Diet for cancer patients during and post treatment

07 July 2020 | Opinion

Nutritional interventions, such as intensive dietary counseling with regular follow-ups, flavor enhancements, recipe modifications, and oral supplementation, have been found to lessen weight loss and improve health status Image Credit: shutterstock.com Image Credit: shutterstock.com

Good nutrition plays an important role in people suffering from cancer. During the cancer treatment process, the human body will have a hard time fighting off the infection. When you are healthy, eating enough food is often not a problem. But when you are dealing with cancer and treatment, this can be a real challenge. Following a healthy diet can help oneself be stronger, maintain a balanced weight and fight back infection. It also helps with the side effects of the treatment.

Patients undergoing treatment experience a multitude of symptoms, including fatigue, pain, nausea, appetite loss, and unintentional variations in the weight. These symptoms can negatively impact ones ability to complete treatment as well as ones quality of life during and after the treatment. The cancer treatment can affect the dietary intake and the changes can exacerbate other treatment-related symptoms.

For example, patients who experience distorted taste and increased sensitivity to smell will have poorer intake. The preliminary results of CoUNT (Collaborating to Understand Nutrition Therapy) study, a survey done at HCG hospitals, revealed a surprisingly high number of patients reporting taste and smell changes that affected their nutritional intake.

Nutritional interventions, such as intensive dietary counseling with regular follow-ups, flavor enhancements, recipe modifications, and oral supplementation, have been found to lessen weight loss and improve health status. Exploring the relationship between diet and health status/quality of life during cancer treatment, the following subgroups have been identified as nutrition-related issues:

 

Unintentional Weight Loss


During cancer treatment, substantial weight loss, especially among patients of lower body mass index, is associated with poorer treatment tolerance and outcomes, and poorer quality of life. Consumption of more energy- and nutrient-dense foods is recommended to increase the overall calorie intake. Smaller, more frequent feedings can be helpful in obtaining adequate energy. While mouth sores may reduce consumption of foods that are either chemically or physically abrasive (e.g., citrus or tamarind-based foods), soft, bland foods are usually well-tolerated. For those unable to eat enough solid food, several liquid supplements have to be included to provide much-needed nutritional support.

 

Problems Related to Weight Gain


While there is undernutrition that is associated with poorer outcomes, there is obesity that has established risk factors for certain cancers. Therefore, a substantial proportion of cancer patients are overweight or obese at the time of diagnosis. Weight gain can happen during or after treatment and may be triggered by some forms of treatment or physical inactivity brought
about by treatment-related fatigue. Guidelines established for weight management in the general population should be applied to cancer survivors and should include not only caloric restriction and increased energy expenditure through exercise, but also behavior therapy.


Dietary Patterns and Food Choices


Cancer treatment influences patients’ appetites and thirst, and their frequency of eating and drinking. Dietary modifications with dietary counseling will enable the patient to incorporate foods that are tolerated better. Frequent food intake, nutrient-dense foods and altering meal timings also help in improved food intake.
Cancer treatment also influences the types of foods that patients were consuming. Patients had a wide range of food preferences and aversions. Individualizing and customizing the foods based on food tolerance and preferences is associated with better intake. Recommendations related to the avoidance of red and processed meats and to reduce salty foods are based primarily on the prevention of selected cancers (e.g., colorectal and digestive
cancers). Sugars (including honey, brown- and raw sugar, jaggery, and high-fructose corn sweeteners), have not been shown to directly increase risk or progression of cancer. However, they can add substantial amounts of nutrient-poor calories, often replacing more nutritious food choices. Therefore, including too much sugar in the diet is not advised.


Patient-centered Nutrition Service


Cancer patients have a variety of food preferences, food-related concerns, and malnutrition. Almost 90% of our patients need ideas to improve food intake and involving a nutritionist right from the time of diagnosis plays an important role in improving nutritional outcomes. A multi- disciplinary team should be involved in identifying nutrition risk, planning of nutrition interventions and in educating the family and patient about the nutrition challenges and their management and this has ensured better compliance with treatment and outcomes.


To summarize, it is important to understand that the cancer patient can face a harrowing journey from diagnosis and treatment, to recovery. In planning interventions among cancer survivors, we must address diverse patient needs, understand unique barriers to change, and collaborate with patients and caregivers to promote disease-free survival and overall health.

 

Tips for healthy eating after cancer treatment


1. Consume plenty of high- fiber foods, like whole-grain bread and cereals.


2. A nutritious and balanced dieting plan is important


3. The amount of fat in meals can be decreased by baking or boiling foods.

 

 

Dr. Esther Sathiaraj, Head- Clinical Nutrition & Dietetics, HCG Cancer Hospital, Bengaluru

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