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If you grew up hearing the phrase “an apple a day keeps the doctor away,” then you’ve probably spent your life trying to eat healthy foods. However, “eating healthy” isn’t necessarily just about eating healthy food; it’s about getting the right balance of nutrients that your body needs.
If you eat an apple every morning, that’s great! Apples are perfect for a quick energy boost, they help with weight loss, and they’re a heart healthy snack. But they also lack many of the vitamins and minerals that lead to optimal health.
Another thing many people don’t consider is that nutritional needs are different for everyone. Whereas everyone needs the same nutrients to stay healthy, diets need to be adjusted and adapted to each individual’s needs at any given time.
Although eating right may sound like a simple concept, it can be complicated by things like changing tastes as we age and medical conditions that affect the way food is processed in the body. Chronic obstructive pulmonary disease (COPD) is just one condition that often has this effect on the body.
How COPD Affects Your Appetite and Sense of Taste
You may be wondering, “how can a disease that affects the lungs affect your appetite?” This is a valid question and one that can’t be answered easily. However, a good place to start is by remembering that everything you put in your body affects every aspect of your health in some way or another — whether directly or indirectly.
And when it comes to COPD specifically, your respiratory health is linked to your diet in one key way: metabolism. Metabolism is the process through which your body breaks down the food you eat and converts it into usable energy. Whether you’re at the gym exercising or you’re in bed sleeping, your body is always using energy, and thus your body always needs a source to draw energy from.
In the metabolic process, there are three main components that your body uses: the food and drink that you consume and the oxygen that you breathe. After consuming a food or drink, it goes to your stomach where it is broken down with digestive juices. The contents move to the small intestines which absorb the nutrients and transport them to your bloodstream.
Meanwhile, the air that you breathe passes over the alveoli in your lungs. A red blood cell protein called hemoglobin moves this oxygen into the bloodstream. Once these nutrients and oxygen are in the blood, it begins a process called cellular respiration where the oxygen breaks down glucose and stores energy in the cells. Nitrogenous wastes like CO2 are also released through this process.
Because oxygen is such a crucial component in converting the food you eat into usable energy, a chronic lung condition like COPD can have an immense impact on your appetite, sense of taste, and general eating habits. Although the most common effect of COPD is weight loss, it can also lead to weight gain in some cases.
Weight Loss in COPD Patients
In a country where 70 percent of people are classified as either overweight or obese, it may come as a surprise that some people suffer with the opposite problem — weight loss. However, according to the Lung Institute, an estimated 40 to 70 percent of COPD patients report losing weight unintentionally.
For a COPD patient, just the act of breathing takes significantly more effort than those without the condition. The Cleveland Clinic reports that breathing can burn up to 10 times as many calories for someone with COPD which can become more severe as the disease progresses. And without an increase in caloric intake, this will inevitably lead to weight loss.
Unintentional and rapid weight loss can be a serious problem and lead to symptoms like muscle loss, loss of energy, and an increased risk of injury and illness. You should visit a doctor regularly to ensure that you are maintaining a healthy weight and aren’t losing weight too quickly as a result of your respiratory condition.
Pulmonary Cachexia
Although weight loss is generally perceived as a good thing for most people, not all weight loss is healthy, even in someone who may be considered overweight. Pulmonary cachexia is one side-effect of COPD that can lead to the unhealthy loss of both muscle and fat tissue. In severe cases, cachexia may result in the loss of a significant amount of muscle function.
Although the exact cause of cachexia is not known, studies have shown that intracellular mechanisms like myonuclear and protein turnover may be the primary cause. In other words, even people who eat enough and get all the proper nutrients through their diet may still experience a loss in body mass index (BMI).
According to Physiology.org, cachexia is a common side-effect of COPD with about 20 to 40 percent of COPD patients affected. Although this condition occurs gradually in most people it’s likely accelerated during acute exacerbations, so it’s important to keep up with the treatment plan your doctor has set for you.
Inflammation
Inflammation in the lungs is the primary cause of COPD and potentially one of the leading causes of weight loss in COPD as well. Both emphysema and bronchitis — the two main types of COPD — result in inflammation in the lungs. Bronchitis is an inflammation of the bronchial tubes which bring air to the alveoli. Emphysema on the other hand, is the result of inflammation on the alveoli, usually due to exposure to irritants like cigarette smoke.
Studies have shown that 85 percent of people experience at least one digestive problem with COPD like bloating which can make it difficult to eat. Although there are a number of things that could potentially be causing this, many COPD patients suffer from hyperinflated lungs due to inflammation and too much air getting trapped in the lungs when breathing. This can put stress on the rib cage, diaphragm, and stomach, especially while eating.
Hormonal Changes
The adrenal glands sit on top of the kidneys and are responsible for a number of important roles in the body. First, and most importantly, they produce hormones that are essential for the normal function of your body. This includes things like regulating your body’s reaction to stress, regulation of blood pressure, and metabolism. There are a number of disorders that can result if the production of hormones is out of balance.
According to COPD News Today, inhaled corticosteroids used to treat COPD and asthma may be at fault for an increased risk of adrenal gland suppression. It’s often difficult to diagnose corticosteroid-induced adrenal suppression because the symptoms can vary widely from something as simple as tiredness to something as serious as a life-threatening illness.
Fortunately, only a small number of people have experienced this issue with inhaled corticosteroids and COPD patients should not quit taking them before speaking with their doctor first.
Anxiety
Anxiety can lead to complications when it comes to weight regulation. One of the primary characteristics of stress and anxiety is an increased release of adrenaline and cortisol in the body. This initiates the “fight or flight” response in your body that can increase your metabolism and cause you to lose weight more quickly. What’s more, anxiety can lead to decreased serotonin and dopamine (the feel good hormone) in the brain. This means you’ll likely feel less enjoyment from eating and you may avoid it as a result.
It’s not uncommon for those coping with COPD to experience anxiety. As symptoms of breathlessness, coughing, and fatigue increase, it’s easy to feel trapped and uncomfortable in your own body. They also may feel stress about being reliant on a loved one for daily tasks or stressed about going somewhere that may cause an exacerbation. For more information on managing anxiety with COPD, read our blog titled COPD and Anxiety: How to Find Peace of Mind.
Weight Gain in COPD Patients
Although it’s significantly less common for someone with a chronic respiratory disease to experience weight gain, it is certainly possible and learning how to keep unnecessary weight off is just as important when it comes to preventing serious COPD exacerbations.
One of the serious threats of being overweight with COPD is the increased risk of obstructive sleep apnea (OSA). According to WebMD, more than half of people with OSA are either overweight or obese. Since sleep apnea causes disruptions in breathing at night, it can be a potentially life-threatening condition for someone who is also suffering with COPD.
Inactivity
Possibly the most common cause of weight gain with COPD is inactivity. As COPD progresses, lung function is reduced significantly. Using a spirometry test, pulmonologists are able to determine both your forced expiratory volume (FEV1) and your forced vital capacity (FVC). Below are the levels of lung function you can expect with each stage of COPD.
- Mild COPD (grade 1) - 80 percent or higher FEV1
- Moderate COPD (grade 2) - 50 to 79 percent FEV1
- Severe COPD (grade 3) - 30 to 49 percent FEV1
- Very severe COPD (grade 4) - Under 30 percent FEV1
It goes without saying that as someone progresses through these stages of COPD, their ability to perform physical tasks will diminish. Many people find that they aren’t able to exercise or perform chores around the house like they used to. Fortunately, pulmonary rehabilitation is an effective method for reducing symptoms of COPD and helping people to regulate their weight more easily while coping with the condition.
Lifestyle Changes
Being diagnosed with COPD means making a lot of lifestyle changes that you may not be prepared to make. Although most people eventually adapt and adjust to a new way of life, some people may find it difficult to cope at first.
It’s easy to fall into bad habits like eating unhealthy food or skipping out on breathing exercises or pulmonary rehabilitation classes. However, these are likely all things that your doctor has recommended as part of your treatment plan and you should take care to follow them as best as possible. You might also be on a strict diet regimen that focuses on providing you with nutrients that you need to improve lung function and reduce COPD symptoms. Although it may seem different at first, stick with it until it becomes routine.
Steroids
Steroids are one of the many medications used to treat acute COPD exacerbations and can be either taken orally or inhaled. These steroids help to fight inflammation in the lungs, reduce swelling, and suppress the immune system so that your body doesn’t attack healthy cells.
Unfortunately, these benefits don’t come without side-effects. Many people who take steroids for COPD experience an increased appetite, fluid retention, and a change in where the body stores fat. This added weight usually appears in the neck, abdomen, and face. And generally, the longer you’re on the steroid and the higher the dose, the more likely you are to experience these symptoms.
Fluid Retention
One thing many people don’t consider when it comes to weight gain is that much of it could be caused by increased fluid retention in their body. Fluid retention is when your body stores water instead of using it. This can be caused by a number of things like pain relievers, antidepressants, and other medications, but one of the most common causes of fluid retention is a high sodium diet and lack of exercise.
Loss of Taste Plays a Role in Weight Management
Aside from the risk factors above, loss of taste or taste dysfunctions can make it difficult to regulate weight and follow a strict dietary routine required for COPD treatment. There are a number of potential causes for this, however, most people tend to experience it more with age, after taking medication, and after smoking. And let’s face it, if you’re not enjoying the food that you’re eating, it’s going to be a lot less likely that you are able to continue eating it.
Medication
Prednisolone is a steroid that can be used to regulate inflammation, metabolism, mineral balance, and the immune system. It’s commonly prescribed by doctors to treat COPD symptoms such as chest tightness, chest pain, and breathlessness. However, some patients report experiencing a metallic taste in their mouth after taking it.
Other drugs like inhaled corticosteroids used to treat asthma and COPD can leave a strange taste in your mouth after using them. Although the taste tends to go away after an hour or two, it can certainly have an impact on your diet, especially if you take medication right before eating.
Age
Taste loss is natural as you age. Over time, taste buds will shrink and be less sensitive to food, especially salty, sweet, or bitter flavors. Since COPD is much more common in old age, it’s imperative that you avoid adding salt or sugar to the food that you eat. Sodium causes your body to retain water, leading to weight gain and increasing your chance of experiencing breathlessness and sleep apnea. Sugar, on the other hand, will also lead to weight gain and leave you feeling fatigued.
Before adding anything to your diet, you should speak with your doctor who may be able to recommend seasonings that won’t add any additional side effects. Also, be sure to look up recipes for low-sodium meals.
Dry Mouth
Dry mouth is just what it sounds like — dry mouth due to a lack of saliva production. COPD patients often experience dry mouth when undergoing oxygen therapy because the air that’s processed through their machine is not humidified. Having dry mouth frequently can lead to taste loss and difficulty eating.
Fortunately, there are solutions to this problem. Whether you’re using a CPAP machine for sleeping, a home oxygen concentrator, or a portable oxygen concentrator, you can purchase a humidifier that either attaches to the device or you can use a regular home humidifier.
What You Can Do To Manage Your Weight
Weight management doesn’t just help you feel better, it’s crucial for preventing serious COPD exacerbations. If you’re overweight, you’ll be more likely to develop sleep apnea which can result in more exacerbations. On the other hand, if you’re underweight, you may start losing muscle mass rather than fat which makes it more difficult to breathe.
Routine Doctor Visits
The best way to manage your weight with COPD is to ensure that you always visit your doctor routinely. Unfortunately, visiting your doctor once a year is not enough for him/her to be able to notice what is actually causing the weight loss or weight gain, so you’ll need to see them regularly to make sure you’re on the right track.
As we mentioned earlier, maintaining your weight isn’t just about eating right. Your doctor will need to adjust your diet regularly to ensure you’re getting the right nutrients.
Stay Active
It’s normal for someone with COPD to experience declining physical abilities, but in the grand scheme of things, any form of exercise you can manage will help, no matter how insignificant it may seem.
Pulmonary rehabilitation is a type of exercise routine that’s designed specifically for those coping with a chronic respiratory condition. It teaches COPD patients the best way to exercise, what exercises benefit the lungs the most, as well as breathing exercises that will help you feel less fatigued. Not only will pulmonary rehabilitation help you keep off unnecessary weight but it can help you retain your muscle mass.
Reduce Salt Intake
The average American diet is very high in salt which is known to increase blood pressure and cause weight gain, especially through water retention. Although it’s healthy to have some sodium in your diet, it’s best to get it naturally through your food rather than through added salt. Since your sense of taste tends to decline with age, you should try to avoid adding additional salt to every meal and use other seasonings to add flavor instead.
Oxygen Therapy
One of the most effective and common treatment options for COPD is oxygen therapy. And the good news is that keeping up with your oxygen therapy treatment will also help you manage your weight. Like we mentioned before, taking a breath can burn as much as 10 times as many calories for someone with a chronic respiratory disease. However, when you use an oxygen therapy device you won’t be exerting any extra energy to breathe.
If you are on the go frequently and want an oxygen therapy device to match that lifestyle, portable oxygen concentrators will help you achieve that. Since oxygen concentrators draw ambient air, you won’t need to carry a heavy and bulky oxygen tank around with you.
Ask For Help
After being diagnosed with a condition like COPD, there’s always the question of how much independence you should maintain. Independence can be great for self-esteem and to help you lead a more fulfilling life. However, simultaneously, you should never be afraid to ask for help when you need it.
Chances are, you know what it takes to maintain a healthy weight, but if you don’t have the energy to cook like you used to or maintain a healthy lifestyle, you may find it more difficult to manage your weight. A little help from a friend or a loved one can go a long way towards improving your health and you’ll become closer in your relationship as a result.
Conclusion
Maintaining a healthy weight while coping with COPD isn’t all about your diet. There are a number of complications that COPD patients need to deal with in order to avoid unintentional weight loss or weight gain. While a healthy diet should be the foundation of your COPD treatment plan, you should take into consideration all of the above in order to achieve optimal results.
While it’s great to make changes to your routine in order to improve your health, it’s best to consult a doctor or pulmonary specialist first. What may be beneficial for one person could be detrimental for another and having a clear treatment plan to follow is key to your success.
