisingly, the patients with the placebo continued to lose weight whereas the patients with the carbohydrate supplementation started gaining weight. (Although it is interesting to note that the health status of both the supplement group and the placebo group increased "significantly.") Additionally, the carbohydrate group made significant improvements in their shuttle walk tests. The study concludes that a nutritional supplement, when combined with a healthy diet and light exercise can lessen the impact of COPD.
Eating well will do nothing to "cure" COPD. Nonetheless, a robust, balanced diet can help minimize the disease's impact. And of course, with a diet encouraging an occasional snack like ice cream, pudding, nachos with cheese, how bad could it be?
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