Is characterized by a slow and progressive obstruction of the airways and the main cause thereof is smoking. Can be subdivided into two categories. The first is the second pulmonary emphysema and chronic bronchitis. Individuals who have COPD are at high risk of malnutrition. In addition to decreased food consumption, nutritional deficiency is manifested by respiratory complications, muscles retightened carbon dioxide and metabolic waste and impaired muscle function. It is important to consider that these patients may retain fluid by complications of the disease, and this retention can camouflage one of the main indicators of malnutrition: weight loss. Studies show that malnourished patients with COPD have a worse prognosis than those who are well nourished. From the nutritional standpoint, patients with emphysema are generally thin and elderly. At a late stage the disease can trigger a cardio-respiratory failure. Patients with chronic bronchitis, however, have a normal weight, and in some cases manifest overweight. Cardio-respiratory failure, however, is triggered by an early stage of the disease. Requirements and nutritional assistance Goals for nutrition support in patients with COPD Provide nutritional wellbeing Maintain an appropriate reason between lean body mass and adipose tissue through proper nutritional intake and increased physical exercise Maintain an appropriate reason between lean body mass and adipose tissue through proper nutritional intake and increased physical exercise Correcting the imbalance of fluids Provide nutritional wellbeing Maintain an appropriate reason between lean body mass and adipose tissue through proper nutritional intake and increased physical exercise Correcting the imbalance of fluids Controlling food-drug interaction Energy When considering nutritional replacement in patients with chronic obstructive pulmonary disease, must be considered the type of malnutrition that present (protein, energy-energy) and requirements that help better breathing for each patient. It is advisable to start with about 35 kcal / kg / day and progressively increase depending on the tolerance. Although power requirements are increased, it is important to avoid excessive energy, and that can lead to respiratory impairment and increased production of carbon dioxide. In patients with stable COPD requirements of protein, fat and carbohydrate are determined by the stability, with its weight, resulting in oxygen therapy, the medication, the evolution of the disease and any fluctuation in liquid from the body. Often patients suffering from COPD and other processes associated with cardiovascular disease, cancer or diabetes, these disorders affect the total amount of calories and nutrients should consume. Proteins It requires sufficient protein, 15-20% of total daily calories should be incorporated through proteins. It should increase the consumption of foods rich in protein such as red meat, poultry, fish, egg, dairy, and legumes, soy, grains and nuts. An adequate supply of protein function can promote lung defense and can maintain or restore muscle strength and lung. But keep in mind that in situations of acute respiratory failure, a diet rich in protein can cause additional fatigue by requiring increased oxygen consumption. Fats It is recommended that 30-45% of total kcal diet are made by fatty foods. It will increase the consumption of nuts, avocados, vegetable oils, egg yolks, and fatty fish (tuna, bonito, trout, salmon, sardines, etc..). And they control the consumption of animal fats, especially rich in saturated fat and cholesterol. Diets and high calorie nutritional supports for patients with COPD should be based more on the administration of carbohydrate fat. However it is advisable higher fat intake to 50% of total caloric value of the diet. Carbohydrates It is recommended that 40-55% of total kcal diet are contributed by carbohydrate-rich foods such as cereals, pasta, bread, potatoes and cereals. Preferably they are integral to increase dietary fiber intake. Vitamins and minerals The vitamin and mineral requirements depend on the individual situation of each patient and the course of the disease and associated diseases. It should increase the requirements for vitamin C in people who smoke. It is estimated that a smoker who consumes a pack a day, vitamin C requirements increase almost to 16 mg / day more than a nonsmoker. Regarding control minerals especially calcium and magnesium, for their role in muscle contraction and relaxation. It is important to ensure at least the recommended daily intake for each of them. It will increase the consumption of milk and dairy products (main source of calcium) and increase the consumption of whole grains, nuts and green vegetables (main sources of magnesium). In patients with fluid retention, will restrict the consumption of these and sodium intake in the diet. It is recommended that the diet of patients with COPD is poor in sodium, with a daily intake of 2.5 g of salt. Enteral nutrition can be an alternative when oral nutrition is not possible. In hospitalized patients is improved and a significant increase in weight, as nutritional support (enteral or paraenteral) maintaining a suitable time, around about 2 or 3 weeks. Recommendations for patients with COPD: Rest before meals Distribute your meals over three main meals (breakfast, lunch and dinner) and two lighter sockets (one mid-morning and mid-afternoon). Eat small amounts of food, avoid tired while eating and allow you to continue eating the same amount of food. Avoid high fat foods that cause reflux feeling, similar to vomiting Avoid legumes or vegetables that cause gas Increase consumption of fruits and vegetables (at least 5/day) especially rich in vitamin C and E (strawberries, kiwi, oranges, tangerines, grapefruit and spinach, beets, asparagus, green beans, etc..) Eat fish at least 3 times a week. He recommends the consumption of oily fish (bonito, tuna, salmon, trout, etc..) Season with olive oil or other vegetable oils Consume plenty of water and liquids. Except in situations retention. Check the temperature of foods to avoid that cause you to cough. They are neither too cold nor too hot. Take little salt. Avoid salty foods such as sausages, smoked meats, ready meals, canned, bouillon cubes, snacks, etc.. And spice your dishes with herbs, pepper, oregano, parsley, mustard, etc.. Do not forget physical activity, it is important to exercise moderately and regularly, without reaching a respiratory requirement. Plan the schedule for taking medicines so not coincide with meal times. In situations with severe nutritional compromise, recourse to enteral feeding by mouth or by tube, which increases the overall nutritional and caloric intake in some patients with COPD
Posted on: Sun, 09 Jun 2013 20:12:56 +0000
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