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COPD Health Center

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COPD Diet Guidelines: Protein, Calcium, Reducing Sodium, and More


An excess amount of sodium chloride, common table salt, can cause fluid retention, increased blood pressure and shortness of breath. (Fluid retention is called edema.) A sodium-restricted diet can help with decreasing water retention. In some people, such a diet may decrease high blood pressure. If your doctor has asked that you reduce your sodium, follow these guidelines:

  • Do not use added salt while making food or for food served at the table.
  • Read labels and ingredients on all foods. Avoid those that contain salt.
  • Read the sodium content on the labels. Look for products having less than 140 mg sodium per serving or labeled "low sodium."
  • Pay close attention to packaged foods that have more than 140 mg of sodium per serving, such as:
    • Cured smoked and canned meats, bologna, frankfurters, ham and salami.
    • Regular canned vegetables, soups and vegetable juices.
    • Salted snacks (nuts, pretzels, chips).
    • Regular frozen meals.
    • Foods in brine (pickles, olives, sauerkraut, feta cheese).
    • Regular processed cheeses.
    • Seasoned salt, meat tenderizer, MSG.
    • Soy sauce, barbecue sauce.


Calcium works with magnesium to regulate lung function, muscle contraction and blood clotting. It also has important roles in the structural strength of bones, the transport of nerve impulses and the work of the immune system. Recommended intakes have recently been increased to 1,000 milligrams per day for both men and women up to age 50, and increased to 1,200 milligrams for those over 50.

Osteoporosis, or "porous bone," affects more than 25 million women and over six million men in the United States. One of the common causes of osteoporosis among women is declining estrogen levels as part of the aging process. By age 65, some women have lost half of their skeletal mass.

Osteoporosis is very common in people with COPD. There is more evidence that COPD may be a risk factor for osteoporosis in both men and women. This may be even worse if you are taking corticosteroids. Corticosteroids are medicines often used in treating lung disease. In both men and women, corticosteroids speed up the loss of calcium. This therefore speeds up bone loss. This is because they affect the hormones that control the deposit of calcium into the bone. In COPD, systemic corticosteroids are needed only for a short time during exacerbations. (This includes those corticosteroids taken orally or intravenously.) Longer term systemic corticosteroid use has not been found to be effective in COPD. It increases risks of side effects including osteoporosis. Inhaled corticosteroids are commonly used in COPD treatment. There is little proof that these inhaled drugs increase osteoporosis risks when used in approved doses. However, in higher doses the risks could increase. You should talk with your health care provider about these osteoporosis risks. Discuss the potential role for calcium, Vitamin D and other osteoporosis treatments.

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