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Nutrition Guidelines for Cancer Patients and Care Givers

food pyramid pie chartA healthy diet is even more important if you have cancer. You’ll go into treatment with reserves to help keep up your strength, prevent body tissue from breaking down, rebuild tissue, and maintain your defenses against infection. People who eat well are better able to cope with side effects of treatment. And you may even be able to handle higher doses of certain drugs. In fact, some cancer treatments work better in people who are well-nourished and are getting enough calories and protein.

In our previous blog, we talked about what patients and care givers can do to maintain good nutrition if cancer and/or its treatment is lessening appetite. Many of those same tips can help to maintain adequate nutrition. If a poor appetite is keeping your patient from eating a healthy diet, please refer to Caring for a Cancer Patient with a Poor Appetite.

One of the most common questions a cancer patient asks is “What should I be eating, or not eating?” It is best to maintain a balanced diet, which includes: lean proteins and lots of whole grains, fruits, and vegetables. Also, avoid foods that are high in fat and sugar. However, sometimes it is necessary to focus on foods that are high in calories, just to maintain fluids, weight and energy. You might need a Nutrition Specialist or Dietitian as part of your team.

Basic guidelines that you should follow, if you can:
• Choose different plant-based foods that are high in protein. Try eating dried beans and peas instead of meat at a few meals each week.
• Try to eat at least 2½ cups of fruits and vegetables a day, including citrus fruits and dark-green and deep-yellow vegetables. Colorful vegetables and fruits and plant-based foods contain natural health-promoting substances called phytochemicals.
• If possible, limit high-fat foods, especially those from animal sources. Choose lower-fat dairy products. Choose a lower-fat cooking method like baking or broiling.
• Try to stay at a healthy weight, and stay physically active. Small weight fluctuations during treatment are normal.
• Limit the amount of salt-cured, smoked, and pickled foods you eat.

Snack as needed. If you are losing weight, snacks can help you keep up your strength and energy level, and help you feel better. During treatment, you may have to rely on snacks that are less healthy sources of calories just for a short while – once side effects go away you can return to a more healthy diet. To make it easier to add snacks to your daily routine, try the following:
• Eat small snacks throughout the day.
• Keep a variety of protein-rich snacks on hand that are easy to prepare and eat. These include yogurt, cereal and milk, half a sandwich, a bowl of hearty soup, and cheese and crackers.
• Avoid snacks that may make any treatment-related side effects worse. If you have diarrhea, for example, avoid popcorn and raw fruits and vegetables. If you have a sore throat, do not eat dry, coarse snacks or acidic foods.
• If you are able to eat normally and maintain your weight without snacks, then do not include them.

Increasing calories
During illness, treatment or recovery, your need for calories and protein may be greater than usual. The following suggestions can help increase the number of calories you consume:
• Add butter or oils to foods. Use butter or margarine generously on potatoes, bread, toast, hot cereal, rice, noodles and vegetables and in soups. Put olive oil or another oil on bread, rice, pasta and vegetables. Avoid low-fat foods unless fats cause heartburn or other problems.
• Spread peanut butter or other nut butters — which contain protein and healthy fats — on toast, bread, apple or banana slices, crackers, or celery. Dip pretzels in peanut butter.
• Use croissants or biscuits to make sandwiches.
• Add powdered creamer or dry milk powder to hot cocoa, milkshakes, hot cereal, gravy, sauces, meatloaf, cream soups or puddings.
• Add sliced avocado or guacamole to salads and sandwiches.
• Add seeds, such as sunflower and pumpkin seeds, to salads, stir-fries and casseroles.
• Add ground flaxseeds to yogurt, smoothies, hot cereals and casseroles.
• Top hot cereal with brown sugar, honey, dried fruit, cream or nut butter.
• Top pie, cake, gelatin or pudding with ice cream, whipped cream or cream.
• Use fruit canned in heavy syrup. It has more calories than does fresh or juice-packed fruit. If you prefer fresh fruit, add sugar and cream.

Increasing protein
Protein is important for growth, health and repair of your body. If you have cancer, you may need extra protein. Some suggestions include:
• Add extra meat, poultry, fish, cheese or beans to casseroles, soups or stews.
• Choose meat salads, such as chicken, ham, turkey or tuna.
• Make your own high-protein milk: Add 1/4 cup powdered milk to 1 cup whole milk, or 1 cup powdered milk to 1 quart whole milk. Use it as a beverage, add it to shakes, or use it in cooking.
• Try a commercially prepared protein supplement.
• If illness has made red meat — beef, pork or lamb — less appealing to you, try eating other foods that also are good sources of protein.

For additional ideas for Healthy Snacks, High Protein and High Calorie foods, click here.

Drinking plenty of fluids also is key to helping your body during treatment. Try to drink at least 64 ounces (2 liters) of fluid a day, unless your doctor has directed you to limit your fluid intake. Try to choose drinks that contain calories and other nutritional value. If sweetened beverages are too sweet, try flavored water or fruit juices diluted with water. If you’re drinking liquid nutritional supplements, those will give you some of the vitamins and minerals you need, so you may not need a multivitamin.

Don’t forget about physical activity. It helps you maintain muscle mass, strength, stamina, and bone strength. It can help reduce depression, stress, fatigue, nausea, and constipation. It can also improve your appetite. Listen to your body, and rest when you need to. Now is not the time to push yourself to exercise. Do what you can when you are up to it.

The following links provided many of the tips in this blog. Click to find more helpful information.

http://www.cancer.org/treatment/survivorshipduringandaftertreatment/nutritionforpeoplewithcancer/nutritionforthepersonwithcancer/nutrition-during-treatment-once-treatment-starts.

http://www.mayoclinic.com/health/cancer/HQ01134

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