Healthy Living
and FAQ

How to keep healthy

A Healthy Body Weight

Achieving and maintaining a healthy body weight is your best defense against all preventable diseases and helps to prolong wellness in chronic disease
If you are having significant issues with either gaining or losing weight, your doctor may be able to refer to you a dietitian for specific nutritional counseling
Extra weight strains all body systems especially the lungs and increases your risk of type 2 diabetes, heart disease, hypertension, high cholesterol, etc.
Achieving a healthy body weight is a matter of balancing the energy in (the food you eat), with the energy that your body burns (from daily living and exercise)

How to Eat Right

Watch your portion sizes – eat 5 to 6 small meals each day instead of 3 large ones – this can be especially helpful during times of respiratory flare when your appetite is reduced
Choose low fat protein from meat, beans, and legumes
Choose higher fiber grains, fruits and vegetables. Fiber intake is associated with increased lung capacity in COPD
Do not forget dairy!

Excellent source of calcium and vitamin D

Good source of calories when you need to gain weight

Dairy does not increase mucus production or make asthma-like symptoms worse

Get Active

Be active in your day to day life – take the stairs instead of the elevator or escalator, walk a few extra blocks instead of taking transit
Get your heart rate up, aim for 30-60 minutes of exercise at least 3 times per week. Decreased physical activity is associated with increased risk of hospital readmission’s for flares
Studies looking at physical activity levels of people with COPD have found significant benefits to increasing activity levels.
People who increased their exercise had improved strength in their breathing muscles, and decreased whole body inflammation

See how you’re affected

Lung Affected

Energy needs may increase by as much as 30% during an A1AT respiratory flare

> Breathing becomes like exercise so you burn more calories when you breathe rapidly

> Also, systemic (whole body) inflammation occurs during a flare, this means your entire body is working harder to function, so your calorie needs increase

It is very common to lose significant weight during a flare both because of increased energy needs, but also because you may feel full sooner, or find that eating takes a lot of effort
Sudden, significant weight loss should be avoided because it is associated with decreased tidal volume, which leads to collapse of the alveoli in your lungs and decreased secretion removal. This then makes you more susceptible to infection. There are a few steps that you can take to prevent this type of weight loss

> Eat foods that are energy dense – make sure you get the best bang for your buck with each bite you take

> If you find yourself feeling full quickly, eat small frequent meals to maximize what you are able to eat

> Continue to eat a variety of foods from all food groups

Minimize you simple sugar intake:

> Acute COPD symptoms may result in insulin resistance due to changes in how your body digests glucose (sugar). One study found that people in acute flares had much higher levels of blood glucose when compared to people without COPD or those with COPD but not in an active flare

Don’t forget to drink lots of fluids. Your body requires more than average fluid, especially when your breathing is increased or you have increased mucus production. You actually lose a lot of fluid from both
Corticosteroids used for treatment of inflammation have some nutritional side effects such as appetite changes (usually increased appetite), decreased blood sugar control and/or bone demineralization which need to be managed. Choose healthy snacks and don’t forget your calcium and vitamin D supplements
Some people find that gas and bloating can make breathing more difficult, this is because the increased pressure in your digestive system can increase the pressure on your diaphragm and therefore your lungs. To minimize gas and bloating:

> Avoid overeating and foods that cause gas or bloating

> Avoid eating quickly or talking while eating

> Slowly increase the amount of fibre containing foods and drink lots of fluids

> Limit carbonated beverages

Iron is essential for normal oxygen transport in the blood. It forms the centre of the haemoglobin in your blood and oxygen attaches to haemoglobin for transportation around the body. Therefore, without iron, oxygen transport can be reduced

> Your doctor can check your iron status as part of routine blood work

> Food Sources: Meat provides iron that is most efficiently used by the body, but vegetables are good sources too, but aren’t used as easily by the body, choose green leafy veggies, and fortified grains

Liver Affected

The liver plays a large role in digestion, so a liver affected individual may experience a number of nutritional difficulties
This happens because when the liver is chronically inflamed, it can become cirrhotic which means that healthy liver cells are replaced by scar tissue. Scar tissue prevents the liver from performing all of its functions
A number of specific complications can occur with liver disease:

> Portal hypertension: blood pressure increase in the large vein going though the liver, results in blood backing up

~ Medical treatment is necessary, nutritional suggestions may be made by your doctor and dietitian

> Ascites: accumulation of fluid in abdomen

~ The abdomen can become quite distended with fluid which may result in decreased appetite or early satiety because the fluid displaces space in the stomach

~ Nutritional treatment: includes sodium or fluid restriction

> Hepatic Encephalopathy: Confusion and altered consciousness due to accumulation of chemicals usually filtered by the liver

~ Treatment will be medically guided, but may include the use of a prebiotic called lactulose

~ Historically, a reduced protein diet was recommended, but we now know it is more important to maximize nutritional status with adequate protein intake

Alternative Treatment

Alternative treatments are very tricky as there isn’t usually a lot of research done
The internet is full of anecdotal evidence from people who have tried various treatments, but scientific research is slow to investigate
There are thousands of products on the market, but only few scientists are investigating their effectiveness
People often think that natural products are harmless because they’re natural. However, this isn’t always the case; natural products can still be harmful and/or interact with any medications that you may be on. It is important that you tell your healthcare providers about any naturopathic supplements that you are taking

Supplements Commonly

Used for A1AT

Co Enzyme Q10

A recent study found that CoQ10 levels were lower during an alpha-1 flare; this was thought to be due to the oxidative stress of the flare. Despite this observation, researchers do not know if lower levels of CoQ10 have a negative effect on the body, therefore it is not known whether supplementing it can be helpful during a flare. At this time, there are no recommendations from the scientific community to supplement with CoQ10

Milk Thistle

Current research looking at milk thistle is only in the alcoholic and hepatitis C populations. A 2011 study indicated more potential effect in the alcoholic liver disease populations than on the Hep C population. A recent Cochrane review (which combined the findings from all previous studies on the topic) in these populations found no effect on liver disease symptoms. There is no indication that milk thistle is helpful in A1AT

Oregano Oil

Oregano Oil has very strong anti-microbial properties and is used in food preservation. There is some thought that it may be helpful in treating symptoms of the common cold; however there is no published research looking at oregano oil in treating a cold. One study looked at its use in treatment on bacteria e.g. E. Coli in intestinal cells. It was found that the activity of the bacteria was greatly reduced, but when taken in very high amounts, damage to the intestinal cells occurred. This study deliberately looked at a very high dose, so this doesn’t automatically suggest regular use of it is harmful, it just suggests that more is not better

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Wüthrich B, Schmid A, Walther B, Sieber R.(2005). Milk consumption does not lead to mucus production or occurrence of asthma. J Am Coll Nutr. Dec;24(6 Suppl):547S-55S

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