Many of us may want to shed a few pounds to look and feel better, but losing weight without trying is a red flag that something unusual is going on in your body. This is a sign to go see your doctor as unintentional weight loss could be a sign that you are malnourished, a condition with many consequences – especially if it comes alongside a cancer diagnosis.
What is Malnutrition?
Malnutrition is when you are getting either too much or too little nutrition in the body, causing the body to not function or perform properly. In the case of cancer, this is caused almost always by too little nutrition. This can be because the tumor is using up extra energy or because side effects of your cancer treatment are causing you to not eat or drink enough. Cancers such as head and neck, stomach, pancreatic and colorectal have the highest risk of malnutrition because they affect eating, drinking and digestion but research estimates that 30% to 85% of all cancer patients will experience malnutrition at some point¹. Malnutrition’s key signs are losing weight without trying, loss of appetite, and muscle weakness.
What are the Effects of Malnutrition?
Being malnourished is something to be avoided as it can lead to decreased ability to tolerate treatment and sometimes stopping treatment early. It also reduces the strength of the immune system and slows wound healing, which is especially bad if you require surgery to remove a tumor. Overall, it has a negative effect on your quality of life by making you more tired and weak and could lead to longer stays in the hospital. This condition increases mortality, with the National Cancer Institute reporting that up to 1 in 5 cancer deaths are related to malnutrition¹.
How Do You Prevent and Treat Malnutrition?
The most important way to prevent malnutrition is to eat! Sounds easy enough, but if you are having symptoms which affect your appetite, your energy level, or the way your body feels, it can be very hard to get enough to eat. There are many ways to meet this challenge, here are a few main points:
- Graze all day: Keep snacks around the house and have a bite or two every hour rather than trying to have three large meals a day as usual
- Make every bite count: If you don’t feel like eating often, make sure when you do it has the most nutrition possible. Choose high fat, high protein snacks like trail mix, protein shakes, or whole fat dairy foods such as cottage cheese and Greek yogurt to keep your energy level up
- Maintain strength: Aim for protein intake each time you eat to make sure your muscles stay strong. Protein can come from animal sources (chicken, fish, turkey, lean beef, dairy) as well as plants (nuts, seeds, soy)
- Eat when hungry: If you know you are hungrier in the morning than at night, take advantage of that fact! Make sure you have a king-sized breakfast to make up for a lighter dinner
Making nutrition a priority is always a healthy thing to do, but it is especially important after a cancer diagnosis. If you have any questions on malnutrition or any other topic related to food, join our community and reach out to OncoPower Nutrition on our app today and one of our Registered Dietitians will be happy to help. Check back soon for our blog post on nutrition-related symptom management for tips on how to eat well when not feeling well.
Welcome to OncoPower Nutrition
OncoPower is excited to announce Rachel Spencer, MS, RD, CNSC as the new Director of Nutrition. Our team is thrilled to be expanding into the nutrition space, because we know so often one of the first things a newly-diagnosed cancer patient asks is “how are my food choices affecting my illness and treatment?”
Most patients look for these answers with the help of internet searches instead of asking a health care provider, as very few doctor’s offices have nutrition professionals on staff1. These search results can be confusing, overwhelming, and sometimes offer conflicting advice – leading many patients to throw up their hands and put off any potentially helpful diet changes.
With the help of our convenient app, OncoPower makes getting answers to your food- and nutrition-related questions as easy as submitting a question and getting a timely response from a qualified Registered Dietitian. Join today and get your questions answered!
What Should I Know About Cancer Nutrition Right Now?
Research shows that as of 2014, at least 18% of US cancer diagnoses and 16% of cancer-related deaths can be traced to the combination of four risk factors: body weight, physical activity, nutrition, and alcohol intake2. Recently in June of 2020, the American Cancer Society released an updated version of the Guideline for Diet and Physical Activity for Cancer Prevention. These guidelines provide information on how to reduce these risk factors. Here is a summary of what they say:
- Achieve and maintain a healthy body weight throughout life.
- Ask your doctor what a healthy range is for you, and avoid gaining weight as you get older
- Ask your doctor what a healthy range is for you, and avoid gaining weight as you get older
- Be physically active.
- Adults should engage in 150-300 minutes of moderate activity per week, or 75-150 minutes of vigorous activity, or a combination of the two; getting over 300 minutes is better
- Children and teens should get at least 1 hour of moderate to vigorous activity daily
- Limit time spent sitting, lying down, and watching television or using screens
- Follow a healthy eating pattern at all ages.
- A healthy eating pattern includes:
- Nutrient dense foods in portion sizes that are appropriate
- A variety of vegetables—dark green, red, and orange, fiber-rich legumes (beans and peas), and others
- Fruits, especially fresh fruits with a variety of colors
- Whole grains
- A healthy eating pattern limits or does not include:
- Red and processed meats (sausage and bacon)
- Sugar-sweetened beverages (soda)
- Highly processed foods and refined grain products (salty snacks and bakery items)
- A healthy eating pattern includes:
- It is best not to drink alcohol.
- People who do choose to drink alcohol should limit themselves to no more than 1 drink per day for women and 2 drinks per day for men
Though these guidelines are for cancer prevention, much of this advice applies to those already diagnosed with cancer. Reach out to OncoPower Nutrition on the app today to see how the foods you eat can affect your cancer care – we look forward to assisting you on your journey.
“In food excellent medicine can be found” – Hippocrates
I want to go over some general nutrition recommendations in three short videos.
I will go over
- about using nutrition to manage side effects in Video 2 (log in to view)
- about food safety in Video 3 (log in to view)
While this is broad guidance based on quality evidence, we recommend you consult with our Registered Dietitian, to tailor a plan to your specific needs.
How to maintain a healthy weight.
- During many cancer treatments, patients can experience loss of appetite or decreased oral intake due to uncomfortable GI side effects such as nausea, vomiting, diarrhea, or constipation, or as a result of some medications.
- The main focus of our nutrition interventions is to help you to take in sufficient calories to maintain your current weight through the course of treatments, so ensure your body stays healthy and can recuperate from treatments accordingly.
- There may be instances in which weight loss before or after treatment in obese persons is appropriate, but your doctor would let you know if it is needed in your case.
- You can also consider adding oral supplemental shakes to your diet, if you feel you are not eating well. Your Registered Dietitian can guide you about which supplements are right for your body, and how much to take in to meet your needs.
- Weigh yourself regularly. If you notice weight loss that is more rapid than 1 pound per week, contact your Registered Dietitian, so that they can help you manage this appropriately.
Getting essential nutrients.
- Getting essential nutrients means consuming a variety of foods, with balanced portions of protein, carbohydrates, and fats, alongside plenty of fluids. During your treatments, your healthcare team does not recommend any dietary restrictions, unless medically necessary due to your cancer diagnosis or other conditions, which would be discussed with you at your visits.
- Getting the appropriate amount of total calories for maintaining your weight, as well as staying hydrated are most important while fighting cancer. Your Registered Dietitian will provide you with goals for calorie intake and fluids to meet these needs, and help monitor your intake and adjust through your treatment course.
- Depending on your needs, taking a multivitamin or specific vitamins and minerals that you aren’t getting enough of during treatment may be necessary. Nutritional supplements such as Boost or Ensure also can help you meet these needs. Before taking any supplements, please discuss with your healthcare team.
It is important to remain as active as you can.
- Exercising to maintain your muscle mass as best possible is key to fighting through treatment with energy and rebuilding strength after treatments.
- For example, take a daily walk or incorporate lower impact activities such as tai chi, yoga, meditation and stretching, or swimming into your exercise pattern.
- Once your treatment is complete, ask your healthcare team about our Cancer Exercise Rehab Program available for patients.
While this is broad guidance based on quality evidence, we recommend that you consult with our Registered Dietitian, either personally or using the computer, to tailor a plan to your specific needs.
How to use nutrition to manage treatment side effects?
Cancer treatment often causes side effects, such as nausea, mouth sores, and taste changes which may make it difficult to eat or drink.
Follow these tips to help you manage side effects:
- If water tastes unpleasant to you:
- take in more liquid through foods and other drinks like soups, popsicles, or
- fruits like watermelon, flavored water, beverages like Gatorade, Powerade, or
- try tea, lemonade, or milk.
- If food tastes bland,
- try seasoning it with flavorful spices such as lemon, garlic, and rosemary.
- Some prefer to simply eat bland foods, such as breads, oats, pastas, mashed potatoes, dairy products, as this helps to mentally cope the taste alterations.
- If you have a metallic taste in your mouth.
- Try things such as mints, chewing gum, teeth brushing more frequently
- Even bites of fresh citrus (yes even sucking on lemon slices), or drinking tomato juices can help
- use plastic or bamboo utensils and cook in nonmetal pots and pans, especially avoiding cast-iron cookware.
- If you experience mouth sores or gum tenderness,
- choose soft, moist, non-acidic and non-spicy foods.
- Use a blender or food processor to make vegetables and meats smooth.
- Smoothies or milkshakes may be a great option that can also help you get additional calories in a texture that is comfortable for you.
- Tricks such as adding butter, mild sauces, gravy, ricotta, or cream to meals or recipes are great ways to add calories and a soothing texture.
- If you feel FULL with smaller portions
- try frequent meals are a great way to get those much needed calories
- try eating 6 small meals a day instead of 3 large meals.
- Choose calorie and protein packed items for those small meals.
- If meat becomes unappealing,
- try getting protein from other foods like fish, eggs, cheese, beans, nuts, nut butters, tofu, or high-protein smoothies or shakes.
- Also sneaking things like ricotta and silken tofu into mixed dishes can be a great way to add extra protein.
- If you are experiencing nausea or vomiting,
- be sure to take all medications as prescribed.
- Unless directed specifically, do not take medications on an empty stomach as this may exacerbate symptoms.
- Some dietary approaches include eating regular meals and snacks, drinking plenty of fluids, and eating bland foods such as crackers, chicken noodle soups, mashed potatoes, toast with peanut butter, etc. Some patients find that drinking ginger teas, or sucking on ginger candies or peppermints help to curb nausea, as well.
While diet can play a role, please reach out to your dietitian if you are experiencing severe constipation or diarrhea.
While this is broad guidance based on quality evidence, we recommend you consult with our Registered Dietitian, either personally or using the computer, to tailor a plan to your specific needs.
Many treatment options weaken the immune system and increase the risk of experiencing food-borne illness.
Patients receiving cancer treatment should follow some basic rules to make sure they are practicing food safety:
- Wash your hands before you handle food, as well as all food prep surfaces.
- Rinse vegetables and fruit thoroughly before eating them.
- Store meat and fish on the bottom shelf of the refrigerator.
- Use separate cutting boards for meat and vegetables.
- Refrigerate food after everyone has been served.
- Eat fully cooked foods and skip raw meats, seafood, or sushi.
- Do not eat unpasteurized foods and pay close attention to cheeses, milk, cider, and juices.
- Follow expiration dates and safe food storage practices.
Food safety is very important. If you have additional questions, talk with our Registered Dietitian at St. Bernard’s.
Eating a balanced diet that incorporates vegetables, beans and legumes, whole grains, and fruits is important during both treatment and recovery.
While there may be more specific recommendations tailored to you based on your specific cancer and treatment course, a healthy overall diet is important to regaining strength and achieving and maintaining a healthy weight.
These are broad evidence-based guidelines. We always recommend patients to consult our Registered Dietitian either personally or using the telehealth platform to tailor a plan to your specific needs.
Feel free to watch this video as many times as you would like or download scripts to read.
Be sure to watch Video 1 on how to Maintain Healthy Body Weight and ensure you receive Essential Nutrients and Video 2 on how to Nutrition to manage Side Effects from Cancer and Treatments.
If you have any additional questions, you are welcome to reach to your doctor’s office
Thank you and good luck!