COPD & Emphysema Support Group
COPD is a progressive disease characterized by airflow obstruction or limitation. Emphysema is characterized by loss of elasticity of the lung tissue, destruction of structures supporting the alveoli and of capillaries feeding the alveoli. Both have symptoms that include shortness of breath, among other respiratory troubles. If you are a COPD or Emphysema sufferer, join...
You must keep in mind these basic facts of living with COPD:
because of your shortness of breath (SOB) you have limited energy resources, and you use a significant amount of energy just breathing (perhaps half of your resting energy requirements), so preparing and eating meals should be made as easy as possible;
overeating, or consuming carbonated drinks, may cause bloating which, in turn, will crowd your lungs and limit your capacity to breathe;
immediately after eating, your body sends increased blood (and oxygen) to the digestive tract, reducing the supply to the brain and motor muscles, suggesting that you avoid strenuous exercise within an hour of eating and, if possible, treat yourself to a nap after a heavy meal;
take your time when eating, pausing as necessary to keep your breathing comfortable, and chewing with the mouth closed, to avoid swallowing air;
avoid caffeine, as it interferes with many medications used to treat COPD.
COPD forces you to accommodate many changes in your life. To revise your eating and food preparation habits you need to retrain your palette and change some old habits. If you give my ideas a sixty-day trial, you'll explore many new flavors and textures that you will genuinely enjoy and, as you apply these principles, you will find yourself eating foods you like and will discover many ways to vary your menu to avoid boredom.
Traditional wisdom has held to the rule, "Refined carbohydrates cause excessive CO, so get more calories from fats than from sugars." The new school says, "Calories are the key, get them right, other things follow. I subscribe to this position (see Appendix), and will prefer a diet that is at least as heavy in complex carbohydrates as in fats or oils.
As mentioned above, many of us are "senior citizens" who live alone or have only 2 in the household. Under these circumstances, many of us find "cooking" to be such a bother that we skip meals or eat "convenience foods" or snacks. I'll attack that problem with menu ideas that make it easy to prepare several meals at the same time, freezing or refrigerating leftovers for future use.
Grocery shopping can be fun but, if you are SOB and toting an oxygen bottle, it quickly loses some of its appeal. It also exposes you to inclement weather, allergens, and contagious diseases carried by the general public. I'll tell you how to stock your pantry and refrigerator to reduce the number of trips you make to the market, and I'll try to stay within your budget.
III. Dietary Requirements of Adults, In General
Nutrients may, generally, be grouped as carbohydrates, fats, proteins, and minerals. Water isn't a nutrient, but certainly is a requirement. Some purists say vitamins are essential, but aren't "nutrients." I include them all, because they are pertinent to the COPD patients regimen, and managing the disease demands a familiarity with them.
As opposed to children, who need copious quantities of certain nutrients to support growth, adults need "only" the nutrients essential to maintain their bodies and furnish the energy for personal activity levels. Generally speaking, we require water to keep every cell healthy and flush out wastes; calcium and phosphorus to maintain our bones and teeth; proteins to maintain our muscles; fats and carbohydrates for energy, and; vitamins and trace minerals for nerve cells, etc. Should we have a good week hunting or fishing, or harvest a bumper crop of corn or peanuts, our bodies can store some of these nutrients for a while, to carry us through the lean times. Others cannot be stored and are required daily. (To keep it simple, you can remember that fats, proteins, minerals, and fat-soluble vitamins can be stored for future use and, conversely, that water, carbohydrates, salts, and water-soluble vitamins must be replaced daily.)
Interestingly, during lean times when carbohydrates are in short supply, the body can substitute fat or protein as an energy source, whether it is being consumed in lieu of carbohydrates, or has been stored in muscles and fat deposits. The converse is not true, however; if fats and proteins are absent from the diet, the body can't manufacture them, regardless of how much carbohydrate is consumed.
This leads us to the term, "balanced diet," the amounts of carbohydrates, fats, proteins, minerals, vitamins, and water, needed to meet the bodys immediate and long-term needs for these nutrients. It refers to the quality of the food one consumes.
The quantity of food consumed is another matter, and can easily get into some areas outside my field of knowledge. I address the matters I feel germane to the COPD patient, including weight gain and weight loss, however, I urge those whose weight problems are associated with medications to seek the advice of both a pulmonologist and a nutritionist, for it is a medical (not nutritional) problem. I have included, in the Appendix, web resources to 2 computer analyses of your "ideal" body weight and an explanation of calculating your BMI (Body Mass Index) devised to calibrate "obesity." I urge you to avoid taking either as gospel, for I believe that individual physiology leaves a 10% to 15% margin of error, but they are the best tools we have.
So, what are the nutritional requirements of an adult COPD patient? My approach follows these guidelines:
low-to-moderate use of sugars; low-salt content; substitute herbs and spices
high ratio of fruits and vegetables, preferably raw or steamed, al dante
generous use of beans and legumes (peas, lentils, etc)
plenty of complex carbohydrates and grains (pastas, whole-grain breads, rice, potatoes, barley, sprouted wheat)
frequent use of polyunsaturated fats and oils (canola, olive, peanut)
moderate number of meat meals, using beef, pork, poultry, eggs, and fish
introduce nuts and seeds into the regular diet
dried fruits supply variety, flavor, and energy boosts.
butter, cheese, dairy products daily
adequate water (sports drinks, fruit juices/ades, or milk)
portion sizes should vary, depending upon patients size and weight objectives.
Serving sizes are a constant source of amazement and amusement, (especially the efforts of the experts to make them understandable to us common folk). One talks in terms of cups, ounces, and tablespoons, another in liters and grams, while someone else says, "large onion" and "medium potato," "the size of a deck or cards," or "as big as your fist." (I especially like that, because the bigger one is, the bigger ones portions may be.) Whichever book you follow, you can be sure that few restaurants serve you a "single portion" of anything.
I will keep it simple and consistent, using the old-fashioned measures of cups, tablespoons, etc., but it becomes relatively moot, as we progress, because the size of your servings will depend upon your personal likings, habits, and tastes. You should, however, learn to read and understand the nutritional labels now found on virtually all packaged foods. See the Appendix for details.
The generally accepted standards for "servings," are expressed in these terms (from U.S. Department of Agriculture publications):
Vegetables, raw, non-leafy - 1 cup
Vegetables, cooked - cup
Fruits, raw - 1 cup
Fruits, cooked/canned/juice - cup
Fats (butter/oleo) - 1 teaspoon (1 pat)
Cooked pasta or rice - cup
Bread/toast - 1 slice
Dry cereal - 1 cup
Cheese - 1 ounces (3 tablespoons)
Sugar/jelly - 1 teaspoon
Meats, fish, poultry - 3 ounces (about 1/3 cup)
Beverages - 1 cup
Eggs - 1 egg, large
Nuts, seeds - 2 tablespoons
A peanut butter and jelly sandwich, then, is 2 servings of bread, 2 of sugar, and one of the meat/nuts category, demonstrating that shows that the "Daily Guide" of the USDA (below) does not imply that we eat to excess:
6 to 11 servings of bread, cereal, or pasta [important sources of energy, complex carbohydrates, B vitamins, minerals, and fiber]
3 to 5 servings of vegetables [provide vitamins A and C, carbohydrates, and fiber]
2 to 4 servings of fruit [rich sources of vitamins, fiber, and natural sugars]
2 to 3 servings of milk, yogurt, or cheese [excellent for their calcium content, protein, fats, vitamin B-12]
2 to 3 servings of meat, fish, poultry, eggs, beans or nuts [essential sources of proteins, minerals, and B vitamins; also contain fats (meat and poultry) and vegetable oils (seeds and nuts)]
3 "spare servings" of sweets, fats, and oils [their contribution is their energy content and flavor]
Following this "guide" will lead to a daily intake of 1,600 to 2,800 Calories, depending upon the choices you make and the number of servings you consume. It also assures a balanced diet, for each entry represents one of the "basic food groups" essential to your total nutritional needs.
Its not necessary to be fanatic about meeting each requirement every day. However, if you go heavy on veggies one day, and skip the meats, you should make up for it the next day or 2. At the very least, your menus should aim at maintaining a balance, across each week.
because of your shortness of breath (SOB) you have limited energy resources, and you use a significant amount of energy just breathing (perhaps half of your resting energy requirements), so preparing and eating meals should be made as easy as possible;
overeating, or consuming carbonated drinks, may cause bloating which, in turn, will crowd your lungs and limit your capacity to breathe;
immediately after eating, your body sends increased blood (and oxygen) to the digestive tract, reducing the supply to the brain and motor muscles, suggesting that you avoid strenuous exercise within an hour of eating and, if possible, treat yourself to a nap after a heavy meal;
take your time when eating, pausing as necessary to keep your breathing comfortable, and chewing with the mouth closed, to avoid swallowing air;
avoid caffeine, as it interferes with many medications used to treat COPD.
COPD forces you to accommodate many changes in your life. To revise your eating and food preparation habits you need to retrain your palette and change some old habits. If you give my ideas a sixty-day trial, you'll explore many new flavors and textures that you will genuinely enjoy and, as you apply these principles, you will find yourself eating foods you like and will discover many ways to vary your menu to avoid boredom.
Traditional wisdom has held to the rule, "Refined carbohydrates cause excessive CO, so get more calories from fats than from sugars." The new school says, "Calories are the key, get them right, other things follow. I subscribe to this position (see Appendix), and will prefer a diet that is at least as heavy in complex carbohydrates as in fats or oils.
As mentioned above, many of us are "senior citizens" who live alone or have only 2 in the household. Under these circumstances, many of us find "cooking" to be such a bother that we skip meals or eat "convenience foods" or snacks. I'll attack that problem with menu ideas that make it easy to prepare several meals at the same time, freezing or refrigerating leftovers for future use.
Grocery shopping can be fun but, if you are SOB and toting an oxygen bottle, it quickly loses some of its appeal. It also exposes you to inclement weather, allergens, and contagious diseases carried by the general public. I'll tell you how to stock your pantry and refrigerator to reduce the number of trips you make to the market, and I'll try to stay within your budget.
III. Dietary Requirements of Adults, In General
Nutrients may, generally, be grouped as carbohydrates, fats, proteins, and minerals. Water isn't a nutrient, but certainly is a requirement. Some purists say vitamins are essential, but aren't "nutrients." I include them all, because they are pertinent to the COPD patients regimen, and managing the disease demands a familiarity with them.
As opposed to children, who need copious quantities of certain nutrients to support growth, adults need "only" the nutrients essential to maintain their bodies and furnish the energy for personal activity levels. Generally speaking, we require water to keep every cell healthy and flush out wastes; calcium and phosphorus to maintain our bones and teeth; proteins to maintain our muscles; fats and carbohydrates for energy, and; vitamins and trace minerals for nerve cells, etc. Should we have a good week hunting or fishing, or harvest a bumper crop of corn or peanuts, our bodies can store some of these nutrients for a while, to carry us through the lean times. Others cannot be stored and are required daily. (To keep it simple, you can remember that fats, proteins, minerals, and fat-soluble vitamins can be stored for future use and, conversely, that water, carbohydrates, salts, and water-soluble vitamins must be replaced daily.)
Interestingly, during lean times when carbohydrates are in short supply, the body can substitute fat or protein as an energy source, whether it is being consumed in lieu of carbohydrates, or has been stored in muscles and fat deposits. The converse is not true, however; if fats and proteins are absent from the diet, the body can't manufacture them, regardless of how much carbohydrate is consumed.
This leads us to the term, "balanced diet," the amounts of carbohydrates, fats, proteins, minerals, vitamins, and water, needed to meet the bodys immediate and long-term needs for these nutrients. It refers to the quality of the food one consumes.
The quantity of food consumed is another matter, and can easily get into some areas outside my field of knowledge. I address the matters I feel germane to the COPD patient, including weight gain and weight loss, however, I urge those whose weight problems are associated with medications to seek the advice of both a pulmonologist and a nutritionist, for it is a medical (not nutritional) problem. I have included, in the Appendix, web resources to 2 computer analyses of your "ideal" body weight and an explanation of calculating your BMI (Body Mass Index) devised to calibrate "obesity." I urge you to avoid taking either as gospel, for I believe that individual physiology leaves a 10% to 15% margin of error, but they are the best tools we have.
So, what are the nutritional requirements of an adult COPD patient? My approach follows these guidelines:
low-to-moderate use of sugars; low-salt content; substitute herbs and spices
high ratio of fruits and vegetables, preferably raw or steamed, al dante
generous use of beans and legumes (peas, lentils, etc)
plenty of complex carbohydrates and grains (pastas, whole-grain breads, rice, potatoes, barley, sprouted wheat)
frequent use of polyunsaturated fats and oils (canola, olive, peanut)
moderate number of meat meals, using beef, pork, poultry, eggs, and fish
introduce nuts and seeds into the regular diet
dried fruits supply variety, flavor, and energy boosts.
butter, cheese, dairy products daily
adequate water (sports drinks, fruit juices/ades, or milk)
portion sizes should vary, depending upon patients size and weight objectives.
Serving sizes are a constant source of amazement and amusement, (especially the efforts of the experts to make them understandable to us common folk). One talks in terms of cups, ounces, and tablespoons, another in liters and grams, while someone else says, "large onion" and "medium potato," "the size of a deck or cards," or "as big as your fist." (I especially like that, because the bigger one is, the bigger ones portions may be.) Whichever book you follow, you can be sure that few restaurants serve you a "single portion" of anything.
I will keep it simple and consistent, using the old-fashioned measures of cups, tablespoons, etc., but it becomes relatively moot, as we progress, because the size of your servings will depend upon your personal likings, habits, and tastes. You should, however, learn to read and understand the nutritional labels now found on virtually all packaged foods. See the Appendix for details.
The generally accepted standards for "servings," are expressed in these terms (from U.S. Department of Agriculture publications):
Vegetables, raw, non-leafy - 1 cup
Vegetables, cooked - cup
Fruits, raw - 1 cup
Fruits, cooked/canned/juice - cup
Fats (butter/oleo) - 1 teaspoon (1 pat)
Cooked pasta or rice - cup
Bread/toast - 1 slice
Dry cereal - 1 cup
Cheese - 1 ounces (3 tablespoons)
Sugar/jelly - 1 teaspoon
Meats, fish, poultry - 3 ounces (about 1/3 cup)
Beverages - 1 cup
Eggs - 1 egg, large
Nuts, seeds - 2 tablespoons
A peanut butter and jelly sandwich, then, is 2 servings of bread, 2 of sugar, and one of the meat/nuts category, demonstrating that shows that the "Daily Guide" of the USDA (below) does not imply that we eat to excess:
6 to 11 servings of bread, cereal, or pasta [important sources of energy, complex carbohydrates, B vitamins, minerals, and fiber]
3 to 5 servings of vegetables [provide vitamins A and C, carbohydrates, and fiber]
2 to 4 servings of fruit [rich sources of vitamins, fiber, and natural sugars]
2 to 3 servings of milk, yogurt, or cheese [excellent for their calcium content, protein, fats, vitamin B-12]
2 to 3 servings of meat, fish, poultry, eggs, beans or nuts [essential sources of proteins, minerals, and B vitamins; also contain fats (meat and poultry) and vegetable oils (seeds and nuts)]
3 "spare servings" of sweets, fats, and oils [their contribution is their energy content and flavor]
Following this "guide" will lead to a daily intake of 1,600 to 2,800 Calories, depending upon the choices you make and the number of servings you consume. It also assures a balanced diet, for each entry represents one of the "basic food groups" essential to your total nutritional needs.
Its not necessary to be fanatic about meeting each requirement every day. However, if you go heavy on veggies one day, and skip the meats, you should make up for it the next day or 2. At the very least, your menus should aim at maintaining a balance, across each week.
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