Nutrition

Good nutrition is an important part of wellness in patients with bronchiectasis and nontuberculous mycobacterial (NTM) lung disease. People who have bronchiectasis and NTM lung disease may use a lot of energy to breathe. This occurs when breathing becomes difficult and you must use extra muscles, those not usually used, to breathe. Repeated antibiotic use can cause nausea, vomiting, and diarrhea. This can cause weight loss or malnutrition. Some people may gain weight because of inactivity. The inactivity may be directly related to having increased shortness of breath during activity. Maintaining a balanced diet will help you feel your best, recover from flare-ups faster, and slow the progression of your disease.1

How Can What I Eat Affect My Breathing?

Metabolism is the process the body uses to change food into fuel. Metabolizing some foods can create a waste gas called carbon dioxide. When the body breaks down carbohydrates (carbs), it produces more carbon dioxide than when it breaks down fat and protein. (Examples of high-carb foods include pasta, bread, sweets, potatoes.) So, if you have a lung disease, like bronchiectasis, eating fewer carbs may be best.2 Do your best to eat the right mix of nutrients. No single type of food will give you the total nutrition that you need.

Balanced Diet

What is a Balanced Diet?

A balanced diet is one that includes a variety of healthy vegetables and fruits. You will also want to include whole grains (like brown rice and quinoa) and lean proteins (like chicken breast and tuna). Some low fat or fat-free dairy products should be included as well.3

Balanced, healthy diets should be low in salt, added sugars, solid fats (lards/butter) and simple carbs (white bread/crackers).

Drinking water–Lung disease patients should drink plenty of water each day. Water helps to thin mucus in the lungs making it easier to cough out. Drinking enough water can also help to keep your skin moisturized, keep your joints loosened, remove waste from the body, and regulate your temperature.4

Supplements –You may be low in vitamins or minerals and may need to take additional supplements or vitamins. Also, supplements (like meal replacement shakes) can be used to help you gain weight as well, if needed. Talk with your doctor before adding any supplements to your diet. Some supplements can interact with medicines that you are taking or affect other health conditions that you may have.

If you have bronchiectasis and/or NTM, we recommend that you meet with a licensed dietitian to make sure you are getting the right balance of nutrients and vitamins in your diet.

For more information on how to eat a balanced diet visit: U.S. Department of Agriculture (USDA) Choose My Plate and/or National Heart, Lung, and Blood Institute (NHLBI) Nutrition Tools

Dietician Helps Bronchiectasis Patients

If You Are Underweight or Struggling With Unplanned Weight Loss…

Unplanned weight loss can be a problem for people who have bronchiectasis and NTM lung disease. This weight loss can be caused by one or more of the following: nausea, decreased appetite, increased calorie needs, diarrhea from taking antibiotics, inflammation side effects, and other medicine side effects.5 If you are unable to control your weight loss, your condition may get worse. To stop or prevent unplanned weight loss, watch your weight closely and talk with your doctor if you become concerned.

If You are Overweight…

Weight gain can occur in bronchiectasis and/or NTM lung disease patients from either eating too many extra calories or becoming inactive because of getting short of breath during activity. Being overweight can affect your lung function.7 Being overweight can also contribute to other health problems or “comorbidities” (coe more bid ii tease) like sleep apnea, coronary artery disease, and pulmonary embolus.8 If you are overweight, talk with your doctor or dietitian about food options. Also consider joining pulmonary rehab to increase your activity level and build confidence with exercise.

Additional Information:

Gastric Reflux

Chronic gastroesophageal (gas troe ee sof a gee ul) reflux disease (GERD), can trigger symptoms of bronchiectasis. GERD can cause stomach acid to move back up into the esophagus (ee sof fah gus). This can cause acid to enter the lungs, irritating them. This irritation can cause a narrowing of the airways and an increase in mucus production. This can cause your lung disease to get worse.9 Your doctors may suggest you elevate the head of your bed and/or adjust your diet. Your doctor may also prescribe medicine that may help you digest food and reduce the amount of acid your body makes.9

Not Enough Vitamin D

Vitamin D is in foods such as salmon, mackerel, mushrooms, and milk. It helps the body by reducing inflammation and improving the immune system. People who have bronchiectasis and/or NTM lung disease tend to have low vitamin D levels. This has been linked to their lung function becoming worse.10,11 Your vitamin D level can be measured by a blood test. Having this test regularly can help you avoid having a level of vitamin D that is too low.

The content on this page is not meant to replace any advice from your doctor. Talk with your doctor before making any significant changes to your diet. Your doctor will be able to guide you based on your body’s specific needs and/or refer you to a specialist.

References:

  1. Despotes KA, Choate R, Addrizzo-Harris D, et al. Chronic Obstr Pulm Dis. Nutrition and markers of disease severity in patients with bronchiectasis. 2020;7(4):390-403. doi: http://doi.org/10.15326/jcopdf.7.4.2020.0178
  2. American Lung Association (ALA). Nutrition and COPD. ALA website. Updated March 5, 2021. Accessed March 18, 2021. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/living-with-copd/nutrition.
  3. National Heart, Lung, and Blood Institute (NHLBI). Bronchiectasis. NHLBI website. Accessed March 18, 2021. https://www.nhlbi.nih.gov/health-topics/bronchiectasis.
  4. Centers for Disease Control and Prevention (CDC). Water and healthier drinks. Health weight, nutrition, and physical activity. CDC website. Accessed March 24, 2021. https://www.cdc.gov/healthyweight/healthy_eating/water-and-healthier-drinks.html. Accessed March 24, 2021.
  5. Lan CC, Lai SR, Chien JY. Nonpharmacological treatment for patients with nontuberculous mycobacterial lung disease. J Formos Med Assoc. 2020;119(Suppl 1):S42-S50. doi: https://doi.org/10.1016/j.jfma.2020.05.013.
  6. Wakamatsu K, Nagata N, Maki S, et al. Patients with MAC lung disease have a low visceral fat area and low nutrient intake. Pulm Med. 2015;218253. doi: https://doi.org/10.1155/2015/218253.
  7. Biring MS, Lewis MI, Liu JT, Mohsenifar Z. Pulmonary physiologic changes of morbid obesity. Am J Med Sci. 1999;318(5):293–297.
  8. Hanson C, Rutten EP, Wouters EF, Rennard S. Influence of diet and obesity on COPD development and outcomes. Int J Chron Obstruct Pulmon Dis. 2014;9:723-733. doi: https://doi.org/10.2147/COPD.S50111
  9. Hu ZW, Wang ZG, Zhang Y, et al. Gastroesophageal reflux in bronchiectasis and the effect of anti-reflux treatment. BMC Pulm Med. 2013;13:34. doi: https://doi.org/10.1186/1471-2466-13-34
  10. Ferri S, Crimi C, Heffler E, Campisi R, Noto A, Crimi N. Vitamin D and disease severity in bronchiectasis. Respir Med. 2019;148:1-5. doi: https://doi.org/10.1016/j.rmed.2019.01.009.
  11. Itoh M, Tsuji T, Nemoto K, Nakamura H, Aoshiba K. Undernutrition in patients with COPD and its treatment. Nutrients. 2013;5(4):1316-1335. doi: https://doi.org/10.3390/nu5041316