COPD (Chronic Obstructive Pulmonary Disease): Staying Healthy General • Environmental Tips • Healthy Eating for People with Lung Disease (OSU Patient Education Materials) • Home Exercise Program for Patients with Heart or Lung Conditions • Breathing and Relaxation (National Jewish Health) • Living Well with COPD (American Association for Respiratory Care) • Make peak flow a habit! • Nutritional Guidelines for People With COPD (Cleveland Clinic Foundation)
There are many things called irritants in the environment that may make breathing more difficult for persons with lung problems. Some of these breathing hazards can be avoided and some cannot. Being aware of the various hazards may help you avoid these conditions or at least limit your exposure to them.
Cigarettes Cigarette smoking irritates the lining in your lungs. This causes mucus cells to produce more mucus, which may plug your lungs. In time, this leads to infection and may cause permanent lung damage. Emphysema and Bronchitis are largely diseases of smokers. Smokers who have emphysema and bronchitis cannot get better until they stop smoking. No matter how long you have smoked, coughing and sputum may decrease when you quit.
Pollution Be sure to pay attention to air pollution alerts. If the pollution count is high (90 - 100), stay inside to limit exposure to your lungs. The worst
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pollution, and the one you can do something about, is cigarette smoke. Ask your family and friends not to smoke around you.
Aerosol Sprays Aerosol sprays pollute your home. These include room fresheners, deodorants and oven cleaners. You cannot avoid breathing in sprayed products that may linger in the air. Breathing these products in is irritating to your lungs. Substitute every aerosol spray in your home for products, which can be poured or rubbed.
Fumes Avoid strong fumes that may irritate your lungs. Ventilate your cooking stove by turning on the exhaust fan or opening a nearby window to draw the cooking fumes out of the house.
Humidity If you live in a very humid area and have mildew or mold in the house, you may want to dehumidify your house. Air conditioning will do this or you can use a dehumidifier. If your house is too dry, it can dry out the mucus linings of your airways. You can use a humidifier to add moisture to the air. Sometimes simply setting pans of water on heating ducts or radiators can do this. A vaporizer is not recommended.
Dust Avoid activities that raise dust, such as sweeping, dusting, driving on dirt roads and mowing grass. If you must get involved in a dusty job, wear a scarf or handkerchief over your nose and mouth or buy a surgical mask to wear. This helps to filter the air that you breathe. Also, regular cleaning of filters in air conditioning and heaters is important.
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Extremely Cold Weather Cold air can irritate the bronchial tubes and cause coughing. When you go outdoors in very cold weather (less than 40 degrees F), breathe through a scarf or handkerchief held over your nose. This will warm the air as it enters your lungs.
■ Talk to your doctor or others on your health care team if you have questions. You may request more written information from the Library for Health Information at (614) 293-3707 or email: [email protected].
If you have COPD, eating right and exercise can help you fight off infections. While your doctor is your best source for information, the American Association for Respiratory Care has a few tips on nutrition and exercise to help you.
Eat well.
A good diet is important when you have COPD. If you don’t get enough protein the body will actually break down muscle to provide the protein needed. The muscles you use for breathing can be weakened and you could lose strength.
COPD can make even the simplest activities tiring. Many people with COPD find that eating makes them more short of breath. Instead of trying to eat three large meals, eat six small meals. When your stomach is full, it pushes up against the lungs and makes it hard to get a deep breath.
• Choose easy- to-prepare foods so that you don’t spend a lot of energy fixing the food. If you live alone or do not have help in preparing your meals, check into programs in your community that will bring meals to your home.
• Rest after eating. • Drink plenty of fluids unless your doctor tells you not to. Water is important to help
keep your mucous thin and easier to cough up. • Avoid foods that cause gas. This is usually different for each person. Pay attention to
what foods make you feel bloated. • Avoid too much salt in your diet. Sodium in salt can cause you to build up fluid,
making it harder for you to breathe. Many prepared and “fast” foods have a lot of sodium. Learn to read labels.
• Eat foods that are high in protein and low in trans fats. Limit breads and foods that are high in sugar.
Stay away from situations that can make you short of air.
• Decrease your chances of infection by staying out of crowds during cold and flu season. Use antibacterial gel or wash your hands often, especially after handling money or opening doors in public places. Clean your nebulizer cup as instructed by the medical equipment company.
• Be aware of the signs that you have an infection. If you run a fever or start to have an increased cough with a change in the color of your mucous, you need to call your doctor, especially if you also feel more short of air.
• Decrease your exposure to irritants in the air such as smoke, dust, aerosol sprays, cold air, and high humidity. Listen to the weather reports and decrease your time outdoors when the ozone level is high.
Develop good medication-taking habits.
• Make sure you know why you are taking medications and how they work. Ask your doctor or respiratory therapist to explain each medication and to provide information that you can understand. Check with your doctor before taking any over-the-counter medications or vitamin supplements.
• Refill your inhalers before you run out. Don’t wait until they are empty. For inhalers that don’t include counters, write the date you started using each one on a piece of tape to put on the inhaler, or keep a calendar. Ask your respiratory therapist to help you calculate how long your inhalers will last.
• Don’t stop taking medications until you have checked with your provider. If a medication is causing you problems, notify your doctor so that he/she can suggest a solution or change your medication.
• If you can’t afford your medications, let your health care provider know. There are programs through the drug companies to help those that have a fixed or low income.
Stay active and learn how to simplify activities around the house.
When you exercise, your muscles become better at using oxygen so you don’t need as much oxygen to move around and the lungs don’t have to work so hard.
• Ask your doctor before starting to exercise. Some people with breathing problems have a lower than normal oxygen level when they exercise. Have your doctor check you to see if you need to use oxygen when active. When your oxygen level is low, it causes your heart to be stressed.
• Start slow. If you are very short of breath with any activity, don’t overdo by trying too much too soon. Start by walking in place a few minutes at a time and increase the time as you go.
• Stop and rest if you get short of breath. If you have chest pain, feel dizzy or weak or sick to your stomach, sit down. Call your doctor or go to the emergency room if you still feel bad after resting.
• Start doing fun activities. Remember that dancing and gardening are forms of exercise, too.
Ask your doctor to order pulmonary rehabilitation. See if there is a pulmonary rehabilitation program in your area. This is a program designed especially for persons with breathing problems and is often paid for by insurance. Respiratory therapists, physical therapists and others work with you on an exercise plan as well as your diet and how to breathe to avoid shortness of breath.
For more information on COPD, visit www.YourLungHealth.org.
Reviewed: May 26, 2005 Revised: June 2008
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If you use more than one peak flow meter (such as one at home and another one at school or work), be sure that all of them are the same brand.
References National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Rockville, MD. National Heart, Lung, and Blood Institute, US Dept of Health and Human Services; 2007. NIH publications 08-4051.
National Asthma Education and Prevention Program. How to use a peak flow meter. How to use a metered-dose inhaler. http://www.nhlbi.nih.gov/health/public/lung/asthma/asthma_tipsheets.pdf. Accessed May 8, 2014.
Cleveland Clinic Nutritional Guidelines for People with COPD
This article provides basic information to help you make healthy food choices. Planning what you eat and balancing your meals are important ways to manage your health. Eating healthy often means making changes in your current eating habits. Changing your eating habits will not cure COPD, but it can help you feel better. A registered dietitian can provide in-depth nutrition guidance, tailor this educational information to meet your needs, and help you create and follow a personal action plan.
Food is the fuel your body needs to perform all activities, including breathing. Your body uses food for energy as part of a process called metabolism. During metabolism, food and oxygen are changed into energy and carbon dioxide. You use energy for all of your activities - from sleeping to exercising.
metabolism food and oxygen--------> energy + carbon dioxide
Food provides your body with nutrients (carbohydrates, fat, and protein) that affect how much energy you will have and how much carbon dioxide is produced. Carbon dioxide is a waste product that leaves your body when you breathe out (exhale). If there is too much carbon dioxide in your body, you might feel weak.
Breathing requires more energy for people with chronic obstructive pulmonary disease (COPD). The muscles used in breathing might require 10 times more calories than those of a person without COPD.
Good nutrition helps the body fight infections. Chest infections are illnesses that often lead to hospitalization for people with COPD, so it is important to reduce your risk of infection by following a healthy diet.
Maintain a healthy body weight. Ask your health care provider or registered dietitian what your "goal" weight should be and how many calories you should consume per day.
If you are overweight, your heart and lungs have to work harder, making breathing more difficult. In addition, the extra weight might demand more oxygen. To achieve your ideal body weight, exercise regularly and limit your total daily calories.
In contrast, being underweight might make you feel weak and tired, and might make you more likely to get an infection. People with COPD use more energy while breathing than the average person. Therefore, the pulmonary (breathing) muscles in someone with COPD might require up to 10 times the calories needed by a person without COPD. It is important for you to consume enough calories to produce energy in order to prevent wasting or weakening of the diaphragm and other pulmonary muscles.
Monitor your weight. Weigh yourself once or twice a week, unless your doctor recommends weighing yourself more often. If you are taking diuretics (water pills) or steroids, such as prednisone, you should weigh yourself daily since your weight might change. If you have an unexplained weight gain or loss (2 pounds in one day or 5 pounds in one week), contact your doctor. He or she might want to change your food or fluid intake to better manage your condition.
Drink plenty of fluids. You should drink at least 6 to 8 eight-ounce glasses of non-caffeinated beverages each day to keep mucus thin and easier to cough up. Limit caffeine (contained in coffee; tea; several carbonated beverages such as cola and Mountain Dew; and chocolate) as it might interfere with some of your medicines.
Some people with COPD who also have heart problems might need to limit their fluids, so be sure to follow your doctor's guidelines.
Include high-fiber foods — such as vegetables, fruits, cooked dried peas and beans (legumes), whole-grain foods, bran, cereals, pasta, rice, and fresh fruit — in your diet. Fiber is the indigestible part of plant food. Fiber helps move food along the digestive tract, better controls blood glucose levels, and might reduce the level of cholesterol in the blood.
The goal for everyone is to consume 20 to 35 grams of fiber each day. An example of what to eat in one day to help you get enough fiber includes: eating 1 cup of all-bran cereal for breakfast, a sandwich with two slices of whole-grain bread and 1 medium apple for lunch, and 1 cup of peas, dried beans, or lentils at dinner.
Control the sodium (salt) in your diet. Eating too much salt causes the body to keep or retain too much water, causing breathing to be more difficult. In addition to removing the salt shaker from your table:
• Use herbs or no-salt spices to flavor your food. • Don't add salt to foods when cooking. • Read food labels and avoid foods with more than 300 mg sodium/serving. • Before using a salt substitute check with your doctor. Salt substitutes might contain other
ingredients that can be just as harmful as salt.
Make sure you are getting enough calcium and Vitamin D to keep your bones healthy. Good sources of these nutrients are foods made from milk (milk, cheese, yogurt, ice cream, and pudding) and foods fortified with calcium and Vitamin D. You may need to take calcium and Vitamin D supplements. Maintaining a healthy weight and exercising will also help with keeping bones healthy.
Wear your cannula while eating if continuous oxygen is prescribed. Since eating and digestion require energy, your body will need the oxygen.
Avoid overeating and foods that cause gas or bloating. A full stomach or bloated abdomen might make breathing uncomfortable. Avoid the foods that cause gas or bloating. Some foods that cause gas for some people include:
peas, peppers, pimentos, radishes, scallions, shallots, and soybeans
Follow your doctor's other dietary guidelines. If you take diuretics (water pills), you might also need to increase your potassium intake. Some foods high in potassium include oranges, bananas, potatoes, asparagus, and tomatoes.
If you are short of breath while eating or right after meals, try these tips:
• Clear your airways at least one hour before eating. • Eat more slowly. Take small bites and chew your food slowly, breathing deeply while chewing.
Try putting your utensils down between bites. • Choose foods that are easy to chew. • Try eating five or six small meals a day instead of three large meals. This will keep your
stomach from filling up too much so your lungs have more room to expand. • Try drinking liquids at the end of your meal. Drinking before or during the meal might make you
feel full or bloated.
• Eat while sitting up to ease the pressure on your lungs. • Use pursed-lip breathing.
Eat a variety of foods from all the food groups to get the nutrients you need. The recommended number of servings per day are listed below. These guidelines are for a 2,000-calorie diet. To find out more about the amounts that are right for you, go to www.ChooseMyPlate.gov.
Grains Vegetables Fruits Milk Meat and Beans
Eat whole-grain cereals, breads, crackers, rice, or pasta every day. 1 oz. is about 1 slice of bread, 1 cup of cereal, or a half cup of cooked rice, cereal, or pasta.
Eat more dark green veggies like broccoli and more orange veggies like carrots. Eat more dry beans and peas like pinto beans and lentils.
Eat a variety of Fresh fruit. Choose fresh, frozen, canned or dried fruit. Go easy on fruit juices.
Choose low-fat or fat-free milk, yogurt, and other milk products. If you don’t or can’t consume milk, choose lactose-free products or calcium-fortified foods or beverages.
Choose low-fat or lean meats and poultry. Bake it broil it, or grill it. Vary your protein routine-choose more fish, beans, peas, nuts, and seeds.
Eat 6 oz daily. Eat 2.5 cups daily. Eat 2 cups daily. Have 3 cups daily. Eat 5.5. oz. daily.
If you are often too tired to eat later in the day, here are some guidelines:
• Choose foods that are easy to prepare. Save your energy for eating, otherwise you might be too tired to eat.
• Ask your family to help with meal preparations. • Check to see if you are eligible to participate in your local Meals on Wheels program. • Freeze extra portions of what you cook so you have a quick meal when you're too tired.
• Rest before eating so you can enjoy your meal. • Try eating your main meal early in the day so you have enough energy to last you for the day.
Tips for improving your appetite
General guidelines
• Talk to your doctor. Sometimes, poor appetite is due to depression, which can be treated. Your appetite is likely to improve after depression is treated.
• Avoid non-nutritious beverages such as black coffee and tea. • Try to eat more protein and fat, and less simple sugars. • Eat small, frequent meals and snacks. • Walk or participate in light activity to stimulate your appetite. • Keep food visible and within easy reach.
Meal guidelines
• Drink beverages after a meal instead of before or during a meal so that you do not feel as full. • Plan meals to include your favorite foods. • Try eating the high-calorie foods in your meal first. • Use your imagination to increase the variety of food you're eating.
Snack guidelines
• Don't waste your energy eating foods that provide little or no nutritional value (such as potato chips, candy bars, colas, and other snack foods).
• Choose high-protein and high-calorie snacks. • Keep non-perishable snacks visible and within easy reach.
Dining guidelines
• Make food preparation an easy task. Choose foods that are easy to prepare and eat. • Make eating a pleasurable experience, not a chore.
o Liven up your meals by using colorful place settings. o Play background music during meals.
• Eat with others. Invite a guest to share your meal or go out to dinner. • Use colorful garnishes such as parsley and red or yellow peppers, to make food look more
appealing and appetizing.
Alcohol guidelines
Ask your doctor for specific guidelines regarding alcohol. Your doctor might tell you to avoid or limit alcoholic beverages. Alcoholic beverages do not have much nutritional value and can interact with the medicines you are taking, especially oral steroids. Too much alcohol might slow your breathing and make it difficult for you to cough up mucus.
Tips for gaining weight
• Drink milk or try one of the "High Calorie Recipes" listed below instead of drinking low-calorie beverages.
• Ask your doctor or dietitian about nutritional supplements. Sometimes, supplements in the form of snacks, drinks (such as Ensure or Boost) or vitamins might be prescribed to eat between
meals. These supplements help you increase your calories and get the right amount of nutrients every day. Note: Do not use supplements in place of your meals.
• Avoid low-fat or low-calorie products unless you have been given other dietary guidelines. Use whole milk, whole milk cheese, and yogurt.
• Use the "Calorie Boosters" listed in this article to add calories to your favorite foods.
High-calorie snacks
• Ice cream • Cookies • Pudding • Cheese • Granola bars • Custard • Sandwiches • Nachos with cheese • Eggs • Crackers with peanut butter • Bagels with peanut butter or cream cheese • Cereal with half and half • Fruit or vegetables with dips • Yogurt with granola • Popcorn with margarine and parmesan cheese • Bread sticks with cheese sauce
Eat a variety of foods from all the food groups to get all the nutrients you need.
High-calorie recipes to promote weight gain
If you are having difficulty maintaining a healthy weight, try some of these "Calorie Boosters."
Super Shake
Ingredients
1 cup whole milk 1 cup ice cream (1-2 scoops) 1 package Carnation Instant Breakfast
Directions
Pour all ingredients into a blender. Mix well.
Makes one serving; 550 calories per serving.
Chocolate Peanut Butter Shake
Ingredients
1/2 cup heavy whipping cream 3 tablespoons creamy peanut butter 3 tablespoons chocolate syrup 1-1/2 cups chocolate ice cream
Blend milk and oil. Add pudding mix and mix well. Pour into dishes (1/2 cup servings).
Makes four 1/2 cup servings; 250 calories per serving.
Great Grape Slush
Ingredients
2 grape juice bars 1/2 cup grape juice or 7-up 2 tablespoons corn syrup 1 tablespoon corn oi
Directions
Pour all ingredients into a blender. Mix well.
Makes one serving; 490 calories per serving.
If you are having difficulty maintaining a healthy weight, try some of these calorie boosters:
Calorie Boosters
Food Item Suggested Use
Egg yolk or whole egg Before cooking, add egg yolk or whole egg to foods such as meat loaf, rice pudding, or macaroni and cheese. (To prevent illness, avoid the use of uncooked eggs.)
Non-fat powdered milk or undiluted evaporated milk
Add to beverages (including milk) or to these foods: creamed soups yogurt scrambled eggs casseroles pudding mashed potatoes
Calorie Boosters
Food Item Suggested Use
custard gravies hot cereal sauces
Cream cheese or shredded, melted, sliced, cubed, or grated cheese
Add to sandwiches, snacks, casseroles, crackers, eggs, soups, toast, pasta, potatoes, rice or vegetables, or serve as a snack.
Vegetable oils, mayonnaise, butter, margarine, or sour cream
Add margarine or mayonnaise to sandwiches; add any of these items to bread, casseroles, soups, eggs, cooked cereals, pasta, potatoes, rice, vegetables, pudding.
Peanut butter (creamy or crunchy) Spread on bread, crackers, apples, bananas, or celery. Or add to cereal, custard, cookies, or milk shakes.
Nut dust (grind any type of nuts in a blender or food processor)
Add to puddings, gravy, mashed potatoes, casseroles, salads, yogurt, cereals
Miscellaneous foods (limit to one serving per day)
Add: sugar, jelly, jam preserves honey corn syrup maple syrup
To: hot cereal, cold cereal fruit, fruit salad sweet potatoes winter squash
References
• American Lung Association. Nutrition Accessed 06/18/2013. • National Heart Lung and Blood Institute. Treatment Treatment Accessed 06/18/2013.
