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Care for Nutrition while treating COPD


Dr Sheetu Singh, MD

 

Are nutritional abnormalities common in COPD?         
Nutritional abnormalities are encountered in 2-50% patients of chronic obstructive airway disease (COPD).

What causes nutritional abnormalities in patients with COPD?                
There are multiple reasons for nutritional imbalance in patients with COPD. These include decreased appetite, shortness of breath while eating, depression accompanying the disease, side-effects of medicines, frequent exacerbations and hospitalization.

Why is there shortness of breath while eating in patients with COPD?          
Exercise improves the well-being of the patients and also increases their physical endurance. Yoga is a form of exercise which involves breathing techniques. Yoga improves physical and mental well-being of COPD patients and also teaches them to breathe better.

What are the ways to reduce shortness of breath while eating?           
A few modifications in lifestyle can help the patient to eat comfortably and acquire sufficient nutrition.
1. Eat multiple and small meals rather than fewer and larger meals
2. Bites should be small and should be chewed slowly
3. Patients on supplemental oxygen, should not remove nasal prongs and oxygen supply while eating
4. Pursed lip breathing should be practiced
5. An hour prior to eating the lungs should be cleared of secretions by coughing
6. Eat while sitting up and not in a recumbent or semi recumbent position.

What to eat and what not to?                          
• Diet should include plenty of fluids (unless there is accompanying heart disease and the doctor has advised fluid restriction). Fluids help in thinning of mucus and clearing of secretions from the airways.
• Protein-rich diet (including milk, egg, meat, lentil and soyabean) should be consumed.
• Calorie intake is decided by the nutritional status of the patient. Under-weight patients need to have high calorie intake and over-weight patients require a lower calorie intake.
• Restrict salt intake as it causes fluid retention.
• Supplement calcium and vitamin D (milk, yogurt, cheese etc) in the diet to make bones stronger.
• Fibre should be included in the diet as it helps in improving the digestive system
• Patients on diuretics or steroids, suffer from potassium loss and require supplementation. Foods with high potassium levels include bananas, tomato, potato and oranges.
• Foods causing bloating of stomach should be avoided.

Is there any role of nutritional supplementation and anabolic steroids in COPD?          
Nutritional supplementation accompanied by exercise may help in patients with severe malnutrition. Anabolic steroids may increase bodyweight but has no effect on the exercise capacity.

         Dr Sheetu Singh, MD
Senior resident,
Division of Allergy & Pulmonary Medicine,
SMS medical college and hospital,
Jaipur, Rajasthan
Phone no: 91-9468603213
Email id : sheetusingh@yahoo.co.in
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