COPD RESOURCE PACK Section 9. Nutrition and COPD

Transcription

1 COPD RESOURCE PACK Section 9 Nutrition and COPD In this section: 1. Screening Tools 2. Advice Leaflets COPD Resource Pack Section 9: Nutrition & COPD Version 3 Last Updated: December 2014

2 1. SCREENING TOOLS The Malnutrition Universal Screening Tool (MUST) can be used by staff to identify adults at risk of malnutrition either if undernourished or obese. MUST can also be used for monitoring patients. The leaflets that follow MUST can be printed off and given to patients as appropriate. If a patient has a MUST score >2 they should be referred to a dietitian. All referrals should be done via the patients GP using SCI gateway. The Malnutrition Universal Screening Tool (MUST) is reproduced here with the kind permission of BAPEN (British Association for Parenteral and Enteral Nutrition). For further information on MUST see 2. ADVICE LEAFLETS The following leaflets are available on subsequent pages: Nutrition and Lung Health gives hints and tips for eating well, if overweight or underweight or suffering from particular symptoms such as dry mouth or breathing difficulties. Nourishing Drinks contains recipes which are useful for patients but perhaps more for relatives or carers who are keen to increase the patient s nutritional intake prior to commencing prescribed nutritional supplements. The Eatwell Plate which should be given out to supplement Eatwell 8 tips for making healthier choices, A guide to Healthy Weight Loss and Easy Meal and Snack Ideas for Weight Loss. These should be given out to patients who are overweight and have a MUST score of 0. People with a BMI>35 should be referred to a dietitian. Eatwell 8 tips for making healthier choices is available to view online at: order free from the Food Standards Agency or from the Information and Resources Centre, Haig House, Cameron Hospital, tel: This is suitable for anyone interested in healthy eating. Further information on healthy eating can be found by visiting the NHS Choices website:

3 If you continue to have problems you may wish to talk to your doctor or specialist nurse about a referral to a dietitian. Oral health message Teeth and gums should be brushed every day after breakfast and before bed at night. Use a pea sized amount of fluoride toothpaste. Do not rinse after brushing. Visit your dentist yearly for a check up. If you would like a copy of this leaflet in an alternative language or format such as audio tape, large print, Braille or British Sign Language, please contact Angela Heyes by telephone on: or by at: AngelaHeyes@nhs.net. This information has been produced by Fife Nutrition and Dietetic Department. It must not be reproduced without permission. January 2012 Hints and tips to help you eat well

4 Why is it important to eat well? We need a variety of different foods to ensure we have all the building blocks to allow our bodies to function as well as possible. We need to base meals on starchy foods such as bread, potatoes, pasta, cereals and aim to eat at least 5 portions of fruit and vegetables daily. Include 2-3 portions of meat, fish and alternatives each day in your diet to provide protein and iron. Also include a pint of milk or other dairy foods each day as they are an important source of calcium. To achieve and maintain a healthy weight. Why is fluid important? To keep your body hydrated you need to drink at least 8-10 cups of fluid per day including a variety of water, milk, fruit juice, diluting juice, tea and coffee. A good fluid intake will help to keep your chest clear by making it easier to cough up any sticky phlegm. We need fluid to get rid of waste products from the body and to replace losses from breathing - even more important if you are on oxygen therapy. If we do not replace the lost fluid we can become dehydrated leaving you feeling tired. If you are feeling bloated limit your fizzy drinks.

5 Have you lost your appetite or lost weight unintentionally? Eat little and often aim for 3 small meals and 3 nourishing snacks daily. Make food as nourishing as possible by avoiding low fat / healthy eating products, select full fat/sugar products add full cream milk, cheese, butter, mayonnaise, jam, sugar where possible. Ask your doctor, specialist nurse or dietitian for a leaflet about this. If you are unable to eat a meal, replace it with a milky drink such as malted drink, hot chocolate, milky coffee, milkshake style drinks or nourishing snacks such as cheese and biscuits, full fat yoghurt. A small amount of alcohol can help to improve your appetite. Please check with you doctor or pharmacist first if taking medication. How can I lose weight safely? If you are too heavy it is important to reduce your weight to a healthy weight to help improve your breathing and make exercise easier. You should aim to lose weight slowly and gradually aiming for 1-2 lb a week. Eat regular meals. Include all food groups discussed on page 2 within your diet. Choose lower fat and low sugar foods and watch your portion sizes, especially when eating out. Remember to keep as active as possible Avoid fad or quick-fix diets and liquid meal replacements. If you would like further information please ask for a copy of Simply Slimming from your doctor or specialist nurse. If you use a nebuliser, try not to take it too close to a mealtime as it may affect your taste and your enjoyment of your food! Remember sugary foods and drinks can damage your teeth so regularly brush your teeth.

6 Do you suffer from a dry mouth? Try soft, moist foods with gravy or sauces as these are easier to swallow and less tiring to chew. Drink plenty of fluid throughout the day. Try sucking ice cubes/lollies or boiled sweets or chewing gum to help stimulate saliva production. Avoid very salty foods. Try citrus fruits. Are you feeling tired? Save your energy rest before and after meals. Choose soft, moist easy to eat foods. Try ready made meals/convenience foods. Accept help with shopping, cooking and/or preparation of food if available. Consider having your meals delivered, discuss with your health care professional. Check with your GP or pharmacist if your medications may be causing your dry mouth. Difficulty breathing? Eat little and often large meals make you feel bloated and increase breathlessness. Choose soft, easier to eat foods as chewing can be tiring. Discuss with your GP or specialist nurse if there is any other equipment that may help you at mealtimes.

7 If you require any further help or advice about your diet, please telephone the dietitian. Your dietitian is: Date: Nutrition & Dietetic Department This information has been produced by the Nutrition and Dietetic Department. It must not be reproduced without permission. March 2012 NOURISHING DRINKS

8 Nourishing drinks are useful between meals when your appetite is poor or when trying to build yourself up. If you are unable to eat a meal, take a nourishing drink instead. This leaflet will give you some ideas for making homemade nourishing drinks. Recipes using every day ingredients The following recipes can be made from items found in your cupboard. NB: WHERE MILK IS USED IN THE RECIPES, USE FORTIFIED MILK:- Add 2oz/60g/4 tablespoons dried milk powder to 1 pint full cream milk and whisk

9 BLACKCURRANT SHAKE 1/3 pint/200mls fortified milk 2 rounded dessertspoons milk powder 1 scoop ice cream 1 tablespoon Ribena/Blackcurrant Cordial Mix milk powder with milk then beat in Ribena and ice cream ORANGE SHAKE 1/3 pint/200mls fortified milk 1 scoop ice cream 1 dessertspoon orange squash Add the orange squash to the milk Stir in the ice cream Serve chilled HOT DRINKS (Sweet) CHOCOLATE MALLOW 1/3 pint/200mls fortified milk 1 tablespoon drinking chocolate 2 teaspoons sugar 4 marshmallows Blend the drinking chocolate and sugar with a little milk Heat the remaining milk with the marshmallows Add to the chocolate mixture and stir MOCHA WARMER 1/3 pint/200mls fortified hot milk 1 tablespoon chocolate or cocoa powder 1 teaspoon instant coffee Sugar to taste Add chocolate and coffee powders to hot milk and stir well Add sugar to taste

10 LUXURY CHOCOLATE CUP 1/3 pint/200mls fortified hot milk 4 squares chocolate, milk or plain Sugar to taste Break chocolate into pieces Heat milk in a pan and add chocolate squares Heat gently until chocolate has melted Sweeten to taste CREAM BANANA FLIP 1/2 pint/300mls cold fortified milk 1 small banana 2 tablespoons double cream and/or 1 scoop ice cream Sugar to taste Liquidise all ingredients together until smooth Serve chilled SPICY SLEEP TIGHT NIGHTCAP 1/3 pint/200mls fortified hot milk 1 teaspoon golden syrup A pinch of ground cinnamon A pinch of mixed spice Add the syrup to the hot milk and stir until dissolved Add cinnamon and mixed spice and stir well HOT MILK AND HONEY 1/3 pint/200mls fortified hot milk 1 dessertspoon honey Cinnamon or nutmeg YOGHURT DRINK 1/3 pint/200mls fortified milk 1 carton sweetened fruit yoghurt 1 teaspoon honey Mix all ingredients together Chill thoroughly Pour hot milk into a mug, add honey and stir well until dissolved Flavour with cinnamon or nutmeg

11 CHOCOLATE PEPPERMINT CREAM (can be served hot or cold) 1/3 pint/200mls fortified milk, hot or cold 1 teaspoon chocolate or cocoa powder 1 tablespoon cream 1-2 drops peppermint essence A little boiling water Sugar to taste Dissolve the chocolate or cocoa powder in a little boiling water Add the milk and stir well Add peppermint essence and sugar to taste Stir in cream HONEY MALT 1/3 pint/200mls fortified milk 1 tablespoon clear honey 1 scoop ice cream 1 heaped teaspoon malted milk powder e.g. Horlicks/Ovaltine Mix all ingredients together Chill thoroughly COLD DRINKS (Sweet) MILKSHAKES 1/2 pint/300mls fortified cold milk Sugar to taste 2 tablespoons double cream and/or 1 scoop ice cream Flavouring FLAVOURING SUGGESTIONS FOR MILKSHAKES 1/2 teaspoon vanilla or other essence 1 teaspoon instant coffee 1 dessertspoon chocolate or cocoa powder 1 tablespoon concentrated fruit cordial, jam or fruit puree Crusha syrup Liquidise all ingredients together until smooth FRUIT FLOAT 1/2 glass fresh fruit juice 1/2 glass lemonade 1 teaspoon sugar 1 scoop ice cream Mix all ingredients together Serve chilled

12 HOT DRINKS (Savoury) BREAKFAST WARMER 1/3 pint strained porridge 1 tablespoon milk powder 3 tablespoon single cream Sugar to taste Add milk powder to cream and stir into porridge with the sugar Add milk to dilute to a drinking consistency SOUP 1/2 tin condensed soup 1/3 pint/200mls fortified milk Dilute soup with milk and heat in the usual way CREAMY CHICKEN BROTH 1/3 pint/200mls fortified milk 1/2 chicken stock cube MILK MARMITE 1/3 pint/200mls fortified milk 1 teaspoon Marmite or Bovril ICED COFFEE 1 teaspoon instant coffee 1/3 pint/200mls fortified cold milk 1 tablespoon double cream or 1 scoop vanilla/coffee ice cream A little boiling water Sugar to taste Dissolve coffee in a small amount of boiling water, or use coffee essence Add sugar to taste Add the cold milk and stir well Add the cream or ice cream and whisk well Chill well Break stock cube into a cup Heat the milk and pour over the cube Stir until dissolved

13 Further information on how to manage your weight can be found at the following websites: Oral Health Message Brush teeth and gums in the morning and last thing at night Use fluoride toothpaste containing at least 1000ppmF (displayed on tube). Try to keep food and drink containing sugar to mealtimes only. If hungry, snack on fresh fruit or sugar free alternatives. Drink milk and water which are kind to teeth. Keep all other drinks to a mealtime. Visit your dentist regularly for a check up. If you need advice on dental services, please contact our Advice Line Remember After Brushing... Fife Nutrition and Dietetic Department A Guide to Healthy Weight Loss Let your toothpaste work If you would like a copy of this leaflet in an alternative language or format such as audio tape, large print, Braille or British Sign Language, please contact Angela Heyes by telephone on or by at: AngelaHeyes@nhs.net. This leaflet contains practical suggestions on how to lose weight If you continue to have problems you may wish to talk to your doctor about referral to a dietitian. Produced by NHS Fife Nutrition and Dietetic Department. It must not be reproduced without permission Jan 2012

14 Increase your activity levels Being active burns calories so will help you to lose weight. How much and how often? 30 minutes of exercise on 5 or more days of the week will help to improve your health. 30 minutes does not need to be all at once - you can build up in bouts of 10 minutes. How can I increase my activity levels? Add a little activity into your daily routine: Why should I lose weight? Being overweight can put your health at risk. You are at greater risk of health problems such as: Diabetes High blood pressure High cholesterol Heart disease Painful back & joints Breathlessness Difficulty climbing stairs Being overweight can also cause anxiety & depression. It can lead to low self esteem and leave you feeling tired & lethargic. Housework Use the stairs, not the lift or escalator Find times in the day to have a brisk walk, ten minutes at a time is as beneficial as a longer walk Walk instead of taking the car for short journeys Get off the bus a stop earlier and walk the rest of the way.

15 How much weight should I lose? Every little bit counts. 1-2lb (1/2 1Kg) per week is ideal. As little as 12lb (5Kg) can help to reduce your risk of health problems. How do I make sure I eat 5 a day? Suggested ways of getting 5 a day: Breakfast Add a banana or some dried fruit to your cereal and drink a glass of fruit juice. What changes should I make to my diet and lifestyle to lose weight? Even small changes can help. Choose 2 or 3 things to change at a time and pick things you feel you can stick to. This booklet will give you ideas on changes you can make. Lunch Baked potato with tuna and a side salad or homemade soup with lots of vegetables. Evening meal Serve at least 2 types of vegetables with your meat, fish or chicken or add vegetables to your bolognaise or curry. Supper Banana on toast. If you are hungry between meals try snacking on fruit.

16 Eat more fruit and vegetables Aim to have 5 portions of fruit & vegetables per day. What is a portion? 1 apple, banana, pear, orange or other similar sized fruit 2 plums or similar sized fruits A slice of large fruit such as melon or pineapple 3 heaped tablespoons of vegetables (raw, cooked, frozen or tinned) 3 heaped tablespoons of fruit salad (fresh or tinned in fruit juice) or stewed fruit 1 heaped tablespoon of dried fruit (such as raisins and apricots) 1 handful of grapes, berries or cherries A dessert bowl of salad A glass (150mls) of fruit juice (counts as a maximum of 1 portion per day) Eat regular meals Eat 3 meals per day, breakfast, lunch & evening meal. Eat at regular times if you can, don t leave more than 4-5 hours between meals. Try to base meals on starchy carbohydrate such as bread, potatoes, pasta, rice & cereals. Don t skip breakfast. Even if you don t feel like eating try to have something. Suggestions for breakfast Sugar free cereal e.g. cornflakes, rice crispies, weetabix, porridge, shredded wheat Fruit Low fat or diet yoghurt Toast with low fat spread or jam or marmalade If you like cooked breakfasts try: Cutting down the number of times a week you have it Reducing the number of items you have. Try replacing a sausage or black pudding with mushrooms or tomatoes. Grilling rather than frying

17 Eat less Fat Fat contains twice as many calories as other foods. Aim to reduce the amount of fat in your diet. How can I eat less fat? Grill, roast, microwave or casserole instead of frying Try low fat spreads and reduce the amount of fats and oils you use Choose low fat dairy products - semiskimmed milk, reduced fat cheese, diet or low fat yoghurts Choose lean meat and remove fat on meat and skin on poultry before cooking Limit crisps, cakes, pastry and fatty meats e.g. pies, burgers, sausages Cut down on sugar Sugar provides empty calories. Aim to reduce the amount of sugar in your diet. How can I cut down on sugar? Avoid adding sugar to hot drinks - if necessary use a sweetener Choose low calorie, diet or sugar free drinks Cut down on cakes, biscuits, sweets and chocolate Choose tinned fruit in natural juice rather than syrup Choose low calorie or diet yoghurts Avoid sugar coated cereals Choose boiled, mashed or baked potatoes rather than chips.

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