In my practice, I saw patients with chronic obstructive pulmonary disease (COPD) who wasted away, becoming so frail that they couldn't breathe. At the same time, I watched my otherwise robust brother succumb to the disease. While he was alive, I wondered about the connection between nutrition and COPD.
Several recent studies have looked at the roles weight and diet play in COPD. Here are a few of the findings:
- Underweight individuals with COPD may not live as long as those who are overweight or obese. This is called the "obesity paradox" and suggests an association between obesity and better outcomes for those with COPD.
- Excess weight, however, still carries risks for people with COPD. It compresses the chest, increases shortness of breath and limits exertion. It also increases the risk of high blood pressure, diabetes and cardiovascular disease.
- Increased fruit and vegetable intake may protect against decline in lung function and over time may even improve lung function.
- Data doesn't support using dietary supplements except to correct deficiencies. Instead, the focus should be on making healthy food choices. Foods have combinations of known nutrients and also unknown compounds that may be essential.
What does this all mean?
Individuals with COPD can benefit by changing their diet to include more fruit, vegetables, fish and whole grains. This eating pattern is effective for achieving a healthy weight, and reducing the risk of cardiovascular disease, diabetes and high blood pressure. It may also be associated with better lung function.
Unintended weight loss should be avoided if possible because it's associated with muscle wasting, weakness and debility. If overweight or obese individuals want to lose weight, they should consult with an experienced health care provider about how to do so safely without muscle wasting.
Pulmonary rehabilitation programs have been proven to significantly improve quality of life and reduce the number and length of hospitalizations for people with COPD. These programs address healthy eating, exercise, smoking cessation, oxygen and medication management.
If you or a family member has COPD, what are your nutritional challenges? Have you sought out a pulmonary rehabilitation program and did it address your concerns? If not, have you met with a registered dietitian? What have you found most helpful?
Sept. 08, 2016
- Hanson C, et al. Influence of diet and obesity on COPD development and outcomes. International Journal of Chronic Obstructive Pulmonary Disease. 2014;9:723.
- Berthon BS, et al. Nutrition and respiratory health. Nutrients. 2015;7:1618.
- Fonseca Wald EL, et al. Dietary fibre and fatty acids in chronic obstructive pulmonary disease risk and progression: A systematic review. Respirology. 2014;19:176.
- Schols AM, et al. Nutritional assessment and therapy in COPD: A European Respiratory Society statement. European Respiratory Journal. 2014; 44:1504.
- Kruis AL, et al. Cochrane corner: Is integrated disease management for patients with COPD effective? Thorax. 2014;69:1053.