A. The 'BMI' Calculation

An example of a statistical tool available to dieters is the new Body Mass Index (BMI), attributed to the federal government, who is encouraging its use to determine the degree of a person’s obesity. I provide it for your information and amusement, assuming it will tell you nothing you haven’t already learned from your mirror. However you look at it, it does allow you to objectively quantify your weight problem.

1) multiply the subject’s weight, in pounds, by 703
2) square the subject’s height, in inches
3) divide the result of step 1 by the result of step 2.

If the result obtained in step 3 is between 25 and 29.9, the subject is "overweight;" if it is above 30, the subject is considered to be "obese." From these values, it seems logical to believe that one scoring 18 or less should be considered "underweight."

B. Re-educating The Taste Buds

I’m not going to tell you to eat all the foods you think you hate, but you may have to change your eating habits, if you are to properly manage your COPD.

Before you argue, remember how you developed your tastes, in the first place… on your mother’s lap, taking a taste of this, a taste of that. If she happened to be a Georgia belle, you probably like country ham, beans, cornbread, and smothered fried chicken; if you were raised in Louisiana, you will forever crave Cajun boil, red beans and rice, and oysters on the half-shell. But it took years for you to develop that palate to its present state, and it may take a while to retrain it. You may or may not like it, but it isn’t going to hurt you.

The dishes and menus I’m going to suggest will emphasize natural taste, varied textures, attractive colors, blends of flavors, varieties of temperatures, and the highest nutritive quality possible. I will try to make each as simple as possible to prepare but, at the same time, interesting and tempting.

If your palate, or taste buds, or appetite, or whatever you prefer to call it, is hindering the successful management of your COPD, you darn-well better take control of the situation. I hope that this booklet introduces you to a new world of eating. You’ll meet lots of raw vegetables and some fruits that are new to you. There will be strange one-dish combinations, delightful salads, easy sandwiches, and new condiments.

Keep your mind open and we’ll have fun with this project.

C. Reading Food Labels

Food manufacturers and packagers are required, by federal law, to provide certain information on their labels.

The first is the list of ingredients, identifying everything used to make the product. It is not a recipe, because it doesn’t reveal quantities, but it does list them in descending order of their amounts used. If it says, "flour, water, salt, wheat bran, calcium propionate, food color," you can be pretty sure it’s mostly flour and has precious little wheat bran. This information is invaluable to those with food allergies but of limited use to those seeking nutritional data.

That’s where the "Nutrition Facts" label comes in. The format of this label is pretty standard, but you must understand that some data is stated in a confusing manner. "Serving Size" is one of these, and it’s the first item listed. The manufacturer does not have to match his serving size to the USDA’s recommendations, so his cold cereal (because it is so dense, or has raisins and nuts in it) may have a serving size of ½ cup, while another brand (because it’s so puffed up) suggests 1 ½ cups. Each varies 50% from the USDA guidelines.

The next item is "servings per container." If you use this for price comparison, beware of differences in serving size.

The next line tells you the total caloric value per serving, and the Calories that come from fat (or oil). This can help you plan and calculate your caloric intake.

You then find a table that lists TOTAL FAT (followed by Saturated, Polyunsaturated, and Monounsaturated); CHOLESTEROL; SODIUM; TOTAL CARBOHYDRATES (followed by Dietary Fiber, and Sugars), and; PROTEIN. For each of the nutrients they show the amount contained in a "serving," in grams, and the percentage of "Recommended Daily Requirement" this "serving" represents. The amounts of fats (and types of fats) and or salt and sugars are critical to those who must limit their intake of these nutrients; the rest of the information will be of interest to those unfamiliar with nutritional guidelines but, in time, will be ignored. The "% Daily Value" is based upon a diet of 2000 calories per day; if your diet varies from this arbitrary standard, the numbers must be adjusted. Unless your doctor advises differently, I suggest you ignore this column.

D. About "Standards" and "Calculations" For Nutrition

The folks who research food values for animals have "laboratories" where the "subject" dogs, cats, cows, or pigs, are individually caged, and fed various diets that are meticulously concocted and weighed (as is the water they drink), while all the feces and urine they excrete is carefully collected, weighed, and analyzed.

From these tests, they can report that the average mature dog requires about this much of that, and that much of this, just to maintain its body weight, while resting, or that the average pig requires given amounts of protein, carbohydrates, and fats, to grow from twenty pounds to 220 pounds in five months.

But, if you were to see the raw data, you would be quite likely to find that, of the 100 dogs in the test (all of the same breed, because we want to remove every variable possible), some used only 85% as much food, while one used as much as 125% of average. The differences may be only plus/minus 5% for 80% of the animals, but individual differences in disposition, thyroid activity, and other genetic traits can make for significant variances. (In the modern farm enterprise, only the "thrifty" producers are used for breeding purposes; the beasts that eat too much are culled from the herd.)

Those of you with a serious weight problem should, with your doctors help, consider all variables when setting up a nutrition program for you, and this certainly should include investigation into over- or under-production of certain hormones. If you have a nervous disposition, or tend to be obsessive-compulsive, or are a chronic worrier, you’re wasting valuable calories. If, on the other hand, you are sedentary or tend to be psychologically depressed, you may not be burning off enough energy.

We should also mention the importance of fluid intake. Your diet must include enough "liquids" to meet you needs and to keep mucous production more manageable. The "standard" medical advice is, "drink eight glasses of water daily." Some I’ve heard even suggest that it must be water; that other drinks "don’t count."

The facts are that eight glasses is an average and that it is far too much for a seventy-year old couch potato who stands five-four and weighs 120 pounds, and far too little for the young bricklayer, toiling in the August sun, standing six-five and weighing 220. You get water from virtually every liquid you drink (liquors being the exception, because the high alcohol content offsets the water’s benefits) and from some foods: coffee or tea are 100% water; milk is 87 to 90%, fruit juices are at least 80%, and raw vegetables may be from 40% to 80% water. Also see Fluids & Water.

MORAL: Average values for diets are excellent for average people; for everyone else, they must be "taken with a grain of salt." (A bit of common sense wouldn’t hurt, either.)

E. Sodium-Free Diets, Lactose Intolerance, Etc.

For those who are diabetic, have a problem with cholesterol, must watch your sodium intake, of have other dietary limitations, please study these guidelines I have established for my menus and recipes, and consult with your physician for advice on adapting them to your use:

• the recipes suggest minimal use of sugar and salt in food preparation; add it at the table, as you are able and inclined.
• most recipes use olive oil, canola oil, or peanut oil for cooking and baking; the use of butter (as a source of energy) is optional; to keep oil consumption at a minimum, use "pan sprays" for frying and prepare meat, poultry, and fish by broiling or baking.
• lactose intolerance (that resists treatment with rennin products) will simply mean you must limit your menus to dishes that contain no dairy products.
• watch for food allergies; you can often substitute ingredients without significantly altering the nutritional values.
• I make use of lots of beans and raw (or al dente) vegetables, considered by many to be sources of stomach and abdominal gas; if you encounter the problem, try using a product like "Beano" before abandoning the menu.
• if you follow the "food pyramid" guidelines for balance in your diet, and my suggestions for variety and preparation, you will probably get an adequate supply of vitamins and most minerals; still, when I consider our chronic illness, and with generic brands so inexpensive, I suggest you take one "complete" vitamin (with iron) daily.
• regular exercise is an aid to good digestion, provided it is started at least an hour after a meal; it stimulated the action of both the small and large intestine.

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