What dietary guidelines

should persons with

Alpha-1-Antitrypsin
Deficiency observe?

Living with
Alpha-1-Antitrypsin
Deficiency

Patient Information Program

 About this booklet Your waist girth
The right dietary habits play an important role in In recent years it has
maintaining healthy lung function. A healthy diet keeps become increasingly clear
the body strong, providing it with all the nutrients needed that body fat deposited
for our organs to function well, including the lungs. around the waist is an
The right diet should also go hand in hand with the right independent risk factor for
body weight. the development of metabolic
diseases (e.g. diabetes) and
Please note that no booklet can replace a medical con-
cardiovascular diseases
sultation, so please contact your doctor if you have any
(e.g. heart attack and stroke). To put it simply, the bigger
questions.
your waist, the greater the risk. This also applies to
people who are otherwise slim. The following risk
categories have been determined in studies:

Waist girth and risk of metabolic and

cardiovascular diseases1
Your ”ideal” weight
Waist girth Waist girth
To maintain healthy lung function it is important and in men in women
sensible to keep to your ideal body weight.
Increased risk 94 cm or more 80 cm or more
A good way to determine your ideal weight is to calculate
your BMI (body mass index). You can read more about Markedly
the BMI on pages 4 and 5. 102 cm or more 88 cm or more
increased risk
If you do need to lose weight, this should be done 1
from Lean M. E. J. et al. Waist circumference as a measure for indicating
need for weight management. Br Med J 311 (1995) 621–628
slowly and carefully (around 1 to 2 kilograms per month).
On no account should you go on a starvation diet. In
order to ensure the right intake of protein, dieting is best Persons with Alpha-1-Antitrypsin Deficiency should
undertaken under supervision by your doctor. therefore be aware of their waist girth.

A healthy diet that also contains sufficient calories will help

maintain your body’s energy and power reserves.

2 3
 Your body mass index (BMI)
The body mass index indicates how heavy you are in If you like to calculate your BMI exactly,
relation to your height.You can calculate your BMI from you can do so by using the following formula:
the following table:
BMI formula
BMI
Your body weight (in kg)
Height in meters
divided by your height (in meters)2
Weight 1.50 1.55 1.60 1.65 1.70 1.75 1.80 1.85 1.90 1.95 2.00
86 kg
30 kg 13.3 12.5 11.7 11.0 10.4 9.8 9.3 8.8 8.3 7.9 7.5 Example: = BMI 24.9
1.86 x 1.86 m
35 kg 15.6 14.6 13.7 12.9 12.1 11.4 10.8 10.2 9.7 9.2 8.8
40 kg 17.8 16.6 15.6 14.7 13.8 13.1 12.3 11.7 11.1 10.5 10.0 Studies have shown a clear correlation between a high
45 kg 20.0 18.7 17.6 16.5 15.6 14.7 13.9 13.1 12.5 11.8 11,3 BMI and the risk of comorbidities. The World Health
50 kg 22.2 20.8 19.5 18.4 17.3 16.3 15.4 14.6 13.9 13.1 12,5 Organization (WHO) has published the following
classification table:
55 kg 24.4 22.9 21.5 20.2 19.0 18.0 17.0 16.1 15.2 14.5 13.8
60 kg 26.7 25.0 23.4 22.0 20.8 19.6 18.5 17.5 16.6 15.8 15.0
Weight classification for adults
65 kg 28.9 27.1 25.4 23.9 22.5 21.2 20.1 19.0 18.0 17.1 16.3
based on their BMI2
70 kg 31.1 29.1 27.3 25.7 24.2 22.9 21.6 20.5 19.4 18.4 17.5
Category BMI Risk of
75 kg 33.3 31.2 29.3 27.5 26.0 24.5 23.1 21.9 20.8 19.7 18.8 comorbidities
80 kg 35.6 33.3 31.3 29.4 27.7 26.1 24.7 23.4 22.2 21.0 20.0
85 kg 37.8 35.4 33.2 31.2 29.4 27.8 26.2 24.8 23.5 22.4 21.3 Underweight 18.5 or less Low

90 kg 40.0 37.5 35.2 33.1 31.1 29.4 27.8 26.3 24.9 23.7 22.5
Normal weight 18.5 – 24.9 Average
95 kg 42.2 39.5 37.1 34.9 32.9 31.0 29.3 27.8 26.3 25.0 23.8
100 kg 44.4 41.6 39.1 36.7 34.6 32.7 30.9 29.2 27.7 26.3 25.0 Overweight > 25
105 kg 46.7 43.7 41.0 38.6 36.3 34.3 32.4 30.7 29.1 27.6 26.3 Pre-obese 25 – 29.9 Slightly raised
110 kg 48.9 45.8 43.0 40.4 38.1 35.9 34.0 32.1 30.5 28.9 27.5 Obese class I 30 – 34.9 Raised
Obese class II 35 – 39.9 High
115 kg 51.1 47.9 44.9 42.2 39.8 37.6 35.5 33.6 31.9 30.2 28.8
Obese class III > 40 Very high
120 kg 53.3 49.9 46.9 44.1 41.5 39.2 37.0 35.1 33.2 31.6 30.0
Obese = abnormally overweight
from WHO, 2000 EK IV
2

4 Underweight Normal weight Overweight 5

 Problems associated with Problems associated with
an elevated BMI a low BMI
The body fat deposited around your midriff can restrict If you have a very low BMI, your body’s defense
the mobility of your diaphragm, which can create problems mechanisms could be affected, since your immune cells
and make breathing more difficult. An elevated BMI puts also need energy from food. The result could be an
a strain on the entire cardiovascular system and the lungs, increased risk of infection. Particularly patients with
because your body is carrying an increased “load” and pulmonary diseases are more prone to frequent, rapidly
consumes more oxygen. deteriorating respiratory infections. Moreover, if you
develop another illness or have to undergo an operation,
you will have less energy in reserve to draw upon.

On pages 9 and 10 you will find an overview with

suggested portions for a healthy and balanced diet.

6 7
 The right diet Suggested portions
The second important point, apart from maintaining your The following portions are a guideline for a balanced
ideal body weight, is a balanced diet. For most patients diet that provides sufficient calories. Please note
with Alpha-1-Antitrypsin Deficiency it is sufficient to eat Groups 4 and 5 in particular.
a balanced vitamin-rich, high-fiber diet (i.e. plenty of fruits
and vegetables but not too much fat and meat).
Your diet should consist of: Group 1 Grains, grain products,
potatoes

Per day
200 – 300 g of bread (4 – 6 slices)
or 150 – 250 g of bread (3 – 5 slices)
30% 55%
and 50 – 60 g of cereal
fat carbo- 200 – 250 g of potatoes (cooked)
hydrates or 150 – 180 g of rice (cooked)
Preferably wholemeal products
15%
protein
Group 2
Vegetables, salad
Per day
Fat a total of 400 g of or more
is the most important energy source. It is also needed
300 g of cooked vegetables
for the body to absorb vitamins A, D, E and K from food.
and 100 g of raw vegetables/salad
or 200 g of cooked vegetables
Protein
and 200 g of raw vegetables/salad
is needed to build new cells, particularly heart and muscle
cells. A lack of protein can lead to a weakened immune
Group 3
system and impaired mental and physical performance. Fruit

Per day
Carbohydrates 2 – 3 portions of fruit (250 g)
are another source of energy that is quickly available. or more
Without carbohydrates the brain and nerve cells are
unable to function.

8 9
Group 4 Tips
Milk, dairy products
Per day Five small meals a day are better than three big
ones. They put less stress on your system, and your
200 – 250 g of milk/yoghurt
performance is better maintained.
50 – 60 g of cheese
Preferably low-fat products Adults should drink 2 – 3 liters a day to meet their
fluid requirements. Not drinking enough puts a
Group 5 strain on your circulation and kidneys and can
Meat, sausage, fish, eggs lead to constipation.
Per week
“Five a day” – Five portions of fruit and vegetables:
300 – 600 g of meat and sausage, 250 g of fruit, 400 g of vegetables (some of which
preferably low-fat products should be eaten raw).
Fisch: 80 – 150 g of low-fat saltwater fish
and 70 g of oil-rich saltwater fish
Eggs: up to 3 (including processed egg
products)
Summary
Group 6
Fats
For people with Alpha-1-Antitrypsin
Per day
Deficiency it is particularly
15 – 30 g of butter, margarine important to achieve and maintain
10 – 15 g of oil (e.g. rapeseed, soya, their „ideal“ weight.
walnut)
Consult your doctor if your BMI is
too high or too low.

Group 7
Drinks A balanced diet is important for
Per day maintaining good lung function.
A total of at least 1.5 liters
Preferably low-calorie drinks

10 11
Would you like to know more?
“Living with Alpha-1-Antitrypsin Deficiency“ is a patient
information program. Its aim is to explain the causes, risks
and treatment of the disease. The following booklets can
be ordered free of charge on the internet at
www.alpha-1-info.com

Breathless –
the Whys and Wherefores

What happens in
Alpha-1-Antitrypsin Deficiency?

What can individuals with

Alpha-1-Antitrypsin Deficiency
do for their health? (Other booklets
on protecting the lungs, exercise
and stress management)

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