The need for a healthy diet is something that every person shares, young and old, sick and healthy, and everything in between. However, the importance of good nutrition grows as we get older, and it becomes critical for many people living with chronic diseases like COPD.
People with COPD need to be particularly careful to get enough calories and nutrients to support their lungs and other body processes that are affected by the disease. COPD also makes you prone to a variety of diet-related problems, including under-nutrition, weight gain, and weight loss.
However, health and nutrition can get complicated, and sticking to a healthy diet isn't an easy thing to do. If you're like many people, the idea of putting together a healthy, well-balanced meal might feel intimidating, or you might not even quite know where to begin.
That's why we've put together this guide to help people with COPD plan healthy meals and get all the nutrition they need. In this post, we explain not only what a healthy COPD diet looks like, but we also show you how to put together healthy meals on the fly at home.
We also present a variety of practical meal ideas and examples of healthy and versatile dishes you can prepare on your own and modify as you please. These, along with the additional guides and helpful resources linked throughout this guide, should give you everything you need to get started eating a healthier diet that improves—rather than exacerbates—your COPD.
Before we start looking at some specific COPD-healthy dishes and meal plans, it's important to have a general grasp of what a healthy diet for someone with COPD looks like. That doesn't mean you have to be a diet guru, but you should know some general principles of nutrition and how to put together a balanced meal.
You should also be aware of the different ways that your diet and eating habits can affect your COPD and worsen symptoms like shortness of breath. We'll address these and a variety of other important dietary considerations in the sections below before we dive into our list of healthy meal examples and some practical diet recommendations for people with COPD.
If you look up nutritional guidelines—which you can find online from a variety of government and health organizations—they contain a list of all the vital components that make up a healthy diet. They tell you everything from what categories of food to eat, down to the exact amount of vitamins and minerals you should take in on a daily basis.
Because this information is readily available from lots of great sources, we're not going to go into them in great detail here. However, we do want to highlight some of the most important principles you need to know in order to learn how to create balanced, nutritious meals.
First, you should strive for a healthy balance of the three major macronutrients in your diet: proteins, fats, and carbohydrates (also known as carbs). Health experts recommend spreading out your daily calories between these nutrient groups, aiming for the following (approximate) percentages:
Second, you should be familiar with which foods from each of these nutrients groups are more or less healthy to eat. Here are a few examples of some healthy vs unhealthy sources of protein, fat, and carbs:
Third, you should know what the basic, top-level food groups are and how many portions of each you should eat each day. Keep in mind that what counts as a single portion varies among different types of food within the group.
You can learn more about correct serving sizes on choosemyplate.gov and in the table just below.
Here's an overview of what US guidelines for daily servings say:
|
Food Group |
Daily Amount |
Serving Size |
| Fruits |
1.5 to 2 cups per day |
A1 cup serving of fruit is equivalent to about 1 cup of raw or cooked fruit, 1 cup of 100% fruit juice, or one cup of dried fruit. |
|
Vegetables |
2 to 3 cups per day |
A 1 cup serving of vegetables is equivalent to about 1 cup of raw or cooked vegetables, 1 cup of vegetable juice, or 2 cups of raw leafy greens. |
| Grains |
3 to 8 one ounce equivalents per day, with at least half coming from whole grains |
A 1 oz equivalent of grains is equal to about one slice of bread, one tortilla, 1 cup of dry cereal, or ½ cup of pasta, rice, or oatmeal. |
| Protein |
5.5 to 6 1-oz equivalents per day |
A 1 oz equivalent of protein is equal to about 1 oz of meat,1 egg, ¼ cup cooked beans, 1 tablespoon of peanut butter, ½ oz of nuts and seeds, and 1 oz of meat. |
| Dairy |
3 cups per day |
A 1 cup serving is equivalent to about 1.5 oz of natural cheese, 2 oz of processed cheese, or 1 cup of milk, yogurt, or soymilk. |
|
Oils |
No more than 5 to 7 teaspoons of oil and fats per day |
You can find a helpful table listing the amount of oils and fats in all kinds of common foods on this page from Choose My Plate. |
As you plan your meals and snacks, make it your goal to choose foods that help you fulfill the daily requirements for each food group. You don't have to be perfect, either; approximating your portions and and getting as close as possible to these targets is a perfectly healthy goal.
Finally, you should know what kinds of foods are unhealthy, or unhealthy in large amounts, and do your best to limit them in your diet. These include things like excess sodium, too many simple carbs, added oils, added sugar, and trans-fats.
Foods and Ingredients to Avoid:
Most people with COPD don't need to follow a special diet, and should be perfectly healthy following the general nutritional guidelines set by the USDA. However, there is one notable exception: some people with COPD may benefit from a diet with fewer carbohydrates.
Because of the nature of how the body processes carbohydrates, eating carbs causes your body to produce more carbon dioxide than when you eat proteins or fats. Because carbon dioxide is a waste product that has to be processed by the lungs, high-carb foods put extra strain on your respiratory system, forcing your lungs to work harder and use up more energy.
If you have COPD, this translates to increased shortness breath, since your damaged lungs are already struggling to process oxygen and carbon dioxide fast enough to meet your body's needs. In fact, studies show that relatively small changes in carbohydrate consumption can have significant effects on COPD symptoms, with more carbs causing notable increases in breathlessness and reduced exercise tolerance.
Because of this, a low-carbohydrate diet can be beneficial for people with COPD, improving their lungs' efficiency and reducing shortness of breath. That means reducing your intake of high-carbohydrate foods (such as grains, beans, and carb-heavy fruits and veggies), and replacing them with low-carb alternatives and more healthy proteins and fats.
You'll find more tips for reducing carbs later on in this guide, both in our sample meal ideas and in our section on practical diet & cooking tips.
Although daily diet recommendations can get very specific, that doesn't mean you need to go overboard tracking every little thing, nor do you need to stress about meeting the exact targets every single day. Unless you have specific instructions from a doctor or dietitian, getting the right balance of nutrients on average is perfectly acceptable, and will prevent the vast majority of nutrient deficiencies.
In fact, most people are able to get a sufficient amount (PDF link) of vitamins and nutrients without tracking their diet too closely. That's because, in general, most people eat a wide enough variety of foods to supply their bodies with everything they need.
Of course, this laissez-faire approach won't work if your diet is too unbalanced. If you're not careful, a diet that's too heavy in one thing or too light in another can lead to nutrient deficiencies, which can be particularly dangerous for people with COPD.
An easy way to prevent this, however, is to always strive for variety in your diet. That means not only eating plenty of nutritious foods, but also eating a lot of different kinds of healthy foods with different types of micronutrients, which include vitamins, minerals, and metals like iron and zinc.
It helps to familiarize yourself with the various food sub-categories, which are simply smaller groups within a food group that have similar nutrient profiles. For example, the USDA divides vegetables into 5 separate categories and recommends that you eat a certain amount from each group every week.
Here is a summary of the weekly vegetable sub-group guidelines for adults:
Knowing these different subgroups makes it easier to ensure that you pick out foods that come from a variety of different groups, instead of just one or two. Maintaining this kind of diversity in your diet will help you ensure that your body gets all the micronutrients it needs to fuel your lungs and keep your body strong.
Here are a couple links to more information about food groups and subgroups:
When you peruse all the boxed foods, frozen dinners, and other processed foods that make up the large part of grocery store shelves, it's often hard to tell what's good for you and what isn't. Even bold claims like “all natural” or “reduced fat” don't tell you much about a product's actual health, or what those claims even mean in the context of a well-balanced diet.
That's why it's best to cook your own meals at home using whole ingredients whenever possible. That means starting with basic ingredients that are as close as possible to their raw, natural state, such as whole fruits and vegetables, plain beans, and whole grains.
Your ingredients don't need to be “fresh” as long as they're are minimally processed and don't contain added ingredients like salt, oil, or sugar. Frozen fruits and veggies, for example, are just as good for you as the fresh (and more expensive) versions you'll find in the produce section.
In ideal conditions, you could get all the nutrients you need just by eating a healthy diet. However, life is often far from ideal, and it's not always possible to get enough vitamins and minerals from the food you eat alone.
This is especially true for people with COPD, who often struggle to get enough nutrients due to both the symptoms and the biological effects of the disease. According to COPD nutrition research, up to 40% of COPD patients are underweight and undernourished.
Certain types of deficiencies are more common in people with COPD than others, including vitamin D, vitamin B12, and iron deficiency. People with disease are also especially prone to osteoporosis, which can be caused by deficiencies in both calcium and vitamin C.
Some of these nutrient deficiencies are directly related to COPD and the medications (such as steroids) used to treat it. Many of them are also associated with certain characteristics that COPD patients tend to have in common, such as age, tobacco smoking history, and other factors related to lifestyle and health.
Research also shows that undernourishment can have particularly severe consequences for people with COPD, including an increased risk of death and hospitalization, more frequent exacerbations. Poor nutrition is also associated with a variety of other negative COPD symptoms, such as reduced lung function, reduced muscle strength, increases shortness of breath, and declines in physical endurance.
Because of this, a large percentage of people with COPD need to take vitamin and/or mineral supplements to satisfy their body's nutritional needs. However, you shouldn't start using supplements without your doctor's permission; when you have a serious chronic condition like COPD, you should never take any new medicines or supplements without consulting your doctor first.
Seeing to your doctor also gives you the opportunity to undergo testing so you can know exactly what—if any—extra nutrients your body needs. Then your doctor can prescribe you the specific supplements you need in proper amounts to correct any deficiencies you currently have or that your doctor believes you are at risk for.
Many people with COPD struggle with weight loss and undernourishment because of uncomfortable COPD symptoms that make it difficult to eat. However, another reason for malnutrition is simply not eating enough to make up for the extra calories burned through breathing, since lungs affected by COPD use up much more energy to breathe.
This extra energy has to come from somewhere, which is why people with COPD often need more calories and nutrients than the average healthy person. Because of this, many patients—especially those with advanced COPD—need to eat a high-calorie diet to satisfy their body's needs.
That's why, if you have COPD, it's important to talk to your doctor about your diet and to figure out how many daily calories you need to eat. If your doctor puts you on a high-calorie diet, make sure to take it seriously and do your best to meet your calorie target every day.
This can be difficult to do, especially if you're one of the many people with COPD who struggle with pain and breathlessness when you eat. However, there are a variety of strategies that can help, such as eating more frequent, smaller meals spaced out throughout the day (you can find more tips for adjusting to a high-calorie diet toward the end of this guide in the section on practical diet and cooking tips).
Make sure to consult your doctor if you're having trouble managing your diet on your own, and consider consulting a registered dietitian for more specialized help. Dietitians are trained to help people with special health and dietary considerations, and they can work with you to find solutions and put together a realistic diet plan that's tailored to your needs.
According to US dietary guidelines, you shouldn't eat more than 2,300 milligrams (mg) of salt per day. However, because salt is ubiquitous in so many types of food, most people get far too much of it in their diet.
Unfortunately, too much salt is bad for your health in a variety of ways, increasing your risk for hypertension and heart disease. It's even more dangerous for older adults, and particularly people with COPD, who have a higher risk for age-related heart problems.
A high-salt diet can also cause water retention and bloating, which can worsen common COPD symptoms like breathlessness and chest discomfort. It can also make mealtimes more difficult if you have trouble eating enough food or struggle with shortness of breath when you eat.
Unfortunately, salt can be very difficult to avoid; many popular foods contain excessive amounts of sodium, especially processed foods and snacks. There are also many seemly-innocuous foods that have lots of hidden sodium, including canned foods, sports drinks, processed cheese, and cured meats.
Because of this, the most reliable way to reduce salt in your diet is to avoid processed foods as much as possible. Instead, cook at home with whole foods and ingredients that aren't pre-packed with added sodium.
Doing this gives you the opportunity to make recipes healthier by limiting how much salt (and other unhealthy ingredients) you add to your food. Home-cooking is also a great way to experiment with other flavorings that you can use to replace salt in your meals, such as herbs, spices, and aromatic ingredients like garlic, onion, and ginger.
To learn more about how to use herbs and spices in meals as a substitute for salt, check out this helpful PDF document from the National Heart, Lung, and Blood Institute (NIH).
So far, we've covered most of the major principles pertaining to balancing your diet and choosing healthier foods. However, you can know all of these things and still feel a little unsure when it comes time to put it all together and construct a nutritious meal.
Luckily, structuring a well-balanced meal doesn't have to be complicated; all you have to do is remember a few simple guidelines. If you ever feel lost or in doubt, keep the following principles in mind:
Basic Components of a Healthy, Well-Balanced Meal (based on three main meals per day)
Keep in mind that these guidelines are flexible, and it's okay to vary your meal make-ups and distribute your food groups unevenly across meals. You should, however, try to achieve an overall balance in your diet as a whole throughout the day.
For example, if you skip some veggies in one meal, make sure to include an extra helping or two of veggies in one of your next meals. Or, if you have a carb-heavy meal with more than one serving of grains, try to make your next meal grain-free so you can focus on other food groups you haven't eaten enough of that day.
Now that you understand the basic principles of good COPD nutrition, let's look at some examples of simple, yet versatile dishes you could make for a healthier diet. These recipes should give you a better idea of what a balanced meal actually looks like, and give you some ideas for healthy meals you can make at home.
These recipes are designed to be highly customizable and include tips for modifying the meal in different ways, whether you're looking to add flavor, variety, or save yourself some cooking time. You'll also find a brief run-down of the dish's main health features to give you a better idea of what makes the meal a healthy, COPD-friendly choice.
Main Benefits:
One of the best features of rice bowls is that they are extremely versatile; they work with a wide range of flavors and cuisines, and you can make them as simple or extravagant as you'd like. This makes it perfect as a lunch or dinner staple, and it's a great way to use up any leftover veggies and proteins you happen to have lying around your kitchen.
Although white rice is a simple carbohydrate, it's okay to eat in moderation, and you can always swap it out with a whole grain alternative like brown rice, quinoa, or barley. But as long as you stick to healthy ingredients, including lots of veggies and a lean protein source, a regular old white rice bowl can make a healthy, balanced meal.
You can also make this dish even more low-carb and COPD-friendly by keeping your veggie-to-rice-ratio high (meaning more veggies and protein and less rice). You could eliminate even more carbs by omitting the rice completely and turning it into a stir-fry or salad instead.
How to Put Together a Healthy Rice Bowl:
Additional Components to Round Out the Meal:
Rice Bowl Recipes to Try:
Main Benefits:
Eggs are a great source of protein, and there are so many delicious ways to combine them with various vegetables and proteins. Cooking them together in a scramble is one of the easiest and quickest ways to do it, and you can easily save on clean-up by making it a one-pan meal.
This meal is also very easy to prepare; all you have to do is roughly chop up whatever vegetable and protein ingredients you want to use. After that, the actual cooking is as quick and easy as can be.
This makes egg scrambles a great everyday meal option for people with COPD who have limited energy and endurance to spend prepping, cleaning, and slaving over the stove. Simple, versatile meals like this can be a lifesaver when you're constantly fighting against breathlessness and fatigue.
The cooking technique is simple: simply throw all your veggies and proteins together to cook in one big frying pan (or you could even leave the veggies raw if you prefer). Once they are nearly done cooking, add your eggs to the pan and stir it all together until the egg is fully cooked through.
You can reduce the cholesterol and fat in this meal by using egg whites instead of whole eggs, and add variation by switching up which types of vegetables or proteins you use. You can also keep this meal exciting by cooking and preparing the same basic ingredients in different ways:
How to Put Together a Healthy Egg Scramble, Casserole, or Frittata:
Additional Components to Round Out the Meal:
Egg Scramble Variations and Recipes to Try:
Main Benefits:
You've probably heard of stuffed peppers before, but what about stuffed squash, stuffed tomatoes, and stuffed mushrooms? Turns out there is a wide variety of vegetables that are perfect for filling up with a healthy balance of nutritious veggies, grains, and cheese.
Stuffed veggies might take a little more effort to prepare than some of the other meals on this list, but they have such a layered flavor and amazing presentation that they're well worth the work. This makes them perfect for special occasions, entertaining, or for treating yourself to something a little bit fancy for no reason at all.
Although stuffed vegetables are often made with rice, you can make this meal a healthier source of carbs by swapping out the white rice with a whole grain (e.g. brown rice, or whole-grain quinoa, or whole-grain couscous). Or, for a low-carb alternative, forget the grain entirely and include extra protein (e.g. meat or beans) or additional veggies instead.
How to Put Together a Healthy Stuffed Veggie Dish:
Additional Components to Round Out the Meal:
Stuffed Vegetable Recipes to Try:
Main Benefits:
They come in many names and types, including meat & cheese plates, fruit & cheese spreads, charcuterie boards, and more. Whatever your preferred style, the core principal of the dish is this: it's a plate with an assortment of cold ingredients ready to mix-and-match, sandwich together, and pop in your mouth as you please.
While you might think of this kind of platter in terms of appetizers or entertaining, it can actually make a very nutritious and filling meal. It's also an easy dish to throw together when you don't have time to cook, and it's well-suited to making ahead and packing up to bring to work.
However, it's important to note that charcutterie ingredients (including cheese) tend to be high in salt. While it might be a good quick meal now and then, you're likely to overshoot your sodium limit if you eat a charcuterie board every day.
However, a carefully-crafted platter with low-sodium ingredients can significantly reduce the amount of salt in the meal while offering lots of protein, calcium, and a variety of healthy vitamins and minerals. You can also take advantage of the ingredient versatility of your cold lunch platter to catch up on nutrients like dairy and fruit, and to tailor your plate for any special nutrition needs you have (e.g. low-carb, high-fat, or high calorie diets).
How to Put Together a Healthy Cold Charcutterie Plate
Additional Components to Round Out the Meal:
Cold Plate Charcutterie Recipes to Try:
Main Benefits:
The idea of a fish and veggie dinner might sound plain or mundane at first, but the right ingredients and technique can take this basic meal from bland to exciting in no time. In this recipe, we spice things up by cooking everything, including all the fruits and veggies, on the grill.
Using a grill to cook this meal adds deliciously smoky notes and a wonderful seared texture to all the ingredients. This gives them a layered, complex flavor without the need for unhealthy additions, and, unlike pan frying, you can grill just about any ingredient without adding extra oil or fat.
Grilled fish is also a pleasingly light meal—nutrient-dense but not too filling—which makes it a great choice for people with COPD who have trouble eating heavier meals. Fish-based meals also help you get much-needed vitamin D, a vital nutrient for bone health and respiratory function that many people with COPD tend to be deficient in.
If you use a fatty fish in this recipe, you also get a healthy serving of omega-3 fatty acids, a type of nutritious, naturally-occuring oil that is difficult to get in adequate amounts from other types of foods. Because of this, health experts recommend eating meals including fish at least twice a week, for a total of 8 ounces all together.
How to Put Together a Healthy Grilled Fish Meal
Additional Components to Round Out the Meal:
Recipes to Try:
While we've already given you some healthy tips and tricks that go with the recipes listed above, we wanted to share some cooking and meal-planning advice that is a little less recipe-specific. That's why we put together the following lists of tips and tricks for preparing meals in healthier, more convenient, and more budget-friendly ways.
Tips for Saving Time When Cooking Healthy Meals at Home:
Tips for Reducing Added Oils and Saturated Fat in Your Meals:
Tips for People on High-Calorie Diets or Those Who Need to Gain Weight:
Tips for Reducing and Substituting Carbs:
Tips for Cooking on a Budget:
Other Guides on Nutrition and Meal Planning from Our Respiratory Resource Center:
Additional Online Resources for Healthy Meal Planning (note that many of these links take you directly to a PDF document):
Sticking to a healthy diet takes a lot of effort and dedication, and it can be a particularly difficult challenge for people with COPD. However, it's much easier when you have the right knowledge and tools and some practical examples to follow.
Providing your body with adequate nutrition is actually pretty simple once you get the hang of what good nutrition looks like and what it means to put together a healthy, balanced meal. And though learning new skills can be intimidating, the work is well worth the benefits it can bring to your life, your health, and your ability to manage your COPD.