NTM/Bronchiectasis Patients and Carbohydrates

Posted on June 04, 2019   |   
Like 11 Likes

This blog post was written by Katie Keating, RN, MS, patient advocate

Eating, breathing and feeling better are part of our daily goals and activities of daily life. What we consume on a daily basis definitely impacts our health and how we feel. A good diet can help to prevent respiratory infections and give our body the energy it needs to do the work of breathing and staying active.

As Hippocrates once said, “Let food be thy medicine and medicine be thy food.” We all wish it were magically possible to eat the right food and to feel better overnight. However, small steps made daily can help you on the road to feeling more energetic.

We must consume the vitamins and minerals our bodies need on a daily basis. When the number of calories taken in is too low to meet a person’s energy needs, the body breaks down fat and muscle for energy. This begins a negative cycle and could cause the breathing muscles to weaken and lead to shortness of breath. This could then lead to decreased appetite and weight loss and the cycle repeats itself1.

Your body produces more carbon dioxide when it breaks down carbohydrates. The extra carbon dioxide must be exhaled so when our meals are heavy in carbs, breathing can become more difficult2.

Carbs are similar to wood in a fireplace- quickly acting. However, you must clean the chimney after the log burns out. Sugars offer quick energy but increase the waste within. It is hard to blow off the extra carbon dioxide within our bodies.

The three main types of carbohydrates are sugars, starches and fiber. They are called “simple” or “complex” based on their chemical makeup and how your body utilizes them.

The energy from simple carbohydrates- such as those found in sugar, soft drinks, candy, cookies and cakes – is quickly absorbed into the bloodstream, causing a quick but brief energy boost, followed by a reduction of energy. Consuming too many simple carbs could cause someone to hold in too much carbon dioxide, which may result in increased fatigue.

Complex carbohydrates, those found in whole grains, legumes, pasta and starchy vegetables, contain longer chains of sugar molecules, which usually take more time for the body to break down and use. That means you will get lower amounts of sugars released at a more consistent rate — instead of peaks and valleys — to provide with a more consistent amount of energy throughout the day. Foods with complex carbohydrates also typically have more vitamins, fiber, and minerals than foods containing more simple carbohydrates. Generally, the higher the sugar content in food, the lower it is in fiber, vitamins and minerals. Clearly there is an inverse relationship between sugar content and lack of the good things we need for a healthy diet. Whole grains and fiber-rich fruits and vegetables are always a better choice over processed foods.

Yes, it is always easier to grab that one piece of junk food for a quick fix. I must admit that I used to call myself a “twizzler junkie.” I remember carrying a large bag of them with me for my first evaluation at National Jewish Hospital. Even as a nurse educated on the basics of nutrition, I still felt that I would do anything for a quick boost when the fatigue increased and I had a young daughter to raise.

I later added on diet Pepsi. I am sure many of the newly diagnosed are doing exactly what I did out of desperation. Please learn from my mistakes. I have come a long way since then. I have learned a lot about the gut-brain connection, which I believe exists, and I acknowledge that serotonin is produced in the gut. I am more mindful and try to eat smaller meals throughout the day and am prepared with healthier snacks when I go out.

Nutritional tips I have found give me the best energy:

  • Consume smaller, more frequent meals, which prevents your stomach from becoming too full. A full stomach can restrict movement of your diaphragm, the muscle that assists you in breathing.
  • Eating smaller, less frequent meals is also less tiring since you are using less energy. Use simple recipes. Make foods easier to chew; cook vegetables until they are soft and easy to digest.
  • Drink fluids one hour before and one hour after a meal. This will decrease the amount of food in the stomach at one time.
  • Sit upright and lean forward with your feet on the floor; this gives you the greatest expansion of the lungs.
  • Eat your larger meals earlier in the day to avoid reflux at night; it may boost your energy levels.

Bottom line: I have found that less carbs, less quick fixes, more whole grains, and more greens and fruits boost your lowered energy levels and thus improve your quality of life. Spring is the right time to start a new way of nutrition. I wish you the very best and encourage you to speak to a Nutritionist if you have any questions or concerns about your diet.

The COPD Foundation advises that before you make any changes to your medication or therapies that you first consult with your doctor.


  1. COPD Slim Skinny Reference Guide, pg. 4

  2. Health Monitor, Guide to Living w COPD, page 26.

    COPD Nutrition Guide: 5 Diet Tips for People with COPD, Healthline Newsletter, Janchote, Clair Nov. 7, 2018

    Nutrition for Someone with COPD -COPD 360 Social