Impact of weight gain and weight loss

Maintaining good nutrition and a healthy weight is important for everyone, but especially for those living with COPD. Eating right can give you more energy for all your daily activities, including breathing, and maintaining a healthy weight is important since your lungs have to work harder to breathe if you have COPD. Good nutrition can also help your body fight infections.

Being overweight or obese can affect lung function in many ways. In particular, the overabundance of fat tissue which occurs from obesity can impair the breathing process. Obesity also leads to a reduction in several pulmonary function tests including:

  • Forced expiratory volume in one second (FEV1)
  • Forced vital capacity (FVC)
  • Total lung capacity (TLC)

Since carrying around excess weight increases the work of breathing, there is a direct association between obesity and shortness of breath, or dyspnea, which is also recognized as the hallmark symptom of COPD. Obesity is also strongly associated with a decrease in exercise tolerance. Along with health problems associated with inactivity, being unable to exercise can severely impact the quality of life.

Conversely, some COPD patients struggle with appetite which can cause weight loss. In severe COPD, inflammation in the lungs can be quite severe and can actually cause lung volume to increase. This reduces the amount of space between the lungs and your stomach, and when you eat, the two organs can push against one another and become quite uncomfortable. This can also cause breathing to become more difficult and these sensations may ultimately discourage you from eating.

Some impacts of being underweight include:

  • Increased risk of infection: being unable to attain adequate nutrients can lead to infections because the body’s immune system is no longer strong enough to fight off illnesses on its own. This is why many people with COPD are hospitalized with chest infections.
  • Chronic fatigue: being underweight can make you feel extremely tired. Chronic fatigue can make it difficult to complete everyday tasks.
  • Increased risk of death: a Swedish study conducted in 2011 determined that people who were underweight were 1.7 times more likely to die than people with a normal body weight (European Lung Foundation, 2011).

Recommended diet and nutrition

Diet Tip #1: Stay Balanced

A healthy diet includes a variety of foods. Try to include these in your daily diet:

  • Low-fat protein foods such as lean cuts of meat, poultry, and fish (particularly oily fish like salmon, mackerel, and sardines).
  • Complex carbohydrates such as whole-grain bread, bran, brown rice, lentils, quinoa, beans, and oats. These foods are also high in fiber, which helps improve the function of the digestive system.
  • Fresh fruits and vegetables contain essential vitamins, minerals, and fiber, which will help to keep your body healthy. Some are better than others.
  • Foods containing high levels of potassium, like bananas, oranges, avocado, dark leafy greens, tomatoes, asparagus, and beets.
Diet Tip #2: Know What to Avoid

Certain foods can cause problems such as gas and bloating, contain too much fat, or are low in nutritional value. Foods to avoid or minimize include:

  • Too much sodium or salt in your diet causes water retention, which may affect your ability to breathe. To reduce the amount of sodium in your diet:
    • Remove the salt shaker from the table.
    • Don’t add salt to your cooking – use unsalted herbs and spices to flavor food instead.
    • Check with your dietician or healthcare provider about low-sodium salt substitutes.
    • Check the labels of the foods you buy and avoid any containing more than 300 milligrams of sodium per serving for snacks, and more than 600 milligrams for whole meals.
  • Fruits that cause bloating and gas like apples and stone fruits may lead to problems with breathing in some patients with COPD. If these fruits cause you discomfort, select another option.
  • Some vegetables that cause bloating and gas including soybeans, beans, cabbage, cauliflower, onions, peas, and peppers. If these foods cause issues for you, they should be avoided.
  • Some people find that dairy products, such as milk and cheese, make phlegm thicker. Avoid these if you find difficulty after consuming.
  • Foods that are fried, deep fried, or greasy can cause gas and indigestion. So can heavily spiced foods, which may also cause discomfort and may affect your breathing. Avoid both where possible.
Tip #3: What you drink matters too!
  • Drink plenty of fluids throughout the day.
    • Aim for 6-8 (8 ounce) glasses of non-caffeinated beverages a day.
    • Adequate hydration keeps mucus thin and easier to cough up.
  • Limit or avoid caffeine altogether, as it could interfere with your medication.
    • Caffeinated drinks include coffee, tea, sodas, and energy drinks.
  • Ask your doctor about alcohol.
    • You may be advised to avoid or limit alcoholic beverages, as they can interact with medications.
    • Alcohol may also slow down your breathing rate and make it more difficult to cough up mucus.
  • Likewise, talk to your doctor if you have diagnosed heart problems as well as COPD. Sometimes it’s necessary for people with heart problems to limit their fluid intake.

Exercise for people with COPD

Note: always check with your healthcare professional before starting any exercise program or new activity. The information on this page is not meant to replace a medical evaluation or information from your doctor. You should ALWAYS talk with your doctor about any exercise program before you start it. Your doctor can help you know how much and how often you should exercise.

We all know we should exercise. But it is easy to find excuses for not exercising. We’re too tired. We don’t feel well. We can’t find the time. In addition, if you have COPD you may think that you can’t exercise. You may think it will make you feel too short of breath. Or you may feel that it is not safe for you. You may think it will make your lung disease much worse.

Actually, avoiding exercise can make you more unfit. You lose fitness when you stop exercising. The less you do, the less you are able to do.

It’s normal to feel this way if you’re short of breath with COPD. However, exercise, done correctly and safely, is one of the best things you can do to be less short of breath. Shortness of breath is called dyspnea. Almost all individuals with COPD have dyspnea, and because of it, they tend to do less and less. The less they do, the less they are able to do, and eventually they become too weak to do much at all. This is called progressive de-conditioning. De-conditioning is losing fitness from lack of exercise.

Exercise itself cannot reverse COPD, but it can change the way you feel, breathe, and function. At first, your exercise routine should be slow and easy. Even if you think you can do more, take it slow. Your muscles are not used to working like that! Your exercise time and effort should gradually increase over time – each day, do a little more. When you’ve reached the point that you’re feeling better and breathing better, don’t stop. Keep it up at least three days a week.

Exercise cannot reverse lung disease but it can reverse de-conditioning and improve your quality of life.

If your healthcare professional has told you to use oxygen with activity, you should also use oxygen with exercise. Your usual oxygen flow rate (the number you set on your oxygen machine) may not be enough for you during exercise. Ask your health care provider how to set your oxygen for exercise.

Ideas for exercising with COPD

  1. Take a walk around the block, or even just to your mailbox!
  2. Consider looking at your local YMCA for “Silver Sneakers” or similar classes which are done at a slower, easier pace.
  3. Consider walking on a treadmill or riding a stationary bike.

Whatever you choose, you can start slow and build up as you gain confidence and fitness! Aim for 20-30 minutes, 3-5 times a week. Lack of routine physical activity can be a predictor for an exacerbation. Exacerbations can land you in the ER, or worse, in the hospital. You CAN be active and have COPD. You doctor can assist you with the right program for you!

Note: this page is intended for educational purposes only. Any changes to diet and nutrition should be reviewed with your physician prior to implementing. This page may contain links to external sites which are not monitored or controlled by Classic VentCare.