COPD Nutrition Care
Chronic Obstructive Pulmonary Disease (COPD)
It is characterized by slow progressive obstruction of the airways. COPD symptoms are subdivided into two categories:
1. Emphysema, a condition of the lung characterized by the chronic enlargement of the alveoli, accompanied with permanent changes in the walls without obvious fibrosis. Pulmonary disorders affect nutritional intake, often making patients at risk for malnutrition, depleting nutrient body stores and marked weight loss.
2. Chronic bronchitis, a condition wherein there is chronic production of cough in response to irritants, often environmental, coupled with inflammation, both causing blockage or narrowing of the airways and difficulty in breathing.
Nutritional care in COPD
The primary goals of dietary care for COPD patients are to facilitate nutritional well-being, maintain an appropriate lean body mass: adipose tissue ratio and correct fluid imbalance.
Energy: Energy requirements are elevated in COPD and they vary for each individual. A 150% increase of the REE calculated by Harris Benedict’s equation is usually recommended. This is approximately 30-40 Kcal/ Kg body weight.
Carbohydrates: A low carbohydrate diet is recommended. About 45-55% of calories should come from carbohydrates. Simple sugars are best avoided. The reason being that carbohydrates when metabolised produce excessive amounts of CO2, contributing to the already existing trouble of expiration.
Proteins: About 1.1-1.3g/Kg body weight is recommended. This should amount to about 16-20% of total calories. More than 20% of total calories put unnecessary stress on the kidneys. First class proteins such as eggs, milk should constitute at least 50% of the total protein. In cases where oral intake is insufficient, protein supplements are helpful.
Fats: About 30-35% of the total calories should come from fat. Care, should however be taken not to plan deep fried foods in the diets as these might irritate the respiratory lining causing cough and vomiting.
Often other concurrent disease processes exist such as CVD, Renal diseases, cancer or Diabetes Mellitus. These underlying diseases affect the total amount and kind of protein, fat and carbohydrate prescribed.