Eating well with pulmonary fibrosis

What is a healthy diet for pulmonary fibrosis?

Eating well helps you to maintain a healthy weight, gives you the energy you need and keeps the immune system working. And of course, eating well and maintaining a healthy weight just makes us feel better!

Being overweight can put extra pressure on your lungs making it harder to breathe. On the other hand, being underweight can lead to a weakening of your breathing muscles, lead to muscle wastage and reduce your immune function.

Malnutrition

Some people with pulmonary fibrosis might be at risk of malnutrition. If someone is malnourished, they have too little or too much of certain nutrients in their diet. This might be caused by a loss of appetite, common in people with pulmonary fibrosis, often because of breathlessness or the side effects of antifibrotic treatments. A lack of appetite leads to a change in the quantity and quality of someone’s diet, which then might not contain the right balance of nutrients.

Here is a list of resources that might be helpful if you are concerned about malnutrition or want to find out more:  

- What is malnutrition?

- Malnutrition Awareness Week

- The NHS Eat Well Guide

- Who is at risk?

- Managing symptoms that affect eating and drinking

Malnutrition can happen to anyone, regardless of their weight. If you’re concerned about malnutrition, you can ask your GP or medical team to refer you to a dietitian. A dietitian can help you maintain a healthy diet.

A balanced diet

Your diet should contain a variety of different foods and food groups, so that you get a wide range of nutrients. Here are some basic tips on the different food groups:

Fruit and vegetables

Eat at least five portions of a variety of fruit and vegetables every day. This can include fresh, dried, frozen, canned and juiced varieties, but not potatoes. Sadly, a portion of chips doesn’t count!

Potatoes, bread, rice, pasta and other carbs

Carbohydrates should make up just over a third of what we eat. Choose wholegrain or higher fibre versions with less added fat, salt and sugar when you can.

Dairy and dairy alternatives

Choose lower fat and lower sugar options if you can.

Beans, pulses, fish, meat, eggs and other protein

Eat a source of protein every day. Try to eat more beans and pulses. Have two portions of sustainably sourced fish per week, one of which is oily - and eat less red and processed meat.

Oils and spreads

Choose unsaturated oils and spreads in small amounts.

Treats

We don’t need chocolate, sweets, cakes and ice-cream for a healthy diet, but it’s nice to have an occasional treat! Just make sure it is occasional, not every day.

Eating the right amount

A healthy diet should provide us with the right amount of energy – usually measured in calories - to maintain energy balance. This means consuming the same amount of calories as our body  needs.

Exactly how much energy you need from your food depends on many different things, such as how active you are. But, on average women need about 2,000 calories a day, and men need about 2,500.

You can find out more about healthy eating and a balanced diet from the British Nutrition Foundation

How can I put on weight?

Some people find that pulmonary fibrosis leads to unwanted weight loss. This can be because you have to use up more energy to breathe normally or have lost your appetite and so are eating less than you need.

The tips below can help you to you put on some weight if this is a problem for you:

• If you struggle to eat large meals, try to eat six to eight small dishes through the day which are high in calories and in nutrients
• Eat more high-fat foods like full-fat cheeses, cream-based foods and yogurts
• Between meals, drink high-calorie drinks like fresh fruit juice, yogurt drinks, hot chocolate, malted drinks, flavoured milk and milkshakes
• Add butter, cream or cheese to mashed potatoes and vegetables
• Pour custard and full-fat cream over fruit or puddings
• Use more butter or mayonnaise on sandwiches, toast, scones or pancakes
  

If you’re losing weight without planning to, it’s very important to talk to your medical team. They may recommend a nutritional supplement or refer you to a dietitian.

If preparing meals is a struggle, talk to your local council about local meal delivery services, or look online - Google ‘meal delivery services’ to see what is on offer.

How can I lose weight?

If you think you might benefit from losing weight, it’s best to ask your medical team first. Not everyone benefits from losing weight, and trying to lose weight can put you at risk of malnutrition. You can ask to be referred to a dietitian who can help you maintain a healthy diet.

Some people find their lung condition makes them put on weight, as they become less active or simply eat for comfort. Taking some types of steroid can also increase your appetite. Being overweight can make breathing more difficult and, just when you need it most, it takes even more effort to be active.

Here are some tips for losing weight:

• Keep an eye on your portion sizes, especially when eating out. Try using a smaller plate
• Make sure vegetables or salad cover about half your plate. Use a vinaigrette or fat-free dressing on salads instead of mayonnaise or salad cream. You can also get low fat versions of these
• Avoid fried foods. Try grilling, steaming, boiling, baking, dry roasting or microwaving instead. Or use a fine oil spray to keep the amount of fat you use to a minimum
• Try not to snack between meals. If you can’t resist, eat fruit instead of biscuits or chocolate – and be careful with things like cereal bars which often contain a lot of sugar
• Use skimmed or semi-skimmed milk, low-fat spread and sweeteners instead of sugar.
  

Don’t forget to speak to your doctor or health care professional. They can refer you to a dietitian or a local scheme. Read NHS advice on losing weight.