Eating well with pulmonary fibrosis | Action for Pulmonary Fibrosis

A well-balanced diet plays an important role in managing pulmonary fibrosis (PF). Eating the right foods can help you maintain muscle strength and support your lung function. It may also help you to manage symptoms like nausea, breathlessness and acid reflux.

Why does diet matter for people with PF?

Getting the right nutrition and eating in a way that suits you can:

support your lung function by keeping your breathing muscles strong
help keep chest infections at bay
give you the energy to help you do more of the things you love
manage medication side effects like nausea, diarrhoea and appetite loss
help manage conditions that often occur alongside PF, such as acid reflux
positively impact your overall wellbeing, including your mental health
help you connect with your loved ones by sharing food and creating memories

Oxygen safety

If you use oxygen, speak to your oxygen team about how to cook safely. Cooking with oxygen can be a fire hazard.

What's a healthy diet for people with PF?

There's no special or specific diet for people with PF. Most people should aim for a balanced diet with lots of different foods and food groups. This is outlined in the NHS's Eatwell Guide.

People with PF may have different dietary needs to help manage symptoms and feel their best. Some may also need to adapt their diet because of other health conditions, such as diabetes. The right approach to eating is different for everyone, so your needs will depend on your own health and situation. This page is for general information only. Please ask your healthcare team for a referral to a dietitian. They can give advice specific to you.

There’s currently no evidence to suggest that what you eat increases your risk of developing PF.

Should I take any vitamins or supplements?

There are no supplements specifically recommended for people with PF. It's important to tell your healthcare team about any supplements or herbal remedies you're taking. Some medications may interact with these, causing unwanted reactions.

It's best to try getting your nutrition by eating the right amount of different foods. However, if you're low in a nutrient, your medical team may advise you to take a vitamin or mineral supplement.

The NHS recommends that most adults take a 10 microgram vitamin D supplement during autumn and winter. During these months, there may not be enough sunlight for your body to make enough vitamin D. If you stay out of the sun or are indoors the majority of the time, you may need to take this all year round. Speak to your ILD team before taking any vitamin D or calcium supplements, particularly if you have sarcoidosis. It's important that your body has the right amount of these nutrients.

Managing medication side effects

Some common medications taken by people with PF can cause side effects. This includes antifibrotics and immunosuppressants. Nausea, diarrhoea or a change in appetite are common side effects of medications. These can make it difficult to eat well and enjoy your food.

If you experience side effects from your medication, it's important to speak to your ILD team.

Managing nausea with pulmonary fibrosis

If you have nausea, you might want to try:

taking medication with food (this is not suitable for all medications – check with your healthcare team)
eating little and often - small, frequent meals are easier to tolerate than large portions
avoiding strong-smelling foods if this triggers your nausea – you may want to try cold meals like salads, yogurt and sandwiches
drinking or eating ginger or peppermint, which can help settle your stomach (some people enjoy these in tea or biscuits)
avoid lying down soon after eating
taking anti-emetics (anti-sickness medication), which may be advised if your symptoms are ongoing. Speak to your GP or healthcare team about this.

Managing diarrhoea with pulmonary fibrosis

If you have diarrhoea, you might want to try:

reducing greasy, high-fat or spicy foods, if this makes your diarrhoea worse
drinking plenty of fluids. Oral rehydration solutions may be suitable for some people. A pharmacist can recommend the right one for you
speaking to your healthcare team about anti-diarrhoea medication

Steroid medications can increase your appetite and lead to weight gain. Read more about a healthy weight in the next section.

Managing weight changes with PF

What is a healthy weight?

For people with PF, this can be complex. Being too overweight may put pressure on the lungs. However, a low weight can be linked to poorer health. Many people with PF lose weight unintentionally as their condition progresses. Because of this, having a higher weight to begin with may sometimes be beneficial.

A healthy weight for you depends on your unique situation. You may want to discuss your weight with your medical team.

If you're losing weight unintentionally

PF can increase the amount of energy your body needs. Because of this, some people may burn more calories even while resting. If you're losing weight unintentionally, speak to your medical team. They may recommend that you change your diet to eat more calories and nutrients. See our fortification information for ideas on how to add energy-dense foods to your diet.

Your healthcare team may also suggest practical ideas to help you eat more calories and nutrients. This could include things such as:

eating soft, easy-to-chew foods if breathlessness makes eating difficult. You may want to try adding sauces such as gravy or custard to help soften your food.
drinking fluids with and between meals rather than before. This may help to avoid getting full with fluid rather than food.
eating four to six small meals throughout the day, if large meals feel overwhelming.
drinking nutritional supplement drinks (such as Complan or Meritene), which can help you add extra calories without the effort of eating. You can buy these from supermarkets and pharmacies, or you may be able to get a prescription for them.

If you need to lose weight for lung health

Being too overweight may put extra pressure on the lungs, making it harder to breathe. If you think you might benefit from losing weight, speak to your healthcare team.

If you are changing what you eat, it’s important to know about muscle. Some research shows that people with more muscle may manage better with lung conditions. Muscle also adds to your body weight. This means that losing weight does not always mean better health.

Food helps maintain muscle, but muscles also need to be used to stay strong. You might hear this described as ‘use it or lose it’. Keeping active, even gentle movement, helps keep your muscles working, including the ones that help you to breathe. Your healthcare team can help you decide what’s right for you, and you can read more about exercise and breathing techniques on our website.

Managing symptoms whilst eating

Managing acid reflux

Many people with PF experience acid reflux. This is when stomach acid flows back into your throat, often causing pain and discomfort. It's sometimes called gastro-oesophageal reflux disease (GORD).

The link between PF and GORD is unclear. Some researchers think GORD comes first and causes lung scarring. Others think PF comes first and puts pressure on the oesophagus, causing GORD.

If you have GORD, you may want to try:

eating smaller meals, little and often
avoiding eating late at night
eating while sitting upright
eating your meals slowly
avoiding wearing tight clothing
staying upright for at least an hour after eating
discussing medication that can help with your healthcare team

For some people, specific foods may trigger GORD. Keeping a diary of what you eat can help you work out if you have any triggers. It's important to have a balanced diet, so you need to be careful not to restrict lots of foods. Your healthcare team may be able to help you manage GORD with medication, rather than by cutting certain foods from your diet.

Managing breathlessness

If you feel breathless while eating, these tips may help:

eat slowly and take small bites
sit upright while eating to ease breathing
try smaller, more frequent meals instead of large portions
avoid talking while eating to prevent shortness of breath
try moist, easy-to-chew meals

Managing fatigue

Fatigue is common for people with PF. It's important to eat regularly to provide your body with fuel. To help you eat well even when you're feeling tired, you may want to:

make your time in the kitchen more efficient with tools like slow cookers, air fryers, pressure cookers and food processors. These gadgets can save you time and effort when preparing meals.
use pre-cooked meals, frozen dinners or microwaveable options that provide balanced meals without needing much preparation
consider meal delivery services that offer pre-portioned, ready-to-eat meals. Many services cater to specific dietary needs, including high-protein, high-calorie meals.
ensure you have somewhere to sit in your kitchen where you can rest while preparing food. A perching stool may be useful. Your healthcare team may be able to supply one.
try batch cooking, so you have extra food prepared for days when you feel more fatigued
have a stock of easy-to-prepare foods to hand, such as tinned beans, rice pudding and frozen meals

Managing a cough

If you struggle with coughing while eating, drinking plenty of fluid may help to keep your throat moist and keep phlegm and mucus moving. If you feel too full to drink fluids with meals, some people find it helpful to take small sips regularly.

If you have a dry mouth, stronger-flavoured foods like citrus, spicy and sweet foods may stimulate your saliva. This moisture may help your cough. It can help you taste more if your sense of taste has changed too.

Eating well before and after a lung transplant

Preparing for and recovering from a lung transplant involves several important steps to ensure you have the best possible outcomes.

Before a lung transplant

Eating well before a lung transplant may look different for everyone. Speak to your transplant team for advice on how to eat well.

Maintaining a healthy weight is important. If your BMI is outside a certain range, it can affect your eligibility for a transplant.

After a lung transplant

Nutrition after a lung transplant may also look different for everyone. Always follow the advice of your transplant team and ask them if you’re unsure about anything.

After your transplant, your risk of infection is greater due to immunosuppressant medications. You may be advised by your transplant team to avoid foods that have a higher risk of carrying infections. These can include raw eggs, raw sushi and unpasteurised dairy products.

Some medications, like steroids, can increase your appetite, leading to weight gain. Speak to your transplant team about how to manage this.

Practical tips for carers supporting someone with PF

If your loved one has PF, it can be difficult to know how to support them to eat well. Some people find it helpful to:

ask how you can support them. Everyone is different, and having an open conversation may help you learn more about their needs. It’s important to respect your loved one’s choices and preferences.
use gentle encouragement to keep mealtimes relaxed and avoid your loved one feeling pressured
make mealtimes social and enjoyable, so the focus isn’t just on food
try planning meals and cooking together

Caring for someone with PF can be an emotional and physical challenge. If you need extra support, don't hesitate to ask for help from your loved ones healthcare team. You are not alone.

Further information and support

Talk to someone

The APF Support line is here for anyone affected by pulmonary fibrosis, whether you have the condition yourself, or you're a carer, friend or family member. If you need support or have questions, call us on 01223 785725. You're not alone with pulmonary fibrosis.

Our website and resources provide general information only. We cannot provide medical advice, treatment or prescriptions, nor can we assess/decide what services or clinicians you should be referred to. Support with these matters will need to be provided by your existing healthcare professional teams.

APF is not responsible for any errors or omissions or for any loss or damage suffered by users resulting from the information published on our website or in our resources.