Patients with chronic obstructive pulmonary disease (COPD) may find it more difficult to eat well and get the nutrients they need.
COPD is a general term used to describe progressive lung conditions that result in increased breathlessness – such as emphysema, chronic bronchitis, severe asthma and some forms of bronchiectasis.
The prevalence of lung conditions in the UK is very high, currently 2% of the population are living with a diagnosis of COPD.
How COPD affects appetite
The nature of COPD symptoms can make eating well difficult and can lead to unintentional weight loss. Some of the reasons why weight loss can happen in COPD include:
- Reduced appetite – chest infections can reduce a person's appetite. Feeling full after just a small amount of food, or experiencing taste changes can all affect food intake.
- Shortness of breath – the characteristic shortness of breath makes it difficult for people to chew and swallow their food. As a result they may begin to eat less, choose only those foods with an easy-to-chew texture, or eat very slowly. The characteristic shortness of breath that often accompanies COPD can make food intake more difficult.
- Tiredness – feeling out of breath can reduce the motivation to shop or prepare healthy food. As a result, people with COPD may skip meals, or rely on less healthy convenience-food options.
- Increased energy needs – the daily calorie needs of people with COPD may be higher than the norm, due to the additional work of breathing and background inflammation linked to the condition. Chest infections may further increase energy needs.
- Dry mouth – certain mainstay treatments for COPD, including oxygen, nebulisers and inhalers can cause a dry mouth. A dry mouth can make chewing and swallowing more difficult, and can sometimes lead to taste changes – both of which can make eating seem like more trouble than it's worth.
Carrying too much weight, or losing too much weight, comes with their own distinct set of problems for people with COPD. Being overweight – from inactivity, comfort eating or steroids to control your condition – can worsen your COPD symptoms. Being underweight can impair muscle strength. People with COPD are at increased risk of chest infections which can affect both energy needs and appetite.
Top tips for eating with COPD symptoms
When you are feeling short of breath you may find it easier to eat foods that are softer and more moist. Foods that would fit this bill include casseroles, soups and sauces, gravy added to meals, milk puddings, fruit smoothies or ice-cream. You should aim to eat three small meals and three snacks or nutritious drinks a day if appetite is poor.
To cope with a dry mouth, eat softer, moister foods. Sucking on ice-cubes made from water, fruit squash or fruit juice can help relieve a dry mouth. Berry fruits, melon and grapes are all moist fruit choices that add vitamins as well as water to your daily diet. Sugar-free gum can also help with a COPD-related dry mouth. This link http://malnutritionpathway.co.uk/copd/ has tips for eating better with COPD.
Concerned about your nutritional needs?
If your breathlessness makes it difficult to eat, you're eating less than you used to and starting to lose weight, make sure your hospital respiratory team or GP knows. Weighing yourself once a week and recording your weight helps your GP to assess the severity (or not) of your weight changes.
If necessary, your GP or respiratory nurse specialist may refer you to a dietitian, or they may prescribe medical nutrition to supplement your diet with protein, energy, vitamins and minerals.
Oral nutritional supplements products are easy to swallow when you're extremely breathless. They come in a range of flavours and types, including ready-made drinks, milk-shake powders to mix with fresh milk, and fortified desserts, yoghurts and juices.
Oral nutritional supplements are foods for special medical purposes for use in the dietary management of disease related malnutrition and must be used under medical supervision.
There are a variety of resources available for helpful information about unintentional weight loss, improving your dietary intake and medical nutrition products.
If you have any questions or concerns about unintentional weight loss and how to improve your nutritional intake, speak to your healthcare professional. A checklist which may help you discuss your concerns can be found at: http://www.patients-association.org.uk/wp-content/uploads/2016/12/The-Patients-Association-Nutrition-Checklist.pdf
For lots of useful information and support for people with COPD visit https://www.blf.org.uk/support-for-you/copd