Nutrition and Pulmonary Rehabilitation – Where the magic happens!


Are you a respiratory patient sitting at home fighting to breathe, feeling anxious, not knowing where your next breath is going to come from? If this is you, then it’s time to act! The tools you need to feel better are readily available, you just need to take the next step.

Many patients are hoping for a magic pill to take which will reduce their symptoms and improve their quality of life. Truth is, there is no magic pill. We have medications and oxygen which helps keep our disease stable but we want to see improvement, we want to re-engage with the outside world.

If you tell a respiratory patient who has never been terribly active they have to become active, you’ll probably send a cold shiver up their spine as they head for the hills. Those of us who were active before we were diagnosed can continue to do so with less fear. But what if we tried a different strategy, one which lessens the burden on patients who are starting out exercising.

Exercise has been shown to improve the quality of life for respiratory patients and so has good nutrition. But what if we focused on nutrition before we went down the road of exercise. If you are a breathless inactive patient who needs to start exercising, wouldn’t it make sense to reduce your breathlessness as much as possible before you focus on exercise?


Think of an elite athlete and how they prepare to get the best out of their body. The main areas they focus on is nutrition, rest and recovery. They know for their body to perform at its best it has to be fuelled well. Do you think Usain Bolt could run like he did with a poor diet? So shouldn’t the same approach be taken to a respiratory patient?

There is plenty of science to support the use of nutritional strategies to reduce breathlessness in patients. If you have been following my articles over the last two years, you’ll know I have been very vocal about this topic. Imagine, instead of an overweight, breathless, scared patient turning up for exercise classes, the patient arrived with their breathing under control, seeing a drop in their weight, feeling excited about improving their health and learning how to exercise correctly for their condition.

I can hear some of you say, we learn about nutrition in pulmonary rehabilitation! My response would be – exactly what do you learn? I have spoken to many nurses, respiratory therapist, physio therapists and doctors about the information given to patients about nutrition. The common response from them all is – we don’t pay too much attention to it.

Totally understandable, why would you try and educate a patient about something you’re not trained in. I don’t have any nutritional training but what I do have is first-hand experience in what works for me and the science to support what I’m doing. It doesn’t take a degree in nutrition to read research papers about the topic. In my experience, if you read enough research papers which come to the same conclusion, and the conclusion is what you have personally experienced in its real-life application, then is it fair to say there’s probably something to it.

Since my diagnosis in 2011 I have completed Ironman events, marathons and cycling events. This has meant a tremendous amount of training hours in the hope it would significantly improve my quality of life. No doubt it has had a great impact on how I feel, but my lung function tests stayed around the same with my FEV1 averaging 26%.

Since adopting nutritional changes to my lifestyle, in particular using a ketogenic diet, I have seen my fev1 rise to an average of 35%. This is very noticeable on a day to day basis as my symptoms have been significantly reduced. On the athletic front, my marathon times have improved by 43 minutes since changing the way I eat. I’m not the only patient who has experienced this change in quality of life. I now know of two other patients who have adopted this way of eating and receive the same benefits.


Now if those scared, breathless patients turned up to their exercise class after changing their nutritional strategies, imagine how much more meaningful the class would be. But how can we make this happen?

In my opinion, it needs to happen in the doctor’s clinic when first diagnosed. When the doctor is writing prescriptions for the medication you require to manage your disease, they should also be referring you to a dietitian, preferably one experienced in the application of a low carbohydrate-high fat or ketogenic diet.

I truly believe once we have this strategy in place, we’ll see the magic happen!

3 responses to “Nutrition and Pulmonary Rehabilitation – Where the magic happens!

  1. Dear Russell,

    I have been reading y our articles, and to say I am impressed would be an understatement. Thank you so much for sharing. I, too, have COPD, and though my FEV1 is better than yours, I am having issues breathing, and when they said I was in stage III, I have pretty much spent the week crying every day, trying to get thru my activities, and wondering how to plan an end of life. The anxiety that I managed to add to the issues, made it worse.
    Like you, I smoked, and quit approx. 12 years ago, but it took its toll. But thank you, you actually gave me some hope. I too, have been active (not like you by a long shot!) all my life, and as my energy has gone down, I missed going to the gym. So, thanks to you, the gym is back on my list of immediate things to do. Spend more time Working out, less time Worrying. Trading one”W” for another..Thank you again. You are unbelievable. I am putting you on my list of heroes, not only because of what you have attained, but also because of the time you have taken to share what you have learned and experienced, because you care about others.

  2. Hi,
    I’m a 40 almost 50 year old man, and I was diagnosed with COPD about 5 years ago. I’ve always been active, running and cycling throughout my life. I have noticed over the past year or so that my fitness has declined a lot. Where I used to be able to run 8.5 min miles, I’m now circa 10-12 min miles. I feel well in myself.

    I was wondering if there is anything in particular I need to be focusing on to quick quicker, and have the stamina to run up to half marathon distance again ( i have run marathons in the past). Do I need to focus on strength training, HIT, Hill Sprints, or just get out running. I still run at least 3 times a week but my times are not getting any quicker.

    Are there any specific food groups that would benefit me? alternatively is there food & drink I should avoid?

    Any help would be fantastic as the doctors just say ‘try and keep fit’. Not that inspirational.

    1. Hi Neil, would be a good idea, if you haven’t already, to have a pulmonary function test to see if you’ve had any decline in lung function. I have slowed over the years as well. For me changing to ketogenic diet 4 years ago was a game changer, ran a marathon PB. Consistency in training is very important as well. This is a link to my published case study showing the benefits of ketogenic diet
      Good luck

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