A Guide to Living With COPD

COPD (chronic obstructive pulmonary disease) is a type of lung disease where air doesn’t flow in and out of your lungs very well. The two main types of COPD are chronic bronchitis and emphysema. It’s a preventable disease (most often caused by cigarette smoking), but it doesn’t have a cure. However, there are many steps you can take to manage this condition and ensure the highest quality of life possible. 

For many people living with COPD, breathing in and out can require a lot of effort. This means they use up more energy breathing than people without COPD. 

So, knowing what to eat and drink, and maintaining good physical shape are key to keeping breathing muscles strong.

Here’s a guide to living healthfully with COPD, including tips on eating better, starting or maintaining an exercise routine, and breathing techniques.

What to eat for COPD

The food you eat has a large impact on your breathing. That’s because food is fuel for the entire body — including your breathing efforts. So, getting the right combination of nutrients in the diet can help people with COPD to breathe easier, stay healthier, and prevent certain complications. 

A COPD-friendly diet can: 

• Help you get the nutrients you need to keep your breathing muscles strong and improve lung function

• Lower the risk of chest infections, and help your body recover faster when infections do happen  

Most of the recommendations for a healthy COPD diet follow the principles of a Mediterranean-style diet. But this isn’t the only way to eat healthily for COPD. Any eating style that prioritizes plant foods, lean sources of protein, and healthy fats is good for your lung health and your overall health.  

In practice, that means limiting saturated fat, salt, sugar, and red or processed meat. Here are some suggestions for how to get started.

Limit carbohydrates

If you have COPD, cutting back on carbohydrates may help you breathe easier. One reason for this is that when your body breaks down carbohydrates, this produces carbon dioxide —  more than when the body breaks down proteins or fats. Carbon dioxide is the waste product that we exhale during breathing, and it tends to build up in the blood of people with COPD. These high carbon dioxide levels can make you breathe harder and feel short of breath.  

And when you do eat carbohydrates, it’s best to stick to complex carbs. Complex carbohydrates are found in whole grains and fresh foods. You should also try to limit the amount of simple (refined) carbohydrate-rich foods you eat like: 

• Rice

• Pasta

• Bread

• Packaged foods   

It’s also likely that cutting back on carbohydrates and increasing healthy fats, lean protein, and vegetables can have other health benefits, too. These may include lower levels of chronic inflammation, a lower risk of heart disease, moderate weight, better nutrition, and feeling fuller for longer. 

Cut back on salt

A high sodium (table salt) intake has been linked to higher rates of COPD and lower lung function. It’s not clear exactly why this is, but it may be that salt contributes to inflammation in the lung airways. Sodium also causes fluid retention in the body. So it’s possible that’s another way sodium could affect how well the lungs work. 

Try to limit salt to no more than 2,300 mg per day, or about one teaspoon. The less salt you eat, the better. 

Great ways to reduce salt intake include:

• Choose low-sodium packaged products

• Limit intake of store-bought soups, processed foods, and condiments

• Season foods with salt-free herbs like garlic, basil, and oregano

Eat more fiber

Dietary fiber is the indigestible part of plant foods. It has been associated with improved lung function, a lower risk of COPD, and fewer breathing symptoms. It’s not clear why this is, but it’s possible there’s a link between fiber and your immune system. In other words, fiber has beneficial effects on the gut microbiome, which might in turn play a role in regulating the immune system and reducing inflammation.  

Women need at least 25 g of fiber per day, while men need 30 g to 38 g per day. A medium-sized apple, for example, has about 4 g of fiber. 

Good sources of fiber include:

• Beans

• Nuts

• Seeds

• Fruits

• Vegetables

• Whole grains

Whole-food sources should be first priority, but fiber supplements are also an option to help meet your fiber needs.

Get enough vitamin D

Low levels of vitamin D have been linked to a higher risk of COPD and more frequent flares of COPD symptoms. And, there’s evidence that for people with COPD, taking vitamin D supplements could improve many measures and symptoms of COPD. 

Vitamin D plays a role in the immune system regulation. But, it’s not found naturally in many foods. Our bodies have to make it — and sunlight is needed for this process. 

Some foods are fortified with vitamin D. Here are some foods that are good sources of vitamin D:

• Fish like tuna, trout, and salmon

• Cod liver oil

• Yogurt and dairy milk

• Plant-based milks, like almond, soy, and rice milk

• Orange juice

• Some cereals

But for many people, taking supplements is the best way to ensure they get enough. Among healthcare practitioners, the preferred form is vitamin D3, which is more potent and longer lasting than vitamin D2.

Tips to make eating easier

For people who feel short of breath, eating can feel like a chore. You may feel like you don’t have the energy for eating. Here are some tips for getting the nutrition you need even when you’re low on energy:

• Eat easy foods. Choose soft, easily consumed foods to reduce effort with chewing.

• Eat earlier in the day. Try eating your main meal earlier in the day, when you have more energy. 

• Plan ahead. Experiment with meal prepping to save time and energy. This can be as simple as pre-chopping vegetables, defrosting meats, or making a batch of hard-boiled eggs for the week. Or it can be more involved and include making an entire meal ahead of time.

• Eat more often. Try eating smaller, more frequent meals throughout the day instead of three larger meals. This can help keep your stomach from getting too full, and help you breathe more easily because your lungs have more room to expand.

• Try healthy convenience options. Find healthier convenience food items, such as frozen meals with plenty of vegetables and protein, lower-sodium boxed or canned soups, and pre-packaged salad mixes or sandwiches.

• Ask for help. Don’t be afraid to ask for assistance when needed. Calling on family or friends for support can help a lot on days when you’re not feeling your best.

• Try meal deliveries. Consider meal-delivery services or programs. These can help take the guesswork out of what to eat and save a lot of time and effort at meal times. If you’re an older adult with COPD, you may even be able to have free meals delivered through a community program like Mom’s Meals or Meals on Wheels. 

Drink plenty of water

Water is the most important nutrient for the body, and it plays many important functions — especially for people with COPD. 

Getting enough fluids can: 

• Help thin out the mucus that’s produced by the lungs

• Make it easier to cough up mucus from the lungs 

• Help manage the dry mouth that sometimes happens with COPD 

Water is always best, but other fluids like milk, broth, and the juice from fruits and vegetables are good options, too. Keep in mind that some people with COPD who also have heart problems might need to limit their fluid intake, so always check with your healthcare provider about your fluid needs.

Achieve or maintain a moderate weight

Being overweight or underweight is not good for COPD. But, weight is hard to change — especially when you have a chronic disease like COPD. If you’re struggling with your weight, a weight-friendly healthcare provider can help. Working one-on-one with other health professionals, such as a registered dietitian, can also provide additional support.

Here’s how weight affects COPD symptoms. 

The impact of a larger body weight on COPD

People with excess body fat who have COPD tend to experience more COPD symptoms than people with weight that’s in the “normal” or “healthy” BMI range. People with COPD who have heavier body weights also tend to have symptoms that are harder to treat. And, research shows that people with COPD who are overweight or have obesity are prescribed more COPD medication than those with lower weights.

It’s not clear why this is. One reason may be that in an overweight or obese body, the lungs have to work harder to breathe in and out against the high body weight.

Another possible reason is that people with a higher weight are more likely to have other conditions that can worsen health and breathing, such as high blood pressure (hypertension), heart failure, diabetes, and osteoarthritis.

People in larger bodies also face medical bias. This means that their COPD symptoms are often not taken as seriously or treated as compassionately as people in “normal-sized” bodies.  

The impact of a smaller body weight on COPD

On the other hand, having a very low body weight is not good for COPD either. A low body weight is associated with a higher risk of death with COPD. Underweight is defined as having a BMI of less than 18.5, or less than 23 in adults over the age of 60.

Best exercises for COPD

In addition to eating well, being physically active is very helpful for people with COPD. In fact, exercise is a key part of pulmonary rehabilitation. This is an evidence-based rehab program that can help people with lung disease breathe more easily. Research shows that pulmonary rehabilitation can improve the symptoms and quality of life of people with COPD.

The benefits of exercise are endless, but for people with COPD exercise is especially good for:

• How the body uses oxygen

• Energy levels

• Shortness of breath

• Heart and lung health

• Anxiety and/or depression symptoms

• Sleep, self-esteem, and mood

• Building lean muscles, which can help to improve metabolism and overall health

• Social interaction, which helps reduce feelings of isolation

There are many different ways to exercise. Here are the four main categories: 

• Flexibility

• Aerobic or cardiovascular

• Strength

• Balance

Each has unique and significant benefits for everyone, including people with COPD. Consider trying out a variety of these exercises or sticking to whichever one works best for your unique health scenario. Let’s take a closer look at each category. 

Flexibility

Flexibility exercises include stretching. You should always stretch before and after exercise to warm up and cool down the muscles. Stretching can be more involved, though, like in yoga practice. Yoga involves holding poses for longer periods of time and gently moving from one pose to the next. 

Stretching increases range of motion and flexibility in muscles, which helps prevent injury. Yoga has the added benefit of including breath control and mindfulness exercises, too.

Cardiovascular/aerobic

Cardio or aerobic exercise uses larger muscle groups. It’s the type of exercise that’s the most likely to get your heart rate and breathing rate up. Cardio strengthens the heart and can improve breathing, because it helps the body use oxygen more efficiently. 

Great forms of cardiovascular exercise include:

• Walking

• Jogging

• Hiking

• Riding a bike (either stationary or outdoor)

• Swimming

Strength

Strength training is best for building up your muscles, including the ones that help you breathe. You don’t need a gym membership to do strength exercises, and you don’t need to be lifting heavy weights either. 

Here are some examples of strength training exercises:

• Resistance bands

• Hand weights

• Pushups

• Crunches

• Squats

• Lunges

• Other activities like rock climbing

As with any exercise, stretch before and after. Start small and gradually build up. And, be prepared for some muscle soreness the following day! Just be sure to listen to your body and not to overdo it.

Balance

Balance exercises are ones that target your core strength, stability, and coordination. They also help you to be more conscious of where your body is in your environment. This is helpful for everyone, but it’s especially important for older adults

Good balance helps to prevent falls. It also helps protect against injuries from other forms of exercise. It’s also great for mental well-being and confidence. 

At home, try heel-to-toe walking, climbing stairs, or standing on one leg. Tai chi and yoga are great ways to improve balance, too.  

Tips for exercising with COPD

Exercise may sound like a great idea. But getting up and doing it is often much more difficult. If you’re frequently short of breath, exercise may seem impossible. But hang in there: Being short of breath doesn’t mean you can’t exercise. It just means you need to find the exercises that are best for you.

Here are some tips for getting started. 

• Start low, go slow. Take slow but complete breaths and pace yourself. This will help keep you motivated and will prevent you from overworking your lungs and body. 

• Exercise sitting down. Start with exercises you can do sitting down, such as using light weights or resistance bands.

• Increase gradually. You can work your way up to exercises that require more movement and raise the heart rate. Be sure to use railings or other support devices as needed to avoid injury.

• Find something you enjoy. You’re much more likely to stick to it and achieve results if you’re having fun. If you start an exercise that you don’t enjoy, try something else until you find what works best for you. 

• Partner with an exercise buddy. Exercise with a friend or family member to stay motivated. 

• Keep it regular. Aim for 20 to 30 minutes a day, 3 to 4 days per week.

• Get professional help. Ask to get referred to a pulmonary rehabilitation program, if there’s one near you. Alternatively, join a gym, work with a personal trainer, or a physical therapist.

• Get online. Online exercise videos, like on Youtube, are a great option for people who have difficulty leaving their home or who have a schedule that makes exercising outside the home more difficult.

Always be sure to check with your healthcare provider before starting or changing an exercise routine.

Breathing exercises for COPD

When you have COPD, your lungs aren’t very flexible. Your lungs have a harder time inflating with oxygen-rich air, and also don’t push air back out very well. This means that they aren’t able to fully replenish their lungs with air on their next inhale, and so it continues. The result is that oxygen levels in the body drop, and carbon dioxide levels (the waste gas) build up.   

And — the less stretchy the lungs are, the more strength you need in the rib muscles and diaphragm to take deep breaths in and out. So breathing becomes very hard work.  

This is where breathing exercises come in.

Regular breathing exercises can help you:

• Maintain or build up strength in your breathing muscles, especially your diaphragm

• Breathe using full deep breaths to increase blood oxygen levels

• Breathe out using full deep breaths to get rid of trapped, stale air

• Relax your mind and body

• Improve feelings of breathlessness

Like all exercises, the more you practice, the stronger you get. Let’s take a look at two commonly taught breathing exercises for people with COPD to get you started.

Pursed lip breathing

1. Sit somewhere comfortable, with your back straight and your hips in line with your knees. Make sure your shoulders are relaxed. Or lie down if that’s more comfortable.

2. Breathe in through your nose with your mouth closed, to the count of two.

3. Purse your lips like you’re blowing out birthday candles.

4. Breathe out through your pursed lips for at least twice as long, to the count of four.

5. Repeat a few times until you feel calmer.

Here’s a video on pursed lip breathing from the American Lung Association.

Belly breathing, or diaphragmatic breathing

1. Sit somewhere comfortable, with your back straight and your hips in line with your knees. Make sure your shoulders are relaxed. Or lie down if that’s more comfortable.

2. Place one hand on your belly and the other on your chest. Or you can have both hands on your belly.

3. Close your mouth and breathe in through your nose to the count of two.

4. Pay attention to how your belly fills up with air. Try to move your hand out by inflating your belly. The hand on your chest should not move.

5. Then breathe out through pursed lips for at least twice as long, to the count of four. You can use the hand on your belly to help it expel all the air in your lungs.

6. Try to keep your neck and shoulders relaxed. Your shoulders shouldn't be going up and down when you breathe. This will be hard to begin with, but it will get easier as your diaphragm gets stronger.

Here’s a video on belly breathing from the American Lung Association.

Other activities that help with COPD

Like with other chronic health conditions, having COPD can feel overwhelming and isolating at times. Try to live your life as normally as possible by getting or staying involved in activities and things you enjoy. Being with people can help improve mental and emotional well-being as well as your overall quality of life.

Here are some hobbies you can try that help improve breathing, COPD symptoms, and mental well-being. 

• Singing groups: These are a great way to work on breath control — not to mention they’re a fun way to meet new people. 

• Cooking classes: Cooking courses are a fun way to try new foods, learn new recipes, and make eating more enjoyable.

• Meditation: This practice is linked to many health benefits, including reduced anxiety and depression and help with quitting smoking (the leading cause of COPD).

• Puzzles and games: Whether you do these on your own or in a crowd, games and puzzles can take your mind off your COPD and keep the brain sharp.

• Arts and crafts: These can be a creative outlet and are great for gaining community. Search for local classes in your community or invite some friends over and learn a new craft together.

• Reading and writing: These can be outlets to learn and also to express yourself or enjoy a great story.

• Traveling: This can be as simple as driving a few hours to the nearest beach or mountain range to enjoy the beauty of nature, and improve your mental health and breathing.

• Gardening: Growing herbs, fruits, vegetables, plants, and flowers is another way to learn and enjoy nature and food. And if you do it outside, it’s a gentle way of exercising, too.

Why trust our experts?

Written by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

Reviewed by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

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