More Nutrition Tips for Alphas with Lung Disease

Our bodies need a long list of nutrients to stay healthy. Some of these nutrients are especially important when you have lung disease. Protein, sodium, calcium, and magnesium are a few to pay attention to. Keep reading to learn how to get key nutrients in your daily diet.

In previous articles, you may have found some practical and useful tips to help you deal more effectively with many of the difficult nutritional issues you may face on a daily basis. Equally important is an understanding of why some of the other essential dietary elements are required to maintain health. While the list of nutrients needed by our bodies is long, we will discuss only a few that are specifically important in lung disease.

Also, you should be aware that some medications used to treat lung disease react with some nutrients. You should consult with your physician or dietician about possible interactions with the specific medications you are taking.

Proteins

Protein is important in that it plays an essential role in protecting the body by producing antibodies to fight infection. Loss of protein and the general difficulty of individuals with lung disease to maintain an adequate nutritional status may severely compromise the ability of the lungs to defend against infection.

The primary sources of protein in your diet are meat, fish, eggs, poultry, legumes (beans), and dairy products. If you are not getting enough protein in your diet, or you have an infection and need extra protein, use the following guidelines:

• Add skim milk powder to hot milk, cereal, eggs, soups, casseroles, gravies, and ground meat dishes. This will add extra protein and calcium to the diet.
• Add chopped high protein poultry, meats, cheese, or legumes to soups and casseroles and vegetables. Nuts also can be added.
• Blend finely chopped hard-boiled egg or egg substitute into a sauce, gravy, or soup.
• Include high protein snacks such as pasteurized eggnog, instant breakfast, and puddings. Commercially prepared nutritional supplements may be needed in some cases.
• Have peanut butter, bean dips, nuts, cottage cheese, or other cheese with snacks to add additional protein and calories.
• Try using double strength milk (add 1 cup powdered milk to 1-quart whole milk).

Fluids

Adequate fluid intake is essential for the thinning and clearance of your pulmonary secretions. Additionally, supplemental oxygen therapy may dry your mucus membranes and cause irritation. Fluids keep you hydrated. The recommended fluid intake for people with COPD is from 8 to 12 cups of caffeine-free liquids per day (a total of 64 to 86 oz).

Water is essential to the body. Drinking plain water may be your best source of fluid. Fruit juices, decaffeinated coffee, and tea are also good sources. Milk is also a good source of fluid, with the added benefit of providing many healthy nutrients. Check with your healthcare provider or nutritionist for the amount of fluid that you should drink each day.

What if I’m on a fluid-restricted diet?

If your healthcare provider tells you that you are “retaining fluid,” or if you are told to follow a fluid restricted diet, ask your nutritionist to help you plan what to eat and drink. Fluid retention may be caused by many factors including medication side effects or disease. Fluid retention can also be caused by an overconsumption of salt, and rarely, by excess intake of fluids.

The milk and mucus myth

One of the most persistent food misconceptions is the widely held belief that consuming cow’s milk causes an overproduction of mucus in the nasal passages, throat, and lungs. Athletes have been known to avoid it before a competition; actors and opera singers avoid it before a performance. And yet, there is little evidence to show that the relationship is true, and there is substantial information to the contrary.

In one such study, volunteers who were fed either cow’s milk or soy-based milk, both disguised with chocolate flavoring, reported similar sensations for both beverages. In another study, subjects who were challenged with a cold virus kept records of their dairy product consumption and their symptoms. Those who believed “milk makes mucus” reported more symptoms when they consumed milk, but an independent measure of their nasal secretions showed they were similar to the non-milk consumers.

Mucus production is part of the body’s defense mechanism against infections. It traps bacteria and dust and carries them to locations where they can be destroyed. The sensation some people experience when they drink milk can be explained in two ways. When you drink milk, some of the proteins may bind to and congeal the proteins in your saliva, particularly around your saliva ducts. This may cause a sensation that you are producing thick mucus. Also, the fats in milk may leave a soft, filmy coating in the mouth and throat, increasing this sensation. The perception is short-lived and confined to the mouth and throat not the sinuses, nasal passages, or lungs. The production of mucus from our nasal passages and throat may thicken as we age, and therefore, older people should be sure to consume enough fluids to keep these secretions thin.

Should milk be removed from the diet without just cause?

For those who are not lactose-intolerant, milk can play an important role in supplying calcium, riboflavin, protein, and vitamins A, D, and B-12. If the sensation is troublesome, try consuming low-fat or skim milk instead.

Sodium

An excess amount of sodium chloride, common table salt, can cause fluid retention (edema), increased blood pressure, and shortness of breath. Contrary to what most people believe, most sodium in your diet comes from packaged and prepared foods. A sodium-restricted diet can aid with decreasing water retention, and in some people, may decrease high blood pressure. If your physician has requested that you reduce your sodium intake, follow these guidelines:

• Do not use added salt in the preparation of food or food served at the table.
• Read labels and ingredients on all foods. Avoid those that contain salt.
• Read the sodium content on the labels. Look for products containing less than 140 mg sodium per serving or labeled low sodium.
• Pay close attention to those common packaged foods that contain more than 140 mg of sodium per serving, such as:
• Cured smoked and canned meats, bologna, frankfurters, ham, and salami.
• Regular canned vegetables, soups, and vegetable juices.
• Salted snacks (nuts, pretzels, chips).
• Regular frozen meals.
• Foods in brine (pickles, olives, sauerkraut, feta cheese).
• Regular processed cheeses.
• Seasoned salt, meat tenderizer, MSG.
• Soy sauce, barbecue sauce.
• Breads and rolls.
• Pizza
• Burritos and Tacos

Check with your physician prior to using salt substitutes because they may interfere with certain medications.

Calcium

Calcium works with magnesium to regulate lung function, muscle contraction, and blood clotting. It also has important roles in the structural strength of bones, the transport of nerve impulses, and the functioning of the immune system. Recommended intakes are 1,000 milligrams per day for both men and women up to age 50, and to 1,200 milligrams for women over 50.

Osteoporosis, or “porous bone,” affects more than 25 million women and over six million men in the United States. One of the common causes related to the development of osteoporosis among women has been traced to declining estrogen levels associated with the aging process. By age 65, some women have lost half of their skeletal mass.

It is not surprising that calcium is one of the most frequently used nutritional supplements. Unfortunately, calcium supplementation can interfere with magnesium and phosphorus absorption, resulting in possible deficiencies of these two important nutrients. It can be a “balancing-act,” maintaining sufficient calcium intake to slow bone loss and reduce the risk of fractures, while not consuming so much that it interferes with magnesium and phosphorus levels. To maintain a proper balance of these nutrients, look for products containing both calcium and magnesium in a 2:1 ratio. It is best taken in small amounts of 250 mg at each meal rather than one large pill a day. The upper level of calcium intake is 2,500 mg daily but remember that you also get calcium from food. Recent studies have shown that too much calcium can also result in an increased risk of kidney stones and heart attacks.

If you are planning to take calcium supplements as a measure against the development of osteoporosis, check with your healthcare provider about the proper dose for you. Osteoporosis, or “porous bone,” affects more than 25 million women and over 6 million men in the United States.  You will want to speak with your healthcare provider about your needs for calcium especially if you require repeated or long-term administration of steroid medications. Corticosteroids are medications frequently used in treating lung disease. In both men and women, corticosteroids accelerate the loss of calcium, and therefore bone loss, because they affect the hormones that control the deposit of calcium into the bone.

Dairy products are the principal source of calcium in the American diet. People who exclude dairy products from their diets, because of allergies, intolerances, or by preference, must either choose their foods carefully to meet their calcium needs or must depend upon supplements. Be aware that just because a food contains calcium, it does not guarantee the calcium can be absorbed by your body. Because calcium is not readily absorbed by the body, osteoporosis prevention can be enhanced by performing weight bearing exercises such as walking, running, and weightlifting.

Sources of calcium (readily absorbed) Mg calcium per serving

Because vitamin D is essential for calcium absorption, a dietary source of vitamin D is important. The recommended intake of Vitamin D for adults up to age 70 is 600 IU per day. For individuals aged 70 and older, the recommendation increases to 800 IU. You can obtain vitamin D from supplements, but be cautious, as excess vitamin D is toxic. An excess of vitamin D can cause nausea, vomiting, poor appetite, constipation, weakness, and weight loss. Milk (to which vitamin D is added), eggs, margarine, and fortified cereals are good sources of this vitamin. You will not overdose from Vitamin D in foods (except cod liver oil) or from sunshine. Supplements cause most overdoses of Vitamin D, though the upper limit for IU’s per day is being challenged. It is best to check with your healthcare provider before taking large amounts of supplemental Vitamin D.

Magnesium

Magnesium is an important mineral that is involved in blood clotting, blood glucose control, blood pressure regulation, muscle contraction, protein manufacture, and the chemical “fuel” that makes muscles work. In addition, magnesium works with calcium to regulate bronchial activity and has an antihistamine-like effect. A magnesium deficiency weakens the power of muscles, particularly breathing muscles. Cramps can occur. The average American consumes only three-fourths of the recommended amount of magnesium.

Be aware that high calcium intake interferes with magnesium absorption, so overuse of calcium supplements (more than 2,500 mg per day) is not recommended. Individuals with COPD should try to consume magnesium-rich foods to meet the dietary recommendation.

The recommended daily intake for people between 19 and 30 years old is 400 mg for men and 310 mg for women. For those older than 31 years, the recommendations rise to 420 mg daily for men and 320 mg for women.

Magnesium is part of chlorophyll, the green pigment in plants, so dark green vegetables are natural rich sources of magnesium. This is just one more important reason to “eat your vegetables.” Other sources of magnesium include whole grains, beans, peas, lentils, tofu, and some seafood. Chocolate contains moderate amounts. Be aware that foods made from refined flours (such as white bread) have 80 percent less magnesium than whole grain flours, and enrichment does not replace it.

Excessive use of magnesium supplements could be toxic. Since excess magnesium is usually excreted in urine, people with renal impairment or kidney failure are more at risk from excessive use of supplements.

Phosphorus

Phosphorus plays a role in the structure and function of all living cells. It acts as an essential component in the formation of energy. Phosphorus is also involved in the building and repairing of tissues, and in the formation of bone. The recommended dietary intake of phosphorus for adults is 700 mg per day. Most Americans can meet their needs for phosphorous by consuming meat, poultry, fish, eggs and milk products. Nuts and legumes such as chickpeas, kidney beans, and black beans are also good sources. Phosphorus deficiency in healthy individuals in the United States is rare, because the typical American diet is abundant in phosphorus.

Many commonly used antacids also contain aluminum or magnesium, which reduce phosphorus levels by preventing phosphorus from being absorbed in the intestinal tract.

Although deficiency is rare in healthy adults, individuals with COPD are at risk for phosphate depletion. Researchers have reported that as many as 20 to 50 percent of people with COPD have low phosphate levels. This deficiency may be due, in part, to medication side effects, as low phosphorus levels have been linked to some of the medications commonly used by people with COPD. Medications such as theophylline, B2 adrenergic bronchodilators, corticosteroids, and some diuretics are reported to cause excess phosphorus excretion from the kidneys. Many commonly used antacids also contain aluminum or magnesium, which reduce phosphorus levels by preventing phosphorus from being absorbed in the intestinal tract. General malnutrition also contributes to low phosphorous levels.

Ask your healthcare provider to check your phosphorous level, particularly if you are taking the listed medications associated with phosphorus deficiencies. Phosphorus is not a part of the routine blood work frequently ordered by physicians; therefore, low serum phosphorus levels may be under-diagnosed and under-treated.

Adequate phosphorous intake is necessary to maintain optimal pulmonary function, and severely low phosphorus levels can have fatal consequences, including respiratory failure. If serum phosphorus levels are low, increasing consumption of phosphorus-rich foods and beverages may improve phosphorus status. Phosphorous-rich foods include milk, cheese, meat, fish, eggs, nuts, and legumes. If you have a low phosphorus level, you can include more phosphorus-rich foods in your diet, or drink four cups of milk per day. If you have a severe phosphorus deficiency, your healthcare provider can prescribe an oral phosphate supplement.

Adequate phosphorous intake is necessary to maintain optimal pulmonary function, and severely low phosphorus levels can have fatal consequences, including respiratory failure.

Potassium

Potassium is necessary for muscular contractions in the body. It is especially important to the heart muscle, as either high or low levels of potassium can cause serious irregularities of heartbeat. Low potassium also contributes to muscle cramps. Some diuretics cause the kidneys to excrete large amounts of potassium from the body, while others “spare” potassium by inhibiting excretion. If you are taking diuretics, your physician will likely check your potassium level on a periodic basis. You can maintain a good potassium levels by eating foods high in potassium content. Good dietary sources of potassium include: milk, yogurt, winter squash, tomatoes, apricots, cantaloupe, bananas, grapefruit, oranges, prunes, carrots, potatoes, raisins, spinach, and dates.

If you suffer from chronically low potassium levels, either due to medication side effects or from malnutrition, your healthcare provider can prescribe a potassium supplement