A person with chronic obstructive pulmonary disease (COPD) may find that consuming specific foods and following certain diets can help manage their condition.
This article describes how diet affects COPD and outlines the best diet for COPD, including foods to eat and avoid. We also provide an example meal plan for COPD, along with tips for cooking and eating.
A healthful diet can help prevent or manage some of the adverse health effects of COPD, a lung condition characterized by airflow limitation that makes it hard to breathe.
According to reviews in 2015 and 2019, a healthful, well-balanced diet can have the following beneficial health effects in people with COPD:
- reducing inflammation
- maintaining and improving muscle strength
- improving lung function
- lowering metabolic and heart disease risk
Research suggests that a balanced diet rich in antioxidants and anti-inflammatory foods may help prevent and manage COPD.
The best diet for someone with COPD often depends on the person’s weight and lifestyle. Below are some general tips on foods to eat and foods to avoid.
The American Lung Association recommend the following types of food for people who have COPD:
Complex carbohydrates
Complex carbohydrates contain long chains of sugar molecules. The body takes time to break down these molecules. As such, complex carbohydrates provide a relatively sustained release of energy.
Foods that contain complex carbohydrates include:
- fresh fruit and starchy vegetables
- whole grains
- whole grain bread and pasta
- beans and lentils
If a person with COPD wants to gain weight, eating a variety of complex carbohydrates alongside healthful sources of fat and protein can help.
Alternatively, if a person with COPD has extra body fat to lose, replacing refined carbohydrate sources with complex carbs, protein, and healthful fat can promote weight loss.
Fiber-rich foods
According to the American Lung Association, a person with COPD should aim for around 20–30 grams of fiber each day. Foods that contain a good amount of fiber include:
- beans and lentils
- fruits and vegetables
- nuts and seeds
- whole grains, such as oats
- vegetables
Protein
A study in the International Journal of Chronic Obstructive Pulmonary Disease found that people in Vietnam with COPD had increased protein needs. Including protein-rich foods at meals and snacks may help with improving nutritional status and quality of life.
Foods that are high in protein include:
Protein sources can help increase muscle mass and help people gain weight if needed. Alternatively, adding high-quality protein sources to meals and snacks or swapping refined carbohydrate sources with healthful proteins may promote weight loss.
Mono and polyunsaturated fats
Mono and polyunsaturated fats are healthful fats that can help lower a person’s cholesterol. Some foods that contain these fats include:
- certain vegetable oils, such as olive oil and avocado oil
- certain fish, including salmon
- nuts and seeds
- avocados
According to the American Lung Association, a person with COPD who is looking to gain weight should try adding these fats to meals. If they are looking to lose weight, they should limit their intake of all fats, including mono and polyunsaturated fats.
The American Lung Association recommend that people with COPD avoid or limit the following food types:
Simple carbohydrates
Simple carbohydrates provide fewer nutrients than complex carbohydrates. Foods consisting of simple carbohydrates include:
- table sugar
- chocolate and candy
- cakes and other sugary desserts
- sugary drinks
- processed foods
- white bread and pasta
Unhealthful fats
Many high-fat foods are nutritious, and people can include them in a healthful diet. However, many highly processed foods are high-fat, and people with COPD should avoid or limit them to promote overall health.
People with COPD must avoid or limit the following high-fat foods:
- fast food
- bacon and other processed meats
- fried foods
- sugary pastries
- margarine
- ice cream
Meal plans for COPD can vary depending on a person’s individual dietary requirements and personal circumstances. However, people can consider the following meal plan as a guide:
| Breakfast | oatmeal with strawberries, blueberries, and almond butter |
| Snack | Boiled egg and fresh sliced vegetables |
| Lunch | Grilled chicken breast with salad and new potatoes |
| Snack | Mixed nuts |
| Dinner | Grilled salmon with quinoa and zucchini |
| Dessert | Greek yogurt with pumpkin seeds and berries |
People interested in developing a more formal or tailored meal plan should seek the advice of a doctor or registered dietitian.
Sometimes, a person with COPD may experience low energy levels and may not feel up to cooking. In these instances, a person may want to consider the following options:
- Quick meals: Some healthful recipes take less than 30 minutes to prepare and cook. Buying pre-cut vegetables can reduce meal preparation times further.
- Crock-Pot: With crock-pot recipes, a person can leave all the ingredients to cook over several hours.
- Leftovers: When making meals, a person may consider cooking more than they need so they can have food the next day.
- Batch cook: On days when a person with COPD may be feeling less fatigued, they may consider batch cooking meals to keep in the freezer.
Some people with COPD may experience a lack of appetite due to breathing difficulties and general chest discomfort. Breathing difficulties also increase the physical effort required for eating, and this can make it difficult for a person to finish meals.
Below are some tips that may help improve a person’s appetite and energy levels, or ease the effort required for eating.
- Eating smaller meals: Instead of eating three large meals a day, it may be helpful to aim to eat four to six smaller meals. This should reduce stomach fullness and associated pressure on the lungs.
- Eating the main meal earlier: A person may find that they have more energy throughout the day if they eat their main meal earlier in the day.
- Drinks: A 2019 review found that readily available high-protein, high-energy drinks can help boost nutrition in people unable to tolerate high volumes of food.
COPD can lead to changes in a person’s metabolism and body composition.
Changes in metabolism
Metabolism is the process that occurs within the body to sustain life, such as converting the food a person eats into energy.
According to an article in The Journal of Translational Medicine, many people with COPD are in a state of hyper-metabolism. This is where the body uses more energy to perform essential body functions, such as breathing.
A person who has COPD and hyper-metabolism will require more calories than someone who does not have these conditions.
Changes in body composition
Around 25-40% of people with COPD develop pulmonary cachexia syndrome (PCS). This is a metabolic condition that causes weight loss and muscle wasting.
Some factors that may contribute to PCS in COPD include:
- widespread, or systemic, inflammation
- hyper-metabolism and insufficient calorie intake
- increased energy expenditure due to more effortful breathing
- muscle atrophy resulting from inactivity
- use of glucocorticoid medications to treat COPD
People with COPD and PCS typically require dietary interventions to counteract the PCS and prevent further health complications.
COPD and weight
People with COPD who have underweight or overweight may encounter additional health issues.
Being underweight can sometimes indicate malnutrition. A 2019 review notes that malnutrition alongside COPD may lead to poor health outcomes, including increased risk of COPD exacerbations or flare-ups.
According to a 2013 review, people who have COPD with obesity tend to experience more significant breathing difficulties compared to people with COPD without obesity. According to the review, excess fat, or adipose tissue, puts pressure on the chest wall, exacerbating breathing difficulties.
A 2014 review suggests that controlling obesity may help prevent and manage lung impairment in people with COPD.
If a person with COPD is looking to gain or lose weight, they should discuss the necessary dietary and exercise requirements with their healthcare team.
According to a 2016 review, exercise can improve muscle function and exercise tolerance in people with COPD.
Another 2016 study found that exercise and dietary restriction provided additional benefits for participants who had COPD and obesity. These benefits included:
- improved weight
- improved exercise tolerance
- improved health status
People with COPD who have underweight or have PCS may also benefit from regular exercise.
If someone with COPD wishes to take up exercise, they should discuss this with their healthcare team.
Consuming a balanced and nutritious diet may alleviate some of the breathing difficulties that people with COPD experience. It may also help to prevent certain health complications.
A person with COPD should try to eat plenty of protein, complex carbohydrates, and fiber-rich foods and add healthy sources of fat to meals and snacks.
Dietary patterns for people with COPD depend on many factors, including body weight and overall health.
When considering a change in diet or lifestyle, talk to a doctor for advice on how to do so safely and effectively.
