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


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.

Dairy products are the main source of calcium in the American diet. People who exclude dairy products from their diets, because of allergies or by choice must choose their foods carefully to meet their calcium needs. Or they must depend on supplements. Just because a food has calcium, does not guarantee your body can absorb the calcium.

Calcium is not readily absorbed. So, osteoporosis prevention can be improved by doing weight bearing exercises such as walking, running and weight lifting.

Vitamin D is essential for calcium absorption. So a dietary source of Vitamin D is equally important. The recommended intake of Vitamin D for adults up to age 50 is 200 IU (5 mcg) per day. For individuals aged 51-70, the recommended intake of Vitamin D is 400 IU (10 mcg) per day. Daily requirements of vitamin D for people aged 70 and older is 600 IU (15 mcg). You can get Vitamin D from supplements. However, be cautious, as excess Vitamin D is toxic. An excess of Vitamin D can cause nausea, vomiting, poor appetite, constipation, weakness and weight loss. Milk, eggs, margarine and fortified cereals are good sources of this Vitamin. (Vitamin D is added to milk.) Two cups of milk can satisfy the daily adult need for Vitamin D. Other dairy products made from milk may not have Vitamin D added.

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