Presentation on theme: "Pulmonary Rehabilitation Dietary Advice"— Presentation transcript:
1Pulmonary Rehabilitation Dietary Advice By Stephanie Lee-BarrettDietitianColchester General Hospital
2Facts About COPD & DietDiet and Nutrition should be an important part of treatmentBreathing requires more energy with COPDMuscles involved may require 10x more calories than those without COPDGood nutrition will help reduce hospitalisation from chest infection
3The eatwell plate Bread, rice, potatoes, pasta Fruit and vegetables Milk and dairy foodsMeat, fish, eggs, beansFoods and drinks high in fat and/or sugar
4General Dietary Advice Enjoy variety of foodsLimit salt intakeDrink plenty of fluids 6-8 glasses/dayInclude high fibre foods e.g. veg, fruit, wholegrain foods, cereal, pasta, riceEat several small meals per day
5Body Mass Index (BMI)Used to measure if an individual is a healthy weight, underweight or overweightBMI= Weight (kg)Height (m²)Fit into certain categories16-19 = Underweight20-25 = Normal weight26-30 = Overweight31-40 = Obese
7Underweight Weight loss Loss of respiratory muscle strength More energy requiredto breatheIncreased difficulty breathing and increased risk of infection
8Poor appetite Have regular meals & snacks Eat anything fancied Eat from a smaller plateAvoid filling up on veg, salads, fizzy drinksSip nourishing high energy fluids e.g. milk, hot choc, malt drink, milkshakeA short walk before meals may increase appetiteA small amount of alcohol can stimulate appetite
9Slow Eater Try eating small amounts little & often Consider a plate warmer & insulated mugDo not hurry over meals, eat slowly and chew foods well
10Short of Breath While Eating/ After Meals Eat more slowlyChoose foods that are easy to chew - softer foodsTry eating 5-6 small meals/dayTry drinking liquids at the end of your meals.Eat while sitting up to ease pressure on the lungs
11Too Tired to Eat Later in Day Choose foods that are easier to prepareIf possible ask family members to help with meal preparationFreeze extra portionsRest before eatingTry eating main meal early in the day
12Feeling of fullness quickly Eat smaller meals more frequently, rather than one or two big mealsTry not to fill up on fluid whilst eating.
13Food FortificationFortified milk - add 4tbsp skimmed milk powder to 1pint full cream milkAdd butter/margarine/ghee/cream/cheese to mash potatoes, vegetables and saucesAdd cream/ice cream/custard to puddings and fruitUse sugary foods (unless diabetic) - jam/sugar/syrup/honey added to cereals and puddings
14Quick Snack Ideas Sandwiches - cheese/egg/meat with pickles/sauces Toast- cheese/beans/ egg/fishToasted crumpets with cheeseConvenience mealsJacket potato with cheese/beans/tuna mayoCrackers or digestive biscuits with butter and cheeseMousse/yoghurt/jelly/ trifle/fromage fraisFruit loaf/malt loaf with butter
15Nutritional Supplements If the discussed ideas do not help to improve your intake, nutritional supplements may be usedComplan® and Build-up® are available to buy “over the counter”.Others are available on prescription from your GP.Variety of flavours (sweet and savoury).Often preferred chilledCan be incorporated into recipes e.g. milk pudding, ice cream, custard, milkshakes, mousses.
17Overweight Consequence of : high energy intake from foodreduced exercise tolerancesteroid useExtra weight increases workload of heart and lungs to supply oxygen around bodyExcess fat in abdominal area makes it difficult for the lungs to expand fully
18Starchy Foods Include at each meal Main source of energy Starchy foods are fillingChoose wholemeal + wholewheat varietiesMyth that starchy foods are ‘fattening’
19Fruit and Vegetables Rich in vitamins and minerals Help protect against infectionAim for 5 portions per dayFresh, frozen, canned or dried
20Meat, Fish and Alternatives Provides protein, vitamins + mineralsRecommend 2 servings/dayAvoid roasting or frying in large amounts of oil/fatTry healthier cooking methodsChoose lean meatRemove visible fat & skins from meat and poultry.
21Milk and Dairy Products Provides protein and calciumRecommend 3 servings/dayUse semi-skimmed milk instead of full cream milkUse low fat cheeses e.g. Cottage cheese, edam, half fat cheddarTry low fat yoghurtsIf on long term steroids - it is important you have enough calcium.
22Fatty and sugary foods Try using sweeteners Choose lower calorie sugar free/no added sugar drinksKeep sweets, puddings, cakes, chocolate, take-aways, pies and pastries as a treatTry tinned fruit in natural juice rather than syrup.
23Hints for weight control Think of the benefits of weight lossMake healthier changes to your dietFill up on fruit and vegHave regular mealsAvoid foods which are high in fat and sugar. Aim for:<3g total fat /100g product<5g added sugar/100g productSet realistic, achievable target lose (1-2lbs/week).Do not crash diet. Consider keeping a food diary
24Alcohol high in calories and should be kept within sensible limits. Women ≤14 units per weekMen ≤ 21 units per weekAim for 2-3 alcohol free days.A unit of alcohol is:Half a pint of beer, cider or larger (medium strength)1 small glass of wine (125ml)1 small glass of sherry1 measure of spirits
25Summary…. Good nutrition helps reduce infections Need energy to help you breatheIf underweight - choose high protein/calorie foods - important have enough energyIf overweight - choose low fat/low sugar foods, eat more fruit/vegRefer to relevant diet sheets - examples of menu plans and snack ideas