A recent survey conducted by the National Heart, Lung, and Blood Institute
suggests that despite a growing awareness of chronic obstructive pulmonary
disease (COPD), only 64% of respondents had ever heard of it. Yet, according to the
Global Initiative for Chronic Obstructive Lung Disease, COPD is the fourth leading
cause of chronic morbidity and mortality in the United States and an estimated 24
million Americans are affected.1
COPD is a progressive lung disease that makes breathing difficult due to partially
obstructed airflow into and out of the lungs. It results from an inflammatory and
destructive process in the lungs stimulated by exposure to toxins, primarily due to a
history of smoking cigarettes.
Healthy peoples bronchial tubes and alveoli are elastic; thus, when they breathe in
and out, they inflate and deflate much like a balloon. In contrast, patients with
COPD experience limited airflow through their airways due to either a loss of
elasticity and/or inflamed, damaged, or mucous-clogged airways. Because the
airways are partially blocked or damaged, breathing becomes difficult, and the
lungs begin to lose their ability to effectively take up oxygen and remove carbon
dioxide.2,3 Expiratory airflow limitation is the hallmark of COPD, and the gold
standard for diagnosis is spirometry, which is a simple lung function test that
measures how well the lungs exhale.1
to 90% of COPD deaths are attributed to smoking, and smoking cessation is the
most effective
According to the ADAs 2008 practice guidelines for COPD, at-risk patients should
take at least 1,200 milligrams of calcium and 800 to 1,000 international units of
vitamin D daily to minimize bone loss.
A healthy diet for patients with COPD can lead to better breathing and possibly
facilitate weaning from mechanical ventilation by providing the calories necessary
to meet metabolic needs, restore FFM, and reduce hypercapnia. Carbon dioxide is a
waste product of metabolism and is normally expelled via the lungs. However,
patients with COPD who have limited and obstructed airflow have a compromised
ability to take in oxygen and eliminate carbon dioxide. In patients with COPD, this
impaired gas exchange increases patients ventilatory demands, as the lungs must
work harder to clear excess carbon dioxide. In healthy individuals, increased carbon
dioxide levels are easily eliminated.7
A July 1993 study in Chest found that a high-fat diet (55% fat) would be more
beneficial to patients with COPD than a high-carbohydrate diet (55% carbohydrate)
because it would decrease carbon dioxide production, oxygen consumption, and RQ,
as well as improve ventilation. However, there is not a general consensus in the
literature to universally recommend a high-fat, low-carbohydrate diet, as it may not
be necessary for stable patients and not all patients may be able to tolerate the