We breathe in order to live. The breathing process is crucial in the exchange of gases such as oxygen and carbon dioxide inside our bodies. Our respiratory system has many different parts that work together to help us breathe. It is composed primarily of the nose, oropharynx, larynx, trachea, bronchi, bronchioles, and lungs.
Breathing seems a simple thing to do but there is a complexity to that. The complex transfer of gases takes place in the lungs which involves millions of bronchi and alveoli. Bronchi are the airways or passages within the lungs whereas alveoli are the tiny air sacs composed of special membranes found at the end of bronchi where the transfer of gases between the blood and air occurs.
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. COPD is a long-term exposure to irritants like cigarette smoking and pollution that damage the lungs and airways. Symptoms of COPD include difficulty in breathing, cough, mucus production, and wheezing.
In the Philippines, this remains among the top 10 leading causes of death and according to the 2018 Expanded National Nutrition Survey (ENNS), 21.59% of Filipinos aged 20-59 years old, and 16.3% among 60 years old are smokers.
As an initiative to intensify campaign against COPD, we celebrate this on 21 November 2020 due to the rising prevalence among Filipinos which should be given attention.
There are two (2) types of COPD, namely chronic bronchitis and emphysema. Bronchitis is characterized by inflammation of the bronchi which results to decreased airflow. On the other hand, emphysema affects the alveoli which causes the alveolar membrane to lose elasticity, leading as well to poor gas exchange.
COPD is a serious disease but can be managed to avoid decline of the nutritional status. Moreover, the right combination of nutrients in the diet is another factor that can help us breathe easier.
Here are some nutrition advices for the management of COPD:
Increase calorie intake among patients with COPD as their breathing requires a conscious effort, thus there is a need to increase their resting energy expenditure (REE) by 10-15%. The insufficient energy supply in the body can result in weight loss. Besides, it is advised that patients are given 4 to 6 small meals a day to easily acquire high caloric intake and to allow the diaphragm to move freely and let the lungs fill with air and empty more easily.
Maintaining normal BMI or Body Mass Index (18.5 kg/m2 to 24.9 kg/m2) for individuals suffering from COPD should be guarded. Overweight or obesity means having the heart and lungs work harder, making breathing more difficult, and demands more oxygen needed in the body. On the other hand, underweight makes you feel weak and tired and more prone to get an infection since COPD uses more energy while breathing.
Since COPD is mainly caused by cigarette smoking which contains free radicals and other oxidants that lead to oxidative stress, subsequent inflammation, and reduced airflow in the lungs it is crucial to have a higher consumption of fruits and vegetables. These have been found beneficial in chronic and acute respiratory conditions as they contain antioxidants, minerals, vitamins, flavonoids, phytochemicals, and fiber. Mainly, vitamins C, E, and selenium found in fruits and vegetables serve as antioxidants. Eating dark green vegetables (broccoli, green bell pepper, kale) and red to orange vegetables and fruits (grapes, oranges, squash, carrots, tomatoes) will help in attaining the micronutrient needs to manage COPD. It is recommended to eat 3 servings of vegetables and 2 servings of fruits daily.
Omega-3 polyunsaturated fatty acids (PUFA) have been shown to have an anti-inflammatory effects and could be a benefit to a chronic inflammatory condition like COPD and also in malnourished patients. Common sources of omega-3 fatty acids are seafood like tuna, herring, mackerel, and sardines.
Vitamin D among COPD patients is low and its deficiency has been relative to its early progression so intake of its food resource should be kept in mind. Also, an increase in calcium intake should be emphasized to compensate for calcium depletion due to the long-term use of steroids. These two nutrients help decrease muscle weakness.
It is also necessary to control sodium intake as this may cause water retention or swelling that increases blood pressure leading to complications with COPD patients. Thus, salt consumption must be kept in check. Food preparation may include herbs and spices to season the food to make it more palatable.
Always stay hydrated to help keep mucus thin for easier removal. Mostly, 6-8 glasses of water are recommended among COPD patients. Fresh fruit juices, and other caffeine-free fluids can be counted as part of the intake.
Stay in shape through being physically active. Allow your body to move and have routine exercise at least 30-60 minutes a day. Yoga can be of great help particularly in your breathing pattern.
Lastly, avoid tobacco smoking, exposure to dust, chemicals, and pollution since these worsen cases of COPD.
Chronic obstructive pulmonary disease can deteriorate the body but with the proper nutrition, it can be prevented. Through optimum nutrition, it helps COPD patients become a well-functioning individual again.
Furthermore, the call for its celebration is a mere reminder that we should take care of our lungs and choose a healthy lifestyle everyday. (ND II Angelique Jean Maggay)
Resources:
Chronic obstructive pulmonary disease. 2020. https://www.mayoclinic.org/diseases-conditions/copd/symptoms-causes/syc 20353679#:~:text=Chronic%20obstructive%20pulmonary%20disease%20(COPD,(sputum)%20production%20and%20wheezing. Mayo Foundation for Medical Education and Research (MFMER)
Chronic obstructive pulmonary disease (COPD). https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)
Chua, JR., Albay, AB Jr., & Tee, ML. 2020. Body composition of Filipino chronic obstructive pulmonary disease (COPD) patients in relation to their lung function, exercise capacity and quality of life.https://www.dovepress.com/body-composition-of-filipino-chronic-obstructive-pulmonary-disease-cop-peer-reviewed-fulltext-article-COPD#:~:text=Chronic%20Obstructive%20Pulmonary%20Disease%20(COPD)%20remains%20among%20the%20top%2010,conditions%20being%20the%20most%20prevalent. Dove Medical Press Ltd 2020.
Florian, I. February 2009. Nutrition and COPD - dietary considerations for better breathing. https://www.todaysdietitian.com/newarchives/td_020909p54.shtml. Great Valley Publishing Company. 3801 Schuylkill Road Spring City, PA 19475.
Rawal, G. & Yadav S. 2015. Nutrition in obstructive pulmonary disease: a review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4936454/. US National Library of Medicine National Institutes of Health.
Introduction to chronic obstructive pulmonary disease. https://www.mentalhelp.net/chronic-obstructive-pulmonary-disease/. Mentalhelp.net. Recovery brands LLC, A subsidiary of American addiction centers, Inc.
Larissa Hirsch, MD 2019. Lungs and Respiratory System. https://kidshealth.org/en/teens/lungs.html. 1995-2020 The Nemours Foundation.
Nutrition and copd. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/living-with-copd/nutrition#:~:text=Eat%2020%20to%2030%20grams,and%20dried%20beans%20or%20peas. American Lung Association.
Nutrition guidelines for people with COPD. https://my.clevelandclinic.org/health/articles/9451-nutritional-guidelines-for-people-with-copd. 9500 Euclid Avenue, Cleveland, Ohio 44195
