By D. Milton Stokes, RD

The food you eat during cancer treatment can play a role in your improvement. And eating the wrong foods may worsen side effects and make you feel just plain awful. Besides this, some patients think they should be on a restrictive diet to lose weight or for cardiovascular protection—like low carbohydrate, low fat, low sugar—but this is not the best advice during cancer.

The top priority for cancer patients is to prevent unintentional weight loss that may result from increased metabolism and depressed appetite. This crushing combination is called cachexia. Apart from no desire to eat and a revved-up metabolism, the third leg of this triad is the actual cancer treatment, which has a role in contributing to cachexia. So it’s like a cycle.

Given what we know about the benefits of nutrition and adequate calories and protein, nutrition therapy can prove a formidable ally during cancer and its treatment. Below is a list of tips to consider.

Mood

• Eat when you are hungry. Don’t let time of day dictate your meal pattern.
• If you are experiencing depression or anxiety, speak with your physician. Mental health plays a role in dietary intake.
• Enjoy meals and snacks with friends or family. Minimize eating alone.
• Eliminate or reduce stressors in the environment. Play music, get plenty of natural light, meditate or sing.

Boost Intake

• Eat nutrient-dense foods first so you don’t get full too quickly on other things.
• Eat smaller, more frequent meals, and don’t fill up on liquids.
• Keep indulgent foods on hand for when absolutely nothing else will do.
• Add powdered milk to liquid milk. Sprinkle grated cheese in soups and on veggies.

Lack of Energy

• Ask for assistance with food shopping and meal preparation.
• Eat off disposable plates and use plastic utensils if you don’t feel like washing dishes.
• Try finger foods. String cheese, bananas covered in peanut butter and avocado sandwiches are quick and satisfying.

Taste Aversions

• Try alternate food temperatures.
• If meat does not taste normal, eat other high-protein foods, such as yogurt, custard, eggs, poultry and fish.
• Use plastic eating utensils instead of the metal ones.

Low Appetite

• Try a couple bites of food even when you’re not hungry.
• Prescription appetite stimulants are available if necessary.

Nausea

• Take anti-nausea medication as directed.
• Cold or room-temperature foods are often well tolerated.
• Limit greasy, fatty and spicy foods.
• Make sure food preparation areas are properly ventilated. Odors may worsen nausea.

Vomiting

• Drink plenty of fluids to avoid dehydration. Keep a cup handy for sipping.
• Choose bland foods and progress from there.
• Do not eat about two hours before or two hours after treatment.

Mouth Sores

• Choose soft textures and moisten solid foods with cheese sauce or gravy.
• Stay away from acidic, spicy and salty items as well as tobacco and alcohol. These are irritating to the mouth.
• Take pain medication before meals or as prescribed by your physician.

Dry Mouth

• Add more fatty liquids, like salad dressing and sauces to coat the mouth.
• Candies and mints help.
• Don’t use alcohol-containing mouthwashes.
• Work with a dentist and your oncologist if dryness persists.

Nutritional consequences of cancer may differ based on where the cancer is located in the body. Some cancers may be contained in a small area while others may affect a major metabolic organ, such as the pancreas or liver. In the latter case, diet would need to be highly specialized under the supervision of a physician and a dietitian/nutritionist.

Whatever you decide, be sure to focus on eating a variety of foods to supply your body with adequate nutrition, and worry about fat and carbs when you’re in remission. Preventing weight loss will help keep you going strong.

D. Milton Stokes, RD, is clinical nutrition manager for Sodexho at North General Hospital in New York City. He’s also managing partner for Culinary Nutrition Consultants, Inc. (www.culinarynutritionist.com).