Ask a Dietitian

As seen on BCTV Noon News

People living with cancer typically have increased nutritional requirements. Those undergoing chemotherapy, as well as other forms of cancer treatment, may experience side effects such as nausea, vomiting, taste and smell changes, sore mouth, loss of appetite or bowel changes, leading to impaired intake, digestion, or absorption of food.  Since therapy can last for several weeks, preventing weight loss and malnutrition are important goals of the chemotherapy patient.   

In order to meet nutritional requirements, the diet should contain energy dense foods that are rich in protein, vitamins and minerals to help overcome the nutritional side effects associated with treatment.  When a loss of appetite is experienced, the focus should be on eating small frequent meals and snacks that are easy to prepare, rather than 3 large meals a day.  If difficulty acquiring adequate nutrients from food is a problem, nutritional intakes can be improved by consuming:

• high protein, high calorie liquid nutritional supplements
• juice and milk
• soup (especially meat or cream-based)
• pudding, yoghurt, milkshakes or fruit smoothies
• cheese, muffins, nuts and nut butters

Loss of appetite can be a consequence of taste alterations associated with chemotherapy.  Many chemotherapy patients experience a metallic taste with certain foods and beverages such as coffee. Taste changes can be combated by increasing the variety of the types of foods eaten or adding different flavorings to foods to change the taste.  One recommendation is to substitute poultry, fish, eggs and cheese for red meat or to eat meat with something sweet such as fruit juice or dressing.  Adding herbs, spices and sauces to food can help overcome the bitter taste changes that may be experienced due to chemotherapy.  Consuming 50mg of elemental Zinc daily may also improve taste and appetite.

Another side effect of chemotherapy that can impair food intake is stomatitis, a condition where cells inside the mouth are damaged or torn resulting in a sore mouth.  To improve nutritional intakes, foods should be soft, easy to chew and swallow and non-irritating.  Foods that should be avoided include those that are acidic, spicy, salty, or coarsely textured.  Consuming hot food should be avoided, as the extreme temperature may exacerbate mouth irritation. Foods to include in the diet are:

• bananas, peaches, pears, applesauce and canned fruit
• eggs, cottage cheese, dessert tofu, tender meats, fish and poultry 
• well cooked vegetables (go for variety/colour!)
• sweet potato, mashed potatoes made with cream and butter, rice and pasta
• puddings, milkshakes, egg custard, oatmeal and cream of wheat 

Nausea and vomiting are common side effects experienced when undergoing chemotherapy.  Foods that trigger nausea and vomiting may include very sweet, spicy, or greasy foods, and those with strong odors.  Eating bland and easy to digest food such as crackers and digestive biscuits can help. Adequate hydration should also be a focus, especially if one experiences vomiting or diarrhea which can be dehydrating.  Proper hydration can be achieved through drinking milk, soup, water, juice, decaffeinated beverages and eating plenty of fruit and vegetables.

Watch for the Eating for Energy segment every Tuesday on BCTV’s Noon News Hour!