COPD

Question 1

COPD Definition

Answer 1

COPD: Progressive, partly reversible lung disease including emphysema, chronic bronchitis, and bronchiectasis.

Symptoms:
Anorexia, dyspnea, chronic cough, sputum production, fatigue, chest tightness.
Pulmonary Cachexia Syndrome (PCS):
Weight loss (5-10% of initial weight or >5% in 3-12 months).
Poor prognosis due to undernutrition or malnutrition.

Question 2

Healthy Eating for COPD

Answer 2

Energy Needs:
25-50% higher than healthy individuals due to increased respiratory effort and infections.

Key Nutritional Components:
- Vegetables & Legumes: 5-6 serves/day for immune support.
- Fruit: 2 serves/day for antioxidants.
- Grains (Whole): 3-6 serves/day for sustained energy.
- Protein: 2-3 serves/day (e.g., meat, fish, tofu) for muscle maintenance.
- Dairy: 2.5-4 serves/day for calcium and bone health.

Weight Management:
Underweight: HEHP diet, fortified meals.
Overweight: Portion control, lean proteins, whole grains, low-fat dairy.

Question 3

COPD Nutritional Management

Answer 3

Diet: Follow dietary guidelines; individualize plans and involve family.

Energy: 30-35 kcal/kg for exacerbations (ECOPD).

Protein: 1.2-1.5 g/kg/day to combat muscle wasting.

Fibre: 25 g/day (W), 30 g/day (M).

Fluids: Encourage hydration to thin mucus (monitor restrictions in CHD).

Calcium & Vitamin D:
For corticosteroid-induced osteoporosis:
Calcium: 1200-1500 mg/day.
Vitamin D: 800-1000 IU/day.

Question 4

ONS & EN in COPD

Answer 4

ONS (Oral Nutritional Supplements):
Supports weight gain, respiratory muscle strength, and QoL.
Administer between meals to prevent early satiety.

Enteral Nutrition:
Low CHO, high-fat formulas reduce respiratory quotient → less CO2 production and respiratory strain.

Question 5

COPD Fatigue & Limited Energy Strategies

Answer 5

Rest before meals.

Eat slowly, chew well, and maintain a relaxed posture.

Use ready-to-eat or fortified meals.

Question 6

COPD Monitoring & Evaluation

Answer 6

Follow-Up:
2 weeks initially, then frequent reviews in the first 3 months.

Key Metrics:
Weight: Monitor 1-2x/week (daily if on diuretics); report unintentional loss >1 kg/week.

Intake: 24-hour recall or food diary.
Lab and functional outcomes.

Question 7

Swallowing Issues in COPD

Answer 7

Impact on Swallowing:
-Increased breathing rate, weakened muscles, and fatigue affect swallowing coordination.
-Consequences: Aspiration, infections, reduced intake → malnutrition.

Signs of Swallowing Problems:
-Coughing/choking after swallowing, increased SOB during meals, wet/gurgling voice, feeling of food stuck, prolonged mealtimes.

Strategies:
-Sit upright during meals.
-Small bites, soft foods, avoid eating while breathless.
-Double swallow per mouthful and exhale after swallowing.

Managing Dry Mouth:
-Sip fluids, use artificial saliva, maintain oral hygiene, avoid alcohol-based mouthwashes.