Author Archives: Jackie Aim

Nourishing diet tips if you are trying to gain weight

If you are suffering from unintentional weight loss at any BMI and struggling to eat a normal diet then you may wish to consider the following:

Choose full fat/ high energy options e.g. whole milk, avoid low fat options
Add cheese, cream, butter to meals where possible
Use mayonnaise/ dressings where possible
Add honey, syrup, jams where possible
Make fortified milk (instructions on next page)
Try to take nourishing drinks e.g. smoothies, fruit juice, milk shakes, hot chocolate, energy drinks
Don’t fill up on drinks before a meal
Try and eat little and often throughout day e.g. three small meals and two-three snacks per day

If you are finding it a struggle to eat enough, are losing weight, or notice that you are losing strength in your muscles and your body shape is changing, you now need to approach your diet differently. You should discuss your weight loss with a health professional and get advice on how to make the most of the nourishment in your food/ drink to help you regain weight and strength. If you have sudden unplanned weight loss you should also seek advice from your healthcare professional as there are many possible causes for this kind of weight loss.

Weight loss/ Healthy Eating tips

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If you are trying to achieve a healthy diet and gradual weight loss you may wish to try the following:

Try to include protein foods with two meals per day e.g. meat, fish, eggs, beans etc for muscle strength.
Starchy carbohydrates should be included with all meals e.g. potatoes, bread, pasta, cereals, rice etc for energy.
Limit high energy foods e.g. cakes, biscuits, chocolate, sweets, fizzy drinks, chips, fried foods, pies which are high in calories giving you a quick fix energy boost and none of the important nutrients you need.
Include plenty of fruits and vegetables, ideally five portions daily. Good source of essential vitamins and minerals to support your immune system. Fresh, tinned, frozen all count.
Dairy foods e.g. cheese, yoghurt and milk are encouraged up to three times per day for bone health (which can be affected in COPD due to medications). Try to choose low fat options where possible as lower calorie also.
Drink plenty fluids to keep you hydrated. Women should drink about 1.6 litres a day and men 2.0 litres.
All drinks count, including hot drinks such as tea and coffee, but water, milk and fruit juices are the healthiest. It is best to avoid alcoholic drinks.
ATry to avoid sugary, soft and fizzy drinks that can be high in added sugars. These can be high in calories and bad for teeth.

To lose weight you need to reduce or restrict the amount of calories in your diet and increase your exercise and activity level. You may need to eat a little more of some things and less of others.

Assessing your Body Mass Index

Your normal diet and your Body Mass Index

If your Body Mass Index is 30 or more it would be helpful to aim for gradual weight loss.
If it is between 20-25 then carry on with a varied healthy balanced diet for weight stability.
If it is 20 or less you may want to increase your energy intake especially if you are keeping active to support weight stability/ weight gain. Some people with COPD may be under nourished as a result of the illness.

Maintaining a healthy body weight is recommended. To assess your nutritional status it would be helpful to calculate your BMI and consider discussing with a health professional if you have had any recent weight changes. Use the BMI calculator to check if you are underweight, overweight or obese.

Why do we need food?

Why do you need food?

Food is converted by oxygen into energy for your body, A waste product of this process is carbon dioxide which you then breathe out. People with COPD can find breathing out harder to do. If carbon dioxide builds up in your body it can make you feel weaker.
A good balanced diet helps maintain your strength and fitness and promote a healthy immune system as well as helps you fight their severity if you do get an exacerbation.

Why do you need energy?

For any activity, including breathing, even at rest.
Someone with COPD tends to need more energy for efficient breathing and for helping prevent recurrent chest infections.
Breathing requires more energy for people with COPD.

Why is food and your diet important if you have COPD?

If you are overweight your heart and lungs have to work harder to supply oxygen to your body so keeping a steady weight can be important.
A good balanced diet helps maintain your strength and fitness and may help to reduce the risk of chest infections and the severity of any exacerbations.

Diagram showing food and oxygen entering body, and carbon dioxide and energy being generated

Control your fatigue

Confidence, coping and control

Once you know how to pace yourself, set goals and control your fatigue you will start to feel:

Confident that you are going to be able to do the tasks which are important to you.

In control of your day, your mind and COPD.

Coping well on days when you feel good and coping with the days when you don’t feel so good.

The key is knowing when to rest and when to be active within the limits of your COPD. Aim to increase your activity and exercise over time to cope better with your fatigue. If you are having difficulty with this speak to your GP, practice nurse or respiratory specialist. There are lots of ways they can help.

Identify your fatigue

Use a diary to note when you feel most fatigue. Is there a pattern? Worse on certain days or times of the day?

Why not try a weekly planner.

Plan what really needs done this week and what jobs can be broken up into more do-able chunks.
Plan what activities you will do for your health and your pleasure. For example, exercising, visiting friends, going to the cinema.
Plan things you know help to recharge your body “battery”. For example, relaxation, reading, knitting, power nap.
Commit to one job/ activity in the morning, one job/ activity in the afternoon and one job/ activity in the evening if you feel you still have enough energy.
Commit to recharging your body “battery” at least once in the day.
Commit to finding time throughout your week for things for your health and things you enjoy.

Remember

A battery that is completely flat is much more difficult to charge and becomes less efficient with time.

On occasions, you might decide it is worth running your battery flat because you want to do things that you wouldn’t miss for the world!!

For information on managing fatigue see:

Moving on together: Managing fatigue [.pdf, 6.08MB]

Moving on Together (MoT): A self-management workbook by NHS Ayrshire & Arran.

For more practical tips see: Chest Heart & Stroke Scotland factsheet: tiredness and fatigue [.pdf].

Overcoming fatigue

Rechargable batteries

Fatigue means extreme tiredness.

Fatigue and breathlessness, what helps you? Have you tried relaxation? Have you tried breathing control techniques?- if not speak to your healthcare team. Do you need some help to manage difficult or heavy tasks?

Recharge your body “battery” and allow your self to slow down for a while. Save some energy for later. You can call on your bank of energy when you need it most.

Review what are the most important tasks to you?

For example housework – would you rather make your bed or clean your windows if you can’t do both?

If you enjoy home cooked meals try making an extra portion to freeze and reheat at a time when you feel less able to cook.

For information on managing fatigue see page 35 :

Moving on together: Managing fatigue [.pdf, 6.08MB]

Moving on Together (MoT): A self-management workbook by NHS Ayrshire & Arran.

For more practical tips see: Chest Heart & Stroke Scotland factsheet: tiredness and fatigue [.pdf].

An example of a goal

Goal:

Over the next six months I want to lose one stone in weight so I feel more comfortable in my summer clothes while on holiday.

Step -Keep a food diary for two weeks
Action- Spend 30 minutes at the end of each day filling in my food diary and look for ways to reduce salt and fat
Step – Cut down my portion sizes
Action – Use a small plate for my evening meals Monday to Friday
Step – Reduce the number of treats I eat
Action – Have a chocolate biscuit only on a Monday and Friday

Why not download your own goal setting template and give it a go:

Goal setting

Goal setting is a way to focus on what is important to you and a way to make a change for the better. Start with a simple goal or two for example an exercise goal could be to aim to walk to your local shop and back. Think of easy steps and how you are going to turn them into actions.

Is this something I really want to do?
Is this something that is important to me?
Is this something that will help me manage my life better while living with my COPD long-term?
Can I realistically see myself achieving this goal?
Have I been specific?

A step ladder to success! Think SMART

Specific – what, when, how often, where?
Measurable – how can you measure if you are improving?
Achievable – something that is important to you and that you can realistically imagine yourself achieving.
Realistic – set a target which can be adapted after you get to each new step.
Time Frame – plan and set a time to reach your goal.

Example

I will walk halfway to the shop and back everyday for three days a week. I will take a two minute rest before coming back. I will note how long it takes me in my diary. If I feel OK I will go a little further for the next three times. I will try to take an extra walk by the end of the month. Once I can do this I will reset my goal.

For more information on goal setting see page 8 :

Moving on together: Goal setting and problem solving [.pdf, 6.08MB]

Moving on Together (MoT): A self-management workbook by NHS Ayrshire & Arran.

Barriers to pacing

A young adult woman showing signs of distress

Ignoring what your body is telling you.
Getting caught by old habits and routines. It is not always easy to change the habits of a lifetime. For example if you are someone who always hurries, it is going to be a challenge for you to slow down.
Not saying “No”, or not negotiating with others what is right for you.
Being fearful of symptoms. This can then lead to avoidance behaviours and disrupt daily activities and plans. Then there is the risk of getting stuck in peak / trough, and not doing enough to support your continued well being.
Feeling overwhelmed by symptoms which may affect your mood.

If you are struggling putting pacing into practice you are not alone. Speak to someone, a friend/family member or health care professional. A problem shared and talked through can offer new solutions.