COPD: Can diet play a role in living better with the disease?

COPD is a disease which, in 80% of cases, is linked to smoking, whether active or passive. It is estimated that more than 16 million people in the US have COPD, of whom millions more are living undiagnosed. More than 140,000 Americans die of COPD each year.

There is no cure for COPD, but with proper treatment and monitoring, quitting smoking, improved diet and physical activity, it is possible to improve daily life with the disease.

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What is the role of diet in COPD?

Eating a healthy and balanced diet is essential and benefits each and every one of us. This is even more true for people suffering with chronic respiratory illnesses. A healthy, balanced diet will improves quality of life, breathing and exercise tolerance.

Good habits to adopt in your diet

Certain dietary habits have the power to influence the course of the disease. Here are some tips:

• Fiber such as vegetables, fruit, wholegrain cereal or beans help to slow the development of COPD and also improve bronchial flow.
• Foods rich in omega-3 help to reduce inflammation. It is recommended to consume oily fish (salmon, trout, sardines, etc.) and oilseeds (nuts, hazelnuts, almonds, etc.).
• Proteins are important for good health; it is advised to vary the source of protein so as not to get bored: eggs, fish, white meat, soy, beans, etc.
• A lower intake of saturated fats such as red meat, cold meats or even cream can helps to avoid an increase in inflammation and a worsening of COPD symptoms.
• It is recommended to avoid processed foods as much as possible as they increase inflammation.
• Care should be taken to ensure adequate hydration to support circulation while keeping the lungs well hydrated and ready to eliminate unwanted toxins.
• Avoid sugary foods, alcohol and salt.

What is the role of weight in COPD?

Nutritional issues are common in COPD patients (malnutrition, overweight or obesity). Malnutrition affects up to 35% of COPD patients.

As we have seen, proper nutritional state is essential in the treatment of COPD.

Be aware of loss of appetite or weight

Being overweight is a problem for good breathing, but malnutrition has consequences that can be more serious.

Malnutrition is an imbalance between the nutrients the body needs and the nutrients it gets. This includes overnutrition (consumption of too many calories or too much of a specific nutrient) and undernutrition (a state in which energy or protein needs are not met). Bioelectrical impedance analysis (BIA), a method of estimating body composition, can detect undernutrition. This technique measures the resistance of an organism to an electric current or acoustic pressure. In practice, it is generally used to evaluate an individual's body fat mass by passing a very low current through the body.

Undernutrition leads to a decrease in muscle mass (also known as lean mass). This decrease affects:

• Skeletal muscles and particularly the thigh muscles, which represent the largest muscular mass of the body.
• Respiratory muscles, leading to respiratory distress and an increase in the energy cost of breathing.
• Undernutrition is also associated with a decrease in bone density.

Undernutrition can be caused by various factors such as smoking, lack of oxygen, treatments such as corticosteroids or the inflammation of the bronchi that accompanies COPD.

There are no real treatments for undernutrition but certain dietary supplements can improve one's nutritional state.

Obesity can lead to other breathing problems

In contrast to undernutrition, obesity can also lead to a worsening of COPD. This is because abdominal obesity, also known as central or truncal obesity, compresses the diaphragm, preventing full breathing and leads to a decrease in lung capacity. The areas compressed by the abdomen are less involved in gas exchange, ventilation is therefore less efficient: the blood is less well oxygenated and carbon dioxide is more difficult to eliminate.

When should you consult a dietician or nutritionist?

To achieve and maintain healthy weight in the long-term, it is advisable to consult a dietician or nutritionist. Your healthy weight will help you to maintain your energy levels, improve your quality of life and your physical capabilities, but also prevent infections.

Whether your aim is to lose or gain weight, it is essential to do so under the supervision of a health professional in order to work together to build the foundations of a healthy and balanced diet that is suited to you.

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