A healthy and well-balanced diet and adequate nutrition are important in keeping as well as possible when living with a lung condition such as Chronic Obstructive Pulmonary Disease (COPD) or bronchiectasis.
Dr Hayley Scott, an Accredited Practising Dietitian and Postdoctoral Fellow at the University of Newcastle, has a special interest in respiratory disease and has answered some of the most frequently asked questions about diet and nutrition. Watch the webinar video here or read more below.
Why is hydration important for our lung health?
Drinking plenty of water is not only important to keep you hydrated, but it also helps to keep your mucous thin. If you’re dehydrated, your mucous can become thick and sticky which can make it more difficult for you to clear your chest, and can increase your risk of developing a chest infection.
How much fluid should I drink?
It’s recommended for women to drink about 8 cups a day, and for men to have about 10 cups a day. On warmer days, it’s important to have more fluids to prevent you from becoming dehydrated.
Tips:
- Don’t try and drink all your fluid at once – spread it out evenly across the day
- Set yourself a daily goal and work towards gradually increasing your intake every few days
- Fill a jug in the morning with all the water that you need for the day
- Add ice cubes or keep the jug in the fridge
- Add slices of fresh or frozen fruit for flavour such as: lime, lemon, watermelon, strawberries or mint
- Take a reusable water bottle with you if you’re out and about.
What fluids should I drink?
All fluids count towards your daily fluid intake, however it’s best if most of this comes from plain water. There are other drink options that can be included in a healthy diet, such as milk, tea or coffee but these should be consumed in moderation. Fruit and vegetable juice should be consumed sparingly, and drinks such as soft drinks and cordials aren’t needed as part of a healthy, balanced diet.
What are the impacts of being underweight on lung function?
Being underweight is common for people with COPD and bronchiectasis due to a range of different factors. Common symptoms such as fatigue and breathlessness can make purchasing, eating and preparing food more difficult, and dry mouth can make eating less enjoyable.
Repeat infections can also result in periods of weight loss, and malnutrition might develop if weight isn’t regained between infections. If you’re malnourished, you then have an increased risk of developing another infection.
Unintentionally losing weight may also be a risk factor for malnutrition, even in people who are in a healthy weight range or overweight. Weighing yourself each month may help you identify early on if you’re unintentionally losing weight, which you can then mention to your healthcare team.
What are the most important foods to eat if I struggle to eat too much?
People who are experiencing a flare up, breathlessness, or a poor appetite often don’t eat enough of what their bodies need, and it’s important to nourish your body to keep as well as possible.
Tips:
- Protein-rich foods include meat, fish, eggs, dairy products, beans, lentils, nuts and tofu. If your weight is stable, you should aim to eat protein-rich foods at least 3 times a day, but if you have a poor appetite or have been losing weight, you should aim to include protein-rich foods between meals as well.
- If you can’t eat much at mealtime, you can try to have a nourishing drink such as a milkshake or smoothie to get protein in between meals, which can be easier to consume than foods.
- Your GP or healthcare team may also recommend an oral nutrition supplement, which is a special drink made up of proteins, vitamins, minerals, calories as well as fluids.
- Ensure you’re having enough calcium for bone strength, which can be found in foods such as milk, yoghurt, cheese, sardines, pink canned salmon (with the bones) and tofu.
- Low vitamin D levels are associated with lower lung function and an increased risk of infection. Vitamin D is also essential for bone health, so try and get vitamin D from the sun by spending a few minutes outdoors on most days of the week. In winter, spend some time outdoors with some skin uncovered in the middle of the day. If you find your vitamin D levels are low, a vitamin D supplement may be required.
If you’ve lost weight or your appetite has dropped significantly and you aren’t sure why, it’s important to discuss this with your healthcare team, and they may refer you to see a dietitian who can provide an individualised management approach.
How do I lose weight when I can’t exercise as much as I would like?
It’s important to stay active to help keep your lungs and your body strong.
A good starting point can be to talk to your doctor for some specific tips on how to be active, and they might be able to recommend a respiratory physiotherapist or exercise physiologist who can come up with an individualised program for you. Your doctor could also refer you to pulmonary rehabilitation, which is a 6–8-week program that helps people living with a chronic lung condition improve their exercise capacity, reduce breathlessness and increase general well-being.
The activity doesn’t need to be strenuous. You could try gentle exercise like walking, but just keeping your body moving can help maintain your muscle mass and help you with weight loss. Making sure you’re having enough protein alongside the regular exercise may help to lose weight while maintaining muscle mass, and can also help with appetite as protein-rich foods keep you fuller for longer.
Tips:
- If your goal is to lose weight, aim to lose up to half a kilogram a week
- Swap out energy dense foods such as fried foods, cakes, and biscuits, for less energy dense options such as fruits and vegetables, lean meats, and wholegrain breads and cereals
- Ensure you’re having enough protein to maintain muscle mass while losing weight
- Choose low-fat sources such as lean meats and low-fat dairy.
What foods are good for my lung health?
The best thing you can do is eat a balanced diet to achieve and maintain a healthy weight. This means choosing a variety of foods from each of the 5 foods groups in suitable proportions: fruits, vegetables, wholegrain foods, protein-rich foods, and dairy.
Tips:
- Try to eat two serves of fruits, and five serves of vegetables a day
- Fibre can be found in fruits, vegetables, legumes, nuts, and wholegrain foods such as brown rice, oatmeal, and couscous. There is some research suggesting a high fibre diet can help prevent reductions in lung function
- Omega-3 fatty acids can be found in salmon, sardines, mackerel, herring, or an omega-3 supplement
- Choose good quality fats such as extra virgin olive oil, nuts and nut butters, seeds, and avocado.
What foods should I avoid?
While there are no foods that should be avoided, there are some foods or nutrients that should be limited. Cured meats such as bacon, hot dogs, and processed meats are associated with lower lung function and a high intake of these meats have been linked to a risk of being hospitalised for COPD. Saturated fats such as butter, fried foods and fatty meats should also be limited and replaced with good quality fats such as extra virgin olive oil and avocado.
To find a dietitian with a special interest in chronic lung conditions, talk to your GP or specialist or visit https://dietitiansaustralia.org.au/.
