Preventing Weight Loss in CPA

Weight loss is a common issue for people with Chronic Pulmonary Aspergillosis (CPA) due to factors like chronic infection, inflammation, poor appetite, and increased energy expenditure from coughing or breathing difficulties. Preventing or managing weight loss involves addressing these underlying causes and supporting overall nutritional health.

  1. Optimizing Nutrition:
    1. Eat More Calorie-Dense Foods:
      • High-Calorie, Nutritious Foods: Focus on calorie-dense options that are also nutrient-rich, such as:
        • Nut butters (peanut, almond)
        • Avocados
        • Full-fat dairy products (milk, yoghurt, cheese)
        • Oils (olive oil, coconut oil)
        • Granola and protein bars
        • Dried fruits and nuts
        • Smoothies with added protein powder or full-fat yoghurt
    2. Balanced Diet:
      • Protein-Rich Foods: Adequate protein intake helps prevent muscle loss. Include lean meats, fish, eggs, beans, legumes, and tofu.
      • Complex Carbohydrates: Whole grains (brown rice, quinoa, oats), starchy vegetables (sweet potatoes, squash), and legumes provide steady energy.
      • Healthy Fats: Include sources of omega-3 fatty acids (fatty fish like salmon, chia seeds, flaxseeds) to reduce inflammation and support overall health.
    3. Small, Frequent Meals:
      • Eating smaller meals every 2–3 hours can make it easier to get enough calories without feeling overwhelmed.
      • Include snacks like protein shakes, smoothies, or meal replacement drinks between meals.
  2. Managing Appetite and Gastrointestinal Issues:
    1. Stimulate Appetite:
      • Ginger or peppermint tea can help improve appetite and reduce nausea.
      • Consider appetizers like small, easy-to-digest meals (soups, smoothies) before a main meal to stimulate hunger.
    2. Address Gastrointestinal Symptoms:
      • Prokinetic Medications (if prescribed): These help with digestion and improve appetite.
      • If you experience acid reflux, GERD, or nausea due to medications, consider discussing alternatives with your doctor or using antacids.
    3. Avoid Food Intolerances:
      • If you notice specific foods worsen nausea, bloating, or discomfort, avoid them to ensure you can eat comfortably.
  3. Managing Fatigue and Physical Activity:
    1. Minimize Energy Expenditure:
      • If fatigue is preventing you from eating enough, try to conserve energy throughout the day by pacing activities.
      • Prioritize rest and sleep, but also engage in light, energy-boosting activities like stretching or walking when possible to stimulate appetite.
    2. Gentle Exercise:
      • Light exercise like walking or gentle stretching may help stimulate appetite, reduce fatigue, and maintain muscle mass.
      • Strength training or resistance exercises can help prevent muscle loss associated with prolonged illness.
  4. Addressing Medical Issues:
    1. Monitor and Treat CPA Progression:
      • If CPA-related symptoms like chronic coughing or breathing difficulties are interfering with eating, optimizing treatment for CPA may reduce these barriers.
      • Ensure your antifungal treatment is well-managed to control the infection, which might help with weight retention.
    2. Address Malabsorption or Digestive Issues:
      • If medications (such as antifungals) are interfering with digestion or nutrient absorption, consult your doctor about alternatives or supplements like probiotics.
    3. Anaemia and Other Comorbidities:
      • Anaemia can lead to fatigue and decreased appetite, contributing to weight loss. Discuss iron supplementation or treatment for any nutritional deficiencies with your healthcare provider.
  5. Consider Supplements:
    • Nutritional Supplements: If it’s difficult to get enough calories and nutrients through food alone, consider using high-calorie meal replacement drinks or protein shakes.
    • Vitamin and Mineral Supplements: Discuss taking a multivitamin or vitamin D supplement to ensure you are meeting your nutritional needs, especially if you’re not eating a wide variety of foods.
  6. Psychological Support:
    • Manage Anxiety or Depression: Chronic conditions like CPA can lead to emotional distress, which might further decrease appetite. Psychological support (e.g., counselling, therapy) can help manage these feelings.
    • Mindful Eating: Try to create a positive eating environment by focusing on meals, reducing stress, and eating slowly to improve digestion and comfort.
  7. Regular Monitoring:
    • Track Weight: Regularly monitor your weight to catch early signs of weight loss. Keep a food diary to assess how much you’re eating and identify patterns.
    • Frequent Doctor Visits: Regular check-ups can help your healthcare team address any underlying causes of weight loss, such as medication side effects or nutrient deficiencies.

Summary: To prevent weight loss with CPA, focus on eating high-calorie, nutrient-dense foods, eating smaller and more frequent meals, and managing gastrointestinal symptoms. Stay hydrated, consider nutritional supplements, and engage in gentle physical activity to stimulate appetite. Monitor your condition closely with your healthcare provider to ensure optimal treatment and nutritional support.

Useful NHS resources:

Unintentional weight loss

Healthy ways to gain weight

The Eatwell Guide

Eat Well – Part One (video)

Eat Well – Part Two (video)