Weekly menu for people with COPD: seven days and a shopping list

Who is this menu for, and who is it not for?

It is designed for an adult with stable COPD who eats by mouth, chews and swallows without difficulty, and has not been prescribed a special diet. It is exactly for you if you have lost weight without trying, find it hard to finish your meals, or have been eating less for months. The full explanation is in the COPD nutrition guide.

It is not calculated for pregnancy or breastfeeding, anyone under 18, diabetes treated with insulin or medicines that can lower blood sugar too much, or chronic kidney disease. It is also not for anyone who has or has had an eating disorder, has difficulty swallowing, or is fed through a tube. If you have coeliac disease, a diagnosed allergy, or heart or liver failure, follow your prescribed plan. With kidney disease, protein should be adjusted with your nephrologist. It is also not suitable for flare-up days, when you eat whatever you can manage.

And this is not a weight-loss menu. The international reference report on COPD identifies risks at both ends of the weight range [1]. A body mass index below 21 is associated with higher mortality, while one above 30 is associated with metabolic syndrome and sleep apnoea. The reference target is a BMI between 21 and 30 [1]. If yours is above 30, the menu still works with two changes described below.

The weekly menu, meal by meal

Seven days, Monday to Sunday. The portions are deliberately small, because a small plate is easier to finish than half of a large one. Add a drizzle of extra-virgin olive oil to every dish: it is the simplest way to add energy without adding volume.

Day	Breakfast	Lunch	Dinner
Monday	Whole milk with cocoa and rolled oats · Bread with extra-virgin olive oil, tomato and mature cheese	Lentil stew with potato and carrot, finished with a drizzle of oil · Two-egg French omelette · Bread	Pumpkin soup with milk and melted cheese · Oven-baked hake with potato
Tuesday	Full-fat plain yoghurt with banana, ground walnuts and honey · Bread with oil and serrano ham	Brothy rice with chicken and vegetables · Bread · Ripe fruit	Mashed potato and carrot with chopped hard-boiled egg and oil · Tinned sardines on soft bread
Wednesday	Shake made with whole milk, banana, rolled oats and peanut butter	Macaroni with tomato sauce, tuna and grated cheese · Ripe fruit	Vegetable soup with milk powder · Spanish potato omelette · Bread
Thursday	Coffee with whole milk · Bread with oil, avocado and fresh cheese	Chickpeas with spinach and hard-boiled egg, dressed with oil · Bread	Fine-noodle soup with shredded chicken · Scrambled courgette with cheese · Bread
Friday	Full-fat plain yoghurt with chopped dried apricots and ground almonds · Bread with oil and turkey	Potato stew with flaked cod and oil · Bread · Ripe fruit	Courgette and potato purée with cheese · Oven-baked salmon with sweet potato
Saturday	Hot chocolate made with whole milk · Bread with oil and mature cheese · Ripe fruit	Chicken and vegetable paella · Bread	Blended lentil soup · Cheese omelette · Bread
Sunday	Whole milk with rolled oats, banana and ground walnuts	Meat cannelloni with béchamel sauce · Small tomato salad with oil	Chicken broth with beaten egg and fine noodles · Oven-baked breaded hake with mashed potato

The two snacks not shown in the table

The table has three meals, but the day has five or six. The other two are a mid-morning and an afternoon snack. With COPD, they help spread energy intake across the day without making any meal too large.

You do not need to come up with something new every day. Just rotate between five options: a full-fat plain yoghurt, a handful of walnuts or almonds, half a cheese or ham sandwich, a glass of milk with cocoa, or two dried apricots with ground almonds. If you skip dinner one day, do not skip these two snacks.

Your weekly shopping list

Approximate amounts for one person for seven days, arranged in supermarket order. If you are cooking for two, double the fridge items, but not the pantry items, which keep well.

Dairy and eggs

• Whole milk: 3 l
• Full-fat plain yoghurt: 8 pots
• Mature or semi-mature cheese: 250 g
• Fresh cheese: 250 g
• Grated cheese: 150 g
• Eggs: 12

Fishmonger and butcher

• Hake: 400 g
• Salmon: 200 g
• Chicken, thighs and breast: 800 g
• Minced meat: 300 g
• Desalted cod: 250 g
• Serrano ham and sliced turkey: 100 g each

Tinned goods and pantry

• Tuna in olive oil: 3 tins · Tinned sardines: 2 tins
• Lentils: 400 g (or two jars of cooked lentils) · Cooked chickpeas: 1 large jar
• Rice: 500 g · Macaroni: 250 g · Fine noodles: 250 g · Cannelloni tubes: 1 pack
• Crushed tomatoes: 2 jars · Chicken stock: 1 l
• Rolled oats: 500 g · Milk powder: 1 pack
• Extra-virgin olive oil: 1 l
• Drinking cocoa or hot chocolate · Honey · Peanut butter

Nuts and dried fruit

• Walnuts: 250 g · Ground almonds: 200 g
• Dried apricots or dates: 200 g

Fruit and vegetables

• Potatoes: 2 kg · Sweet potato: 500 g
• Pumpkin: 1 kg · Courgettes: 3 · Carrots: 1 kg · Spinach: 400 g
• Onion, garlic and tomato for stews
• Bananas: 7 · Avocados: 2 · Seasonal ripe fruit: 10 pieces

Bakery and frozen foods

• Soft-crumb bread for the whole week, sliced and frozen in portions
• One bag of frozen vegetables as a backup for days when you have nothing fresh

How much protein should you spread throughout the day?

This is the most important amount in this menu and the hardest to spread across meals when you eat alone. There is no COPD-specific figure supported by a consensus guideline. The closest recommendation comes from the European Society for Clinical Nutrition and Metabolism (ESPEN) for hospitalised people with several illnesses and nutritional risk: 1.2–1.5 g of protein per kilo of body weight per day [2]. The same guideline lowers the target to 0.8 g per kilo if the glomerular filtration rate is below 30 and the person is not on dialysis [2]. The filtration rate is the blood-test result that measures how well the kidneys filter. If yours is low, this figure does not apply to you.

For someone weighing around 65 kilos, that is 80–100 grams a day, which this menu spreads across all the eating occasions. A full-fat dairy food or an egg at breakfast, cheese or ham mid-morning, and pulses, fish, meat or egg at lunch. Yoghurt or nuts for the afternoon snack, and fish, egg or cheese at dinner.

How to enrich a dish without eating a larger portion

This technique underpins the whole week. It means increasing a dish’s energy and protein without increasing its volume. Add a tablespoon of extra-virgin olive oil to cream soup, grated cheese to soup, or a chopped hard-boiled egg to purée. Add ground nuts to yoghurt, three tablespoons of milk powder to a glass of milk, and use whole milk instead of skimmed milk.

There is evidence for this approach. An analysis of 31 trials in people with COPD found that higher energy and protein intake improved weight, lean mass and handgrip strength [3]. In those trials, the extra intake came from enriched food or oral supplements [3]. The authors themselves caution that the certainty of the evidence is low or very low, so it helps, but without guarantees [3].

Physical activity helps preserve the muscle you regain by eating better. The longevity nutrition guide explains how to work on muscle when gaining it has become difficult. The overall eating pattern behind this menu is covered in the anti-inflammatory eating guide.

What if your concern is excess weight?

That happens too, and quite often. The menu still works with two changes. First, remove the enrichment: use semi-skimmed milk, skip the milk powder and grated cheese topping, and measure the oil with a spoon. Second, make the two between-meal snacks a piece of fruit or a yoghurt. The structure stays the same, with a lower energy density.

What you should not do is follow a crash diet. At Alimmenta, we do not recommend diets below 1,200 kcal a day. Going below that amount requires medical supervision and can cause nutrient deficiencies. A reasonable rate is half a kilo of fat per week. With COPD, you should not do this on your own. Weight loss and muscle loss look very similar on the scales but have very different effects on your prognosis.

What to do on a day when eating leaves you breathless

Rest for ten minutes before sitting down to eat, and eat seated upright and unhurriedly. If you have been prescribed oxygen, use it during meals too. Save drinks for between meals, because water fills you up but does not provide nourishment. If you cannot manage one dish, swap it for one from another day instead of skipping it.

Two things matter even more here. The first is eating dinner late. Lying down with a full stomach encourages reflux, and the GOLD report associates reflux with more COPD flare-ups [1]. The reflux nutrition guide explains this in detail.

The second is bloating. A meal that makes you bloated pushes against the diaphragm and makes breathing harder. The bloating guide can help, as can the constipation guide if you are also constipated. Straining in the bathroom is tiring when you have COPD; prevention involves fibre, fluids and movement, never cutting out food.

What mistakes do we see in appointments?

These are five recurring mistakes, almost always made with the best intentions.

• Skipping a meal because you are not hungry. This has the greatest impact in COPD and is the least often considered.
• Leaving all your protein until dinner, the meal that is hardest to manage at the end of a tiring day.
• Serving yourself a large plate to make up for the previous day. When the stomach is very full, it pushes against the diaphragm and makes you feel short of breath.
• Switching to skimmed milk and cooking oil spray “because it is healthier”. Here, the energy in your meal works in your favour.
• Buying supplements “for your lungs” on your own. Your doctor or dietitian should prescribe a shake for weight gain.