Factors that influence dietary intake in adults with stable chronic obstructive pulmonary disease

Aim: Malnutrition is common amongst people with chronic obstructive pulmonary disease (COPD) and nutrition status is an important determinant of symptoms, morbidity and prognosis. Inadequate diet is recognised as a contributor to malnutrition in this population; however, there are limited studies exploring individual perspectives on nutrition amongst people with COPD. The aim of this study was to identify factors that influence dietary intake patterns in a metropolitan, stable COPD population. Methods: This qualitative study investigated participants with stable COPD who attend pulmonary rehabilitation programs. Thirty participants underwent body composition measurements, completed a validated food frequency questionnaire and participated in a semi-structured interview to explore influences on food choices. Qualitative responses were examined using thematic analysis to identify major barriers and enablers shaping nutrition-related behaviours. Results: Mean (±SD) body mass index was 26.6 ± 7.6 kg/m². Analysis of food intake showed inadequate servings per day of dairy, fruit and vegetables. Common themes influencing food choices included: breathlessness and fatigue affecting appetite, swallowing problems, limited social and financial supports, reduced motivation and limited knowledge about the impact of nutrition on COPD. Conclusions: Nutrition assessment of patients with COPD should encompass physical and social circumstances influencing dietary intake and support networks that promote healthy eating behaviours. Nutrition intervention should be tailored to individual circumstances, with ongoing follow-up to maintain motivation and adapt to changing clinical status.