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Dr Anne Holdoway

Consultant Dietitian, Chair of the Malnutrition Pathway Community and COPD Panels, Education Officer at the British Association for Parenteral and Enteral Nutrition (BAPEN)

Chronic obstructive pulmonary disease (COPD) is a lung condition where the airways have become narrow, making it hard to get air in and out of the lungs.


People with COPD are at particular risk of undernutrition (malnutrition). This can develop over several years or might occur following a flare up of symptoms.

Factors impacting dietary intake for those with COPD

Breathlessness and fatigue can affect the ability to eat, drink and consume a normal sized meal. Individuals with COPD can be left feeling they are ‘gasping for air’ when chewing and swallowing.

The condition can lead to a reduction in the body’s ability to maintain muscle, resulting in gradual muscle loss. This reduces the ability to breathe well and keep active.

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The effort of laboured breathing increases the amount of energy the body requires.

Oxygen, nebulisers and inhalers, often used in COPD treatment, can cause dry mouth and taste changes which may affect appetite.

Depression, social isolation and living conditions can also interfere with the ability to shop, purchase, and prepare food.

All these factors can result in less nutrients being consumed than required with subsequent unplanned weight loss, muscle loss, increased susceptibility to infections and the need for hospital care.

How do I know if I am undernourished?

A self-screening website is available for people who are concerned about their diet and weight, it helps calculate the risk of malnutrition and advises on next steps.

What can I do to keep well nourished?

The Malnutrition Pathway has developed free leaflets for people with COPD; containing advice on diet and the importance of protein rich foods combined with physical activity to increase the strength of the lungs and body, along with tips for coping with common symptoms.

Similar eating and drinking difficulties can occur with COVID-19 infection and advice is also available: www.malnutritionpathway.co.uk/covid19


The Malnutrition Pathway is supported by an unrestricted educational grant from Nutricia

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