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  • Eating Well

  • Important nutrients

  • Eating a healthy and balanced diet is vital for maintaining good health. This includes eating foods from all the different food groups. If you have a cancer diagnosis, it is more important to eat well to support your body through treatment. Unfortunately, it is often at these times that you may not be able to eat as much as you usually would do.

  • Protein

  • Protein is needed by the body to help repair your body’s cells and maintain a healthy immune system. In addition to providing energy (calories) it is also important for repair and muscle building. Rich sources of protein are often found in foods from animal sources, such as meat, poultry, fish, dairy products and eggs. It can also be found in plant based food sources, such as nuts, peas, beans, lentils, cereals, grains and soy products. Without consuming enough protein, it may take longer for you to recover from treatment or to fight off infection.

  • Fats

  • Fats are an important energy source (calories) and essential for the proper functioning of the body. They provide essential fatty acids which are important for controlling inflammation, blood clotting and brain development. They also store additional calories in fat cells which help insulate the body. Fats can be found in vegetable oil, butter, margarine, nuts, seeds, and also in animal products such as meat, poultry, fish, dairy products and eggs.

  • Carbohydrates

  • Carbohydrates provide your body with fuel to keep it going and help with proper organ function. Carbohydrate rich foods include pasta, bread products, cereals, rice and potatoes, as well as beans and peas.

  • Vitamins and minerals

  • Vitamins and minerals have many important roles to help with the proper functioning of the body. They occur naturally in the foods you eat. If you are eating a healthy and balanced diet, you are likely getting all the vitamins and minerals you need. However, if you are losing weight or not eating enough it’s important to speak with your Healthcare Professional to make sure you are getting all the nutrients your body needs. In addition, if you have had surgery to remove tumours within your gut, this may well reduce your ability to absorb certain vitamins and minerals and therefore this should be discussed with your health care professional.

    If you are struggling to eat enough and have started to lose weight, it is important to speak to your Healthcare Professional about your concerns. Your Healthcare Professional may refer you to a Dietitian, who can provide more advice on ways to help you gain weight. There are two main options that your Dietitian may suggest you try:

    • Food fortification: Fortifying your normal foods will increase the calorie and protein content of your diet and can help you gain weight, or slow down further weight loss.
    • Oral nutritional supplements: These are available as milkshake, juice, yogurt style drinks, soups, puddings or powders that you make up with milk.They are high in calories and protein, and contain the full range of vitamins and minerals. These products can be used in addition to a normal diet to help you reach your nutritional goals.
  • Food fortification

  • If you have a poor appetite and are losing weight, food fortification may help you to increase your energy and protein intake without necessarily having to eat a lot more. Food fortification focuses on eating foods that are high in calories and protein. You may normally think of some of these foods as unhealthy, but if you are losing weight they can help you to get the additional calories and protein your body may need.

    The following tips can help you increase the energy and protein intake in your diet:

    • Eat small, frequent meals and high calorie snacks every 2-3 hours.
    • Increase intake of foods that are high in calories and protein, for example: meat, fish, eggs and full fat dairy products (like yogurt and cheese).
    • Quick and nourishing snack ideas:
      • Sandwiches with cold meat, tinned tuna/salmon or egg with mayonnaise.
      • Toast with melted cheese, tinned fish, cream cheese or scrambled egg.
      • Puddings such as plain sponge and custard or cream, baked custard, tinned fruit and cream, ice cream, full fat yogurt or fromage frais, crème caramel or trifle.
      • Toasted crumpet, croissant, hot cross bun, scone, pitta/roti/naan or bagel with added butter, margarine, jam, honey or cream.
    • Consider adding the following to your breakfast cereals and porridge: full fat milk/yogurt/fromage frais or cream. You could also add jam, honey or syrups.
    • Consider adding thickly spread butter/margarine/cream cheese to your bread. You could also add, jam, honey, syrup or meat/fish paste.
    • Eating snacks such as biscuits, cakes, rice cakes, corn-based crisps, bread sticks, crackers with butter or cream cheese, chocolate, nuts or crackers may be useful.
    • Add cream, butter, crème fraiche or cream cheese to meat or fish dishes, stews and curries to increase calorie and protein intake.
    • Consider frying foods instead of steaming, boiling, poaching or grilling.
    • Add mayonnaise, salad cream or oil-based dressings to salads.
    • If you know you will be away from home for more than a few hours carry some snacks with you. Biscuits, cereal bars, rice pudding pots, yogurts and sandwiches are good options.
    • Avoid drinking fluids with meals, which may reduce how much is eaten.
    • Avoid foods that make any treatment-related side effects worse. You can read about more tips on coping with treatment-related side effects here. 

    Check out some of our recipe ideas on fortifying your diet for extra calories and protein.

  • Modified consistency diets

  • These diets make it easier for you to eat when you have difficulty chewing or swallowing, otherwise referred to as dysphagia. Modified consistency diets can be defined as diets that alter the texture and consistency of food and/or fluids. These are often termed a thin or thick pureed diet, a pre-mashable diet or fork mashable diet for foods. Talk to your Doctor or Healthcare Professional before altering the consistency of your diet to make sure that you continue to get all the nutrients and fluids you need.

  • Oral nutritional supplements

  • Oral nutritional supplements are nourishing drinks or desserts that are high in calories, protein, vitamins and minerals. If you are struggling to eat enough and continuing to lose weight, your Doctor or Dietitian may prescribe or recommend oral nutritional supplements. These can help give you the extra calories, protein and all the vitamins and minerals that your body may need.

  • When would you be prescribed an oral nutritional supplement?

  • If you are struggling to eat enough and have started to lose weight, it is important you talk to a Healthcare Professional about your concerns. They can assess how much weight you have lost and decide whether oral nutritional supplements are suitable for you. At these times, it can be difficult to eat enough and many people find it helpful to take oral nutritional supplements as a ‘top up’ to ordinary food.

  • When would I take oral nutritional supplements?

  • Oral nutritional supplements should be taken alongside a normal diet, ideally in between meals at snack times or before bedtime.

    During treatment: Taking oral nutritional supplements alongside dietary advice is often recommended to help increase nutritional intake and prevent weight loss during cancer treatment. Read more about the effect of weight loss here.  

    Before surgery: Some people with cancer may benefit from taking oral nutritional supplements even before having surgery. The amount of time for which oral nutritional supplements will need to be taken will vary from person to person.  The more weight you have lost, the longer you may need it. Ask your Healthcare Professional for further advice.

  • What are the different types of oral nutritional supplements available?

  • Oral nutritional supplements are available in a variety of styles including milkshake, juice, soup and pudding style. There are also powder supplements that you can make up yourself with milk or water.

    These different supplements can add extra calories and protein to your diet. There are different options available which can help you manage certain treatment-related side effects:

    • High protein milkshake style drinks, in which greater than 20% of the energy comes from protein. Oral nutritional supplements that are high in protein are sometimes recommended for people with cancer. You can learn more about the role of protein in cancer here. Low volume, high protein, high energy drinks are also available.  
    • Low volume, high energy drinks (e.g. 125ml) may make it easier to get the calories you need even if you have a small appetite. Many people find it difficult to finish large volumes of drinks when they have appetite loss. Drinks that are low volume and high in energy help people with appetite loss to get the calories, protein, vitamins and minerals they need.
    • Yogurt style drinks can help manage any taste changes that may be caused as a side effect of cancer treatment.
    • Juice style drinks can help manage a dry mouth that may be caused as a side effect of cancer treatment.
  • Oral nutritional supplements are also versatile. Whilst they are usually taken between meals, you can also mix them into food and serve them warm, chilled or frozen. As a general guide, they are best taken in between meals, as a top-up to a normal diet. See the recipe ideas section for more tips on how to incorporate supplements into your diet. 

    Oral nutritional supplements do not need to be refrigerated until you open them. That means you can carry them with you and have them whenever you feel hungry or thirsty. You may want to take a ready-to-drink oral nutritional supplement with you when you go for your treatment or at other times when you may have a long wait.

    The content of this page was reviewed by Saira Chowdhury
    Specialist Upper GI Oncology Dietitian
    Guys & St Thomas' NHS Foundation Trust
    January 2015