Nourish - Article 02
A guide to eating well with cancer
Eating well with cancer looks different for each person. Everyone has their own unique set of circumstances – symptoms, tumour type, stage of cancer, type of treatment, blood test results, body size and level of physical activity – that can influence how they need to eat. Your dietary goals may also change over the course of your cancer journey.
Struggling with a poor appetite, eating difficulties and weight loss are common side effects. In these circumstances, just getting enough calories and protein, regardless of how you get them, may be the focus. It is not unusual for dietitians to encourage people to eat whatever it is that takes their fancy, especially during more difficult times. While this may seem unorthodox, sometimes it’s about the bigger picture: preventing malnutrition, improving outcomes and overall survival.
If you have a good appetite or are able to eat normally, your focus may be on improving the overall quality of your diet; striving to get a wide variety of nutrients from all the key food groups: carbohydrates, protein, fats, dairy, fruit and vegetables.
Many people get fixated on specific foods or food groups that they may have heard to be beneficial or detrimental to their condition. We also hear of people splashing out on dietary supplements, looking to give their diet an extra boost during treatment or recovery. But often they don’t really understand or have access to the existing research (or lack thereof!).
As health professionals, we have no good evidence or reason to promote any particular superfood, or to demonise any food or food group. It is important to weigh up the pros and cons of taking supplements or following a specific diet in the context of your treatment and recovery. Raising this with a member of your healthcare team or a specialist dietitian would be a good idea. As long as whatever you choose does not put you at any particular disadvantage, your healthcare team are likely to respect and support your decision.
7 Top Tips
Though there is no one-size-fits-all diet for people with cancer, here are some general guidelines for approaching nutrition after a diagnosis of cancer.
- As a general rule, if you are feeling well and your weight is pretty healthy, try to focus on eating well, striving for a healthy balance of a wide variety of nutrients each day:
- 5+ portions of fruit and veg
- 3+ portions of wholegrains
- 30% of your total energy intake from fats (choose healthy fats where possible).
- 3+ portions of protein per day or at least 60g per day.
- Calcium in the form of dairy, dairy alternatives, fish and leafy greens
- Sugar and sweet things in moderation
- If you are feeling poorly, have lost your appetite or are struggling to eat, focus on eating little and often, using extra fat and protein in your meals and snacks to help boost the energy-value of each bite. Also, don’t underestimate the power of liquid nutrition. Calorie-rich milky drinks and smoothies can be a lot easier to face than meals or snacks and can pack a lot of energy into just a small glass.
- As a rule of thumb, try to go ‘food-first’ instead of reaching for supplements. Food provides the body with vitamins, minerals and other important nutrients in a balanced and natural way. When it comes to supplements, there are a lot more unknowns. Nutrient doses can be too high for some people, and potential interactions with medications are important to consider. If you are struggling to eat or to get enough nutrition, your healthcare team may temporarily recommend specific supplements to help you to meet your nutritional needs.
- Always prioritise hydration. While hydration is important for everyone, it is especially key during chemotherapy, or where eating becomes a struggle. It’s very easy to forget about drinking enough when you’re feeling rough. Aim for up to 7-8 glasses of fluid a day and don’t be afraid to use tea, coffee, juice, milky drinks and soups to make up your daily quota.
- Steer clear of extreme diets. There are many confusing dietary claims out there that can actually cause more harm than good. Avoiding sugar, acidic, dairy or soy foods will not cure your cancer. Take what you hear with a pinch of salt and always confide in a qualified professional so that what you choose to do will be safe for your health.
- Address your eating behaviours. How you eat can impact how you feel, therefore becoming mindful of or making improvements to your eating habits could give your overall mental wellbeing a boost. You might want to focus on eating your meals while sitting at a table, or in a relaxed environment, and chewing your food really well, slowing down to savour the flavours. Try listening to hunger and fullness signals so that you don’t get to the point of discomfort or ‘h-anger’, or changing your mindset by thinking about food as a means of nourishing your body with what it really needs rather than providing comfort in times of distress.
- Finally, don’t be afraid to ask for help. If you are struggling with your eating, if you are losing weight unintentionally or if you are confused about what to eat or how to reach your goals, getting some clarity and support will only accelerate you chances of success. Suffering in silence may exacerbate stress levels and delay chances of getting to the root of the problem. Our team at Onko are always happy to answer your questions or give you the support you need to set you on the right path.
Secret to nutrition success (shopping, meal planning)
Once you know the direction you should be taking, whether it’s building up using extra calories and protein, nourishing drinks and supplementary snacks, or boosting the amount of fruit, vegetables and fibre in your diet, the next step is figuring out how to do this. Coming up with a game plan is key and working through the practicalities of how a plan gets implemented is often the most important part of goal setting.
Here are 4 of our top suggestions for staying on track with your nutrition goals in cancer:
- Write down your nutrition goals. It is far more likely you will stick to your goals and achieve success if they are agreed and set in stone. Make sure they are always specific, measurable, achievable and realistic.
- Create a shopping list. This ensures your fridge is stocked with the right foods week after week. It also avoids the issue of forgetting to buy what you needed which makes it easier to slip back into your old ways.
- Set reminders to keep your goals ‘top of mind’. Stick them on your phone or post them on the fridge! It might be a reminder to fit in a mid-morning snack or to drink an extra glass of water. The more you set, the less likely you’ll forget your goals
- Share and discuss your goals with others. Achieving your goals may well include other people. For example, who does the shopping? Who does the cooking and food preparation? Are the individual goals of two people in a house different? It is important that others at home understand what your goals are so that they can support in their implementation.
Eating well with cancer will look different depending on your individual circumstances and this can change from week to week.
You may need to adapt your eating style to a high calorie, high protein diet including some typically ‘less healthy’ foods if you are struggling with your appetite but then revert to general healthy eating as you start to feel better.
Nutritional supplements are best left as a second-line intervention. Always try to get the nutrition you need from food first.
Eating behaviours and how you approach mealtimes and food in general can make a big difference to not only what you eat but also how you feel.
Making a plan which encompasses how you will achieve your goals is likely to deliver the most success. This should include writing down goals, having the food cupboards stocked appropriately, setting reminders and sharing your plan with those at home.