Health & Medicine

COPD: A Nutritional Challenge

1. COPD A Nutritional Challenge Researched by Sandy Erhart January, 2009 2. An Introduction… A client comes for nutritional counseling. She is 64, thin and short of…
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  • 1. COPD A Nutritional Challenge Researched by Sandy Erhart January, 2009
  • 2. An Introduction… A client comes for nutritional counseling. She is 64, thin and short of breath with audible wheezing. As she sits, she pulls out and uses her rescue inhaler.
  • 3. Then she begins to cough, a deep, productive cough that she must expectorate into a tissue. This client has COPD….
  • 4. Chronic Obstructive Pulmonary Disease
  • 5. Definition and History
  • 6. COPD: Pathophysiology • Chronic lung inflammation in response to noxious particles, gases • 3 separate processes, alone or combined Emphysema Chronic bronchitis Asthmatic bronchitis • Progressive and irreversible
  • 7. Separate processes
  • 8. COPD: Signs and Symptoms • chronic cough, sputum production • Taking in less O2 retaining CO2 • shortness of breath and wheezing • recurrent infections • chest tightness
  • 9. Emphysema: “Pink Puffers” • Retains CO2 (pink) • Shortness of breath • Ineffective cough • Barrel chest yet thin limbs • Significant weight loss • Labored, “pursed lip” breathing • Anxious, short sentences
  • 10. Emphysema affects Alveoli Healthy Damaged
  • 11. Chronic Bronchitis: “Blue Bloaters” • Color dusky to cyanotic (lack of O2) • Persistent productive cough • Retains CO2 leading to acidosis • Shortness of breath with exertion • Normal-overweight
  • 12. Chronic Bronchitis affects Airways
  • 13. COPD: Historical Aspect EMPHYSEMA 1661, from Greek. emphysema "swelling," from emphysan "inflate." René-Théophile-Hyacinthe Laennec
  • 14. Lung function gets measured • 1846: Hutchinson invents the spirometer, which measures vital capacity of lungs. • 1947: Tiffeneau adds “timed” VC. • 1965: “COPD” term first used and defined.
  • 15. Spirometry: Vastly underutilized by Primary Care Doctors
  • 16. COPD theories & discoveries • 1966: scientists induce emphysema in lab animals with pancreatic enzymes. • 1968: a rare genetic marker, deficiency of alpha-one-antitrypsin discovered. • 2006: hypothesis that COPD is an autoimmune disease. • 2008: systemic inflammation shown to raise plasma leptin levels.
  • 17. Affect on Nutrition
  • 18. COPD: A catabolic “wasting” disease CATABOLISM 1875-80, from Greek. catabole “a casting down,"
  • 19. Reasons for poor nutrition • Dyspnea and coughing interfere with adequate dietary intake • Fatigue interferes with buying and preparing foods • Chronic mouth breathing alters the taste of food • Headaches, mental status changes occur because of hypercapnia (excess blood level of CO2)
  • 20. COPD: Carbohydrates • CHO produce the most CO2 during metabolism • CHO should be 40% of intake • Complex CHO best
  • 21. COPD: Fats and Proteins • Need at least 30% of calories from fat, whole dairy encouraged • Need 30% from protein
  • 22. Micronutrients: Fruits and Vegetables • Antioxidants • Vitamin C • Calcium, Vitamin D • Phosphorus
  • 23. Nutrition & Exercise Tips
  • 24. COPD: Help Eating Succeed  Prepare meals early  Rest and medicate before eating  Oral care before meal  Stimulate the appetite  Liquefy foods to reduce chewing  Eat small, frequent meals  Adequate water intake daily
  • 25. Pulmonary Rehabilitation Never too late! • Even mild to moderate helps • Improves strength and endurance • Reduces dyspnea and fatigue • Improves cardiovascular function • Contributes to stronger, improved breathing
  • 26. Why Should We Care?
  • 27. Knowing about COPD Is Important • Fastest growing chronic disease, half not even diagnosed • Disease not apparent until damage is done and irreversible • Costs $39 billion yearly in health care and hospitalizations in the U.S.; $150 billion worldwide • There is no cure
  • 28. Prevention Is KEY
  • 29. COPD: Risk Factors • Long-term exposure to tobacco smoke • Occupational exposure to dusts and chemicals, air pollution • Age over 40 years • Very rarely caused by alpha-1-antitrypsin deficiency, genetic disorder
  • 30. Meet The Smokers BEFORE Wayne McLaren Maureen Hamilton
  • 31. 20 Years Later… Wayne Maureen
  • 32. References http://www. (National Lung Health Education Program)
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