Chronic obstructive pulmonary disease (COPD) is commonly associated with heart failure. While chronic obstructive pulmonary disease and heart failure are two different conditions, they can both cause breathing problems, especially when you’re exercising, climbing stairs, walking or running.

What Are COPD and Heart Failure?

Chronic obstructive pulmonary disease (COPD) is used to describe chronic lung diseases, including bronchitis, refractory (non-reversible asthma) and emphysema. Patients with COPD have difficulty exhaling all of the air in their lungs. In many cases, this lung damage is caused by smoking. If you have COPD, it’s important to see your physician regularly, because the disease is characterized by flare-ups and remissions. In some cases, it affects patients silently, and it’s only later that it impacts their quality of life and leads to hospitalization or death.

If you have heart failure, your heart doesn’t pump blood efficiently, which leads to shortness of breath. Certain conditions such as coronary artery disease can lead to heart failure. There are two types of heart failure: left-sided and right-sided. 

How COPD and Heart Failure Are Related

If you have severe chronic obstructive pulmonary disease, you can experience heart failure in your heart’s lower right chamber (ventricle), which is also known as right-sided heart failure. It causes fluid to build up in your body, which can make breathing difficult. While left-sided heart failure is generally caused by coronary artery disease or high blood pressure, low oxygen in the blood from COPD can worsen the condition. 

To determine if you have COPD and/or heart failure, your physician may perform a:

• Physical exam
• Pulmonary function test
• Echocardiogram
• Chest x-ray
• Cardiac enzymes test

The main treatment for COPD is a bronchodilator (inhaled medication). There are a number of different heart failure medications. If your shortness of breath is severe from COPD and heart failure, your physician may also prescribe:

• Corticosteroids
• Antibiotics (to treat a viral infection)
• Machine-assisted breathing
• Oxygen

There are also certain lifestyle changes you’ll need to make, including quitting smoking, eating a heart-healthy and COPD-friendly diet, and getting enough exercise.

Dietary Modifications for COPD & Heart Failure

Nutrition plays an important role in managing COPD and Heart Failure and their complications. Fiber and the macronutrient protein are very important as well as certain vitamins and minerals such as vitamin D, calcium, phosphorus, magnesium and sodium. Antioxidants, found in richly coloured fruit and vegetables, as well as omega-3 rich foods like salmon can also play a role in helping to reduce inflammation in the body.

1. Fiber

Fiber is an important part of everyone’s diet, and especiall for those with COPD. Fiber helps move food through your digestive system, and it can help control cholesterol and blood sugar levels. Look for high-fiber foods such as:

• Fruits (apples, oranges, strawberries)
• Vegetables (yams, sweet potatoes, broccoli)
• Whole grains (whole grain bread & pasta, oats, brown rice, spelt, buckwheat)

2. Protein

Protein is an essential component for overall health and supports a healthy immune system. Good sources of protein include:

• Lean meats
• Poultry
• Fish
• Eggs
• Beans
• Nuts
• Peanut and nut butters
• Tofu

3. Phosporus

Up to half of COPD patients have low phosphorus levels due to poor nutrition and/or certain medications. Phosphorus contributes to healthy lung function, so look to include foods such as:

• Dairy products
• Meat
• Fish
• Eggs
• Nuts
• Beans

4. Magnesium

Magnesium is another mineral that contributes to healthy lung function. Foods high in magnesium include:

• Dark green vegetables
• Tofu
• Whole grains
• Beans and lentils

5. Calcium & vitamin D

Patients with COPD need to eat foods rich in calcium and vitamin D to keep bones healthy and strong. One side effect of chronic obstructive pulmonary disease is weak and brittle bones. Include food such as:

• dairy products
• canned fish such as sardines & salmon (with the bones!)
• almonds
• collard greens & broccoli
• fortified orange juice

6. Sodium

Excess dietary sodium can cause fluid retention which makes breathing difficult. Choose:

• fresh, unprocessed foods
• avoid packaged, prepared foods
• read food labels for sodium values
• use more herbs, spices and salt-free seasonings to add flavour

Some individuals benefit from the DASH diet which is an excellent plan to help reduce their sodium intake. The DASH diet stands for Dietary Approaches to Stop Hypertension. The DASH diet encourages whole grains, lots
of vegetables and fruit, nuts/seeds and legumes, lean meats and fish.

Here is an example meal plan:

Breakfast:

• 2/3 cup steel cut oatmeal with ¼ cup ground almonds and ¼ tsp cinnamon
• 1 cup mixed berries and 2 tbsp Greek yogurt

Lunch:

• Quinoa and bean salad – 1 cup cooked quinoa, ½ cup mixed beans, cucumber, green beans, red onion, shredded carrots, celery, balsamic vinaigrette.
• 1 cup cantaloupe

Snack:

• 1 cup seedless grapes and 1oz cheese

Dinner:

• Kale salad in lemon Caesar dressing
• 4oz grilled salmon
• Roasted cauliflower, sweet potato and white potato
• Baked apple in cinnamon

To learn more about the DASH diet click here.

COPD Complications and Nutrition

1. Breathlessness

Some patients experience breathlessness during or after a meal which can effect the ability or desire to eat. You can reduce or prevent this symptom by:

• Taking small bites
• Chewing slowly
• Eating smaller meals
• Drinking liquids after a meal, not during
• Clearing mucus from the airways before eating

2. Weight Control

Patients with COPD may be under or overweight depending on the individual. If you have chronic pulmonary obstructive disease and are underweight, you may need to find ways to add additional calories to your diet through things like nutritional shakes. If you’re overweight or obese, you may need to go on a low-calorie diet. If either of these situations apply talk to your healthcare provider about the right options for you.  

3. Water Retention

Water retention can cause uncomfortable symptoms for people with COPD. Always check labels for the sodium content, and avoid adding salt to your food. If you want to add flavour, use herbs or salt substitutes. 

4. Medications

COPD medications can interact with certain foods, especially caffeine and alcohol. Talk to your healthcare provider about your medications and possible interactions.

If you'd like more information on COPD & Heart Failure talk to your family physician.

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