Nutritional Guidelines for People with COPD

This article provides basic information to help you make healthy food choices. Planning what you eat and balancing your meals are important ways to manage your health. Eating healthy often means making changes in your current eating habits. Changing your eating habits will not cure COPD, but it can help you feel better. A registered dietitian can provide in-depth nutrition guidance, tailor this educational information to meet your needs, and help you create and follow a personal action plan.

Food is the fuel your body needs to perform all activities, including breathing. Your body uses food for energy as part of a process called metabolism. During metabolism, food and oxygen are changed into energy and carbon dioxide. You use energy for all of your activities - from sleeping to exercising.

food and oxygen--------> energy + carbon dioxide

Food provides your body with nutrients (carbohydrates, fat, and protein) that affect how much energy you will have and how much carbon dioxide is produced. Carbon dioxide is a waste product that leaves your body when you breathe out (exhale). If there is too much carbon dioxide in your body, you might feel weak.

Breathing requires more energy for people with chronic obstructive pulmonary disease (COPD). The muscles used in breathing might require 10 times more calories than those of a person without COPD.

Good nutrition helps the body fight infections. Chest infections are illnesses that often lead to hospitalization for people with COPD, so it is important to reduce your risk of infection by following a healthy diet.

Maintain a healthy body weight. Ask your health care provider or registered dietitian what your "goal" weight should be and how many calories you should consume per day.

If you are overweight, your heart and lungs have to work harder, making breathing more difficult. In addition, the extra weight might demand more oxygen. To achieve your ideal body weight, exercise regularly and limit your total daily calories.

In contrast, being underweight might make you feel weak and tired, and might make you more likely to get an infection. People with COPD use more energy while breathing than the average person. Therefore, the pulmonary (breathing) muscles in someone with COPD might require up to 10 times the calories needed by a person without COPD. It is important for you to consume enough calories to produce energy in order to prevent wasting or weakening of the diaphragm and other pulmonary muscles.

Monitor your weight. Weigh yourself once or twice a week, unless your doctor recommends weighing yourself more often. If you are taking diuretics (water pills) or steroids, such as prednisone, you should weigh yourself daily since your weight might change. If you have an unexplained weight gain or loss (2 pounds in one day or 5 pounds in one week), contact your doctor. He or she might want to change your food or fluid intake to better manage your condition.

Drink plenty of fluids. You should drink at least 6 to 8 eight-ounce glasses of non-caffeinated beverages each day to keep mucus thin and easier to cough up. Limit caffeine (contained in coffee; tea; several carbonated beverages such as cola and Mountain Dew; and chocolate) as it might interfere with some of your medicines.

Some people with COPD who also have heart problems might need to limit their fluids, so be sure to follow your doctor's guidelines.

Include high-fiber foods — such as vegetables, fruits, cooked dried peas and beans (legumes), whole-grain foods, bran, cereals, pasta, rice, and fresh fruit — in your diet. Fiber is the indigestible part of plant food. Fiber helps move food along the digestive tract, better controls blood glucose  levels, and might reduce the level of cholesterol in the blood.

The goal for everyone is to consume 20 to 35 grams of fiber each day. An example of what to eat in one day to help you get enough fiber includes: eating 1 cup of all-bran cereal for breakfast, a sandwich with two slices of whole-grain bread and 1 medium apple for lunch, and 1 cup of peas, dried beans, or lentils at dinner.

Control the sodium (salt) in your diet. Eating too much salt causes the body to keep or retain too much water, causing breathing to be more difficult. In addition to removing the salt shaker from your table:

Make sure you are getting enough calcium and Vitamin D to keep your bones healthy. Good sources of these nutrients are foods made from milk (milk, cheese, yogurt, ice cream, and pudding) and foods fortified with calcium and Vitamin D. You may need to take calcium and Vitamin D supplements. Maintaining a healthy weight and exercising will also help with keeping bones healthy.

Wear your cannula while eating if continuous oxygen is prescribed. Since eating and digestion require energy, your body will need the oxygen.

Avoid overeating and foods that cause gas or bloating. A full stomach or bloated abdomen might make breathing uncomfortable. Avoid the foods that cause gas or bloating. Some foods that cause gas for some people include:

Follow your doctor's other dietary guidelines. If you take diuretics (water pills), you might also need to increase your potassium intake. Some foods high in potassium include oranges, bananas, potatoes, asparagus, and tomatoes.

If you are short of breath while eating or right after meals, try these tips:

Eat a variety of foods from all the food groups to get the nutrients you need. The recommended number of servings per day are listed below. These guidelines are for a 2,000-calorie diet. To find out more about the amounts that are right for you, go to

Grains Vegetables Fruits Milk Meat and Beans
Eat whole-grain cereals, breads, crackers, rice, or pasta every day.

1 oz. is about 1 slice of bread, 1 cup of cereal, or a half cup of cooked rice, cereal, or pasta.
Eat more dark green veggies like broccoli and more orange veggies like carrots.

Eat more dry beans and peas like pinto beans and lentils.
Eat a variety of Fresh fruit.

Choose fresh, frozen, canned or dried fruit.

Go easy on fruit juices.
Choose low-fat or fat-free milk, yogurt, and other milk products.

If you don’t or can’t consume milk, choose lactose-free products or calcium-fortified foods or beverages.
Choose low-fat or lean meats and poultry. Bake it broil it, or grill it.

Vary your protein routine-choose more fish, beans, peas, nuts, and seeds.
Eat 6 oz daily. Eat 2.5 cups daily. Eat 2 cups daily. Have 3 cups daily. Eat 5.5. oz. daily.

If you are often too tired to eat later in the day, here are some guidelines:

Tips for improving your appetite

General guidelines
Meal guidelines
Snack guidelines
Dining guidelines
Alcohol guidelines

Ask your doctor for specific guidelines regarding alcohol. Your doctor might tell you to avoid or limit alcoholic beverages. Alcoholic beverages do not have much nutritional value and can interact with the medicines you are taking, especially oral steroids. Too much alcohol might slow your breathing and make it difficult for you to cough up mucus.

Tips for gaining weight
High-calorie snacks

Eat a variety of foods from all the food groups to get all the nutrients you need.

High-calorie recipes to promote weight gain

If you are having difficulty maintaining a healthy weight, try some of these "Calorie Boosters."

Super Shake

1 cup whole milk
1 cup ice cream (1-2 scoops)
1 package Carnation Instant Breakfast


Pour all ingredients into a blender. Mix well.

Makes one serving; 550 calories per serving.

Chocolate Peanut Butter Shake

1/2 cup heavy whipping cream
3 tablespoons creamy peanut butter
3 tablespoons chocolate syrup
1-1/2 cups chocolate ice cream


Pour all ingredients into a blender. Mix well.

Makes one serving; 1090 calories per serving.

Super Pudding

2 cups whole milk
2 tablespoons vegetable oil
1 package instant pudding
3/4 cup non-fat, dry milk powder


Blend milk and oil. Add pudding mix and mix well. Pour into dishes (1/2 cup servings).

Makes four 1/2 cup servings; 250 calories per serving.

Great Grape Slush

2 grape juice bars
1/2 cup grape juice or 7-up
2 tablespoons corn syrup
1 tablespoon corn oil


Pour all ingredients into a blender. Mix well.

Makes one serving; 490 calories per serving.

If you are having difficulty maintaining a healthy weight, try some of these calorie boosters:

Calorie Boosters
Food Item Suggested Use
Egg yolk or whole egg Before cooking, add egg yolk or whole egg to foods such as meat loaf, rice pudding, or macaroni and cheese. (To prevent illness, avoid the use of uncooked eggs.)
Non-fat powdered milk or undiluted evaporated milk Add to beverages (including milk) or to these foods:
creamed soups
scrambled eggs
mashed potatoes
hot cereal
Cream cheese or shredded, melted, sliced, cubed, or grated cheese Add to sandwiches, snacks, casseroles, crackers, eggs, soups, toast, pasta, potatoes, rice or vegetables, or serve as a snack.
Vegetable oils, mayonnaise, butter, margarine, or sour cream Add margarine or mayonnaise to sandwiches; add any of these items to bread, casseroles, soups, eggs, cooked cereals, pasta, potatoes, rice, vegetables, pudding.
Peanut butter (creamy or crunchy) Spread on bread, crackers, apples, bananas, or celery. Or add to cereal, custard, cookies, or milk shakes.
Nut dust (grind any type of nuts in a blender or food processor) Add to puddings, gravy, mashed potatoes, casseroles, salads, yogurt, cereals
Miscellaneous foods
(limit to one serving per day)
sugar, jelly, jam preserves
corn syrup
maple syrup
hot cereal, cold cereal
fruit, fruit salad
sweet potatoes
winter squash


This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact the Center for Consumer Health Information at the Cleveland Clinic (216) 444-3771 or toll-free (800) 223-2273 extension 43771. If you prefer, you may visit or This document was last reviewed on: 12/31/2011