Hi, my name is Sina Teskey and I’m a registered dietitian for HealthPartners Cancer Care Center at Regions Hospital. As you may know, nutrition has a big role
when it comes to cancer. I am here today provide some nutrition
information and tips for cancer patients and survivors. During this video we will go through
some eating tips for common side effects that may occur during treatment. Next, I will answer some common nutrition
questions patients have asking me about sugar, soy, organic food and dietary supplements.
Lastly, I will give a quick overview of diet recommendations to help prevent
recurrence that are supported by national oncology
societies. I hope you find this information useful. If you have further questions or would
like to set up an appointment to discuss your individual nutrition issues, please request an appointment. Your nurse or doctor can schedule an
appointment at any point throughout your cancer journey. Cancer puts big demands on your body and nutrition is a key component in your path to recovery. It is important to supply your body with enough fuel so it can heal and repair in the fight against cancer.
Sometimes consuming enough food can be difficult due to side effects from your
treatment. Side effects vary greatly, but may
include weight loss, diarrhea nausea, vomiting, constipation, difficulty
swallowing sore mouth, taste or smell changes, pain fatigue or mechanical obstruction. How do you cope with changes in eating when food isn’t as enjoyable? It is often hard to think about changing
the way we eat, but during treatment you may need to
reprioritize your nutritional goals. Staying nourished during treatment should be your number one goal. A temporary change in your diet to higher
calorie foods, such as full-fat dairy products or
fortified milk may be warranted to help with weight
maintenance. Another consideration with weight maintenance is using high calorie, high protein
supplements. It can be hard to get all the nutrients you need in a day when the
amount of food you are consuming has decreased. Nutrition supplements are great aid in
providing nutrition when eating enough food becomes too
large of a task. These supplements contain vitamins,
minerals, protein and added calories and can be a great snack or addition to
a meal. Some common high-calorie, high -protein supplements are Boost, Ensure and Carnation Instant Breakfast. A lot of pharmacies and stores, such as
Target and Wal-Mart, also offer a generic form of these products that could be used
as well. There are also juice flavored high-protein, high-calorie supplements called Enlive and Resource Breeze, and a
flavorless calorie supplement called Benecalorie
that can be added to food for additional calories and protein. These products are less commonly found
on shelves and may have to be ordered in from your pharmacy or online. It will also be helpful to
keep ready to eat food accessible at all times throughout treatment. Prepare and store your favorite meals in
single portions when you are feeling well so you can grab
them on the days you may not want to cook. Also, stock your refrigerator and cabinets
with ready-prepared snack, such as string cheese, pudding
yogurt, ice cream, canned fruits, cottage cheese canned soup or other foods you like so you
always have something ready to eat if you’re hungry. Nausea is one of the most common
side effects you may experience during treatment. If you’re feeling nauseous, cold or room-temperature food may be tolerated better than hot food. Also, try to stay away from the kitchen
when food is being cooked to avoid the aroma of food as this may trigger your nausea. You can
also try separating your consumption of liquid and solids at meals. Have your solids first and the liquids at the end of your meal. Mornings can be tough on your stomach if
you’re taking multiple medicines. It may help to have dry toast or
crackers in the morning when you get up to prevent taking your medicine on an
empty stomach. Lastly, don’t forget to ask your doctor
about medications that can’t help with nausea as these are sometimes the best solution. If you already have anti-nausea medicines prescribed to you, make sure to take them as ordered to help
relieve your symptoms. If you are noticing continued weight
loss, lack of appetite difficulty eating large meals or
difficulty swallowing foods, you should change from eating three
large meals a day to grazing throughout the day. It can be easier and less overwhelming to focus on consuming small meals or snacks five to six times a day to meet your energy needs. It is a good rule of thumb to think
about eating every two to three hours if you’re having small meals. Keeping a journal of what you have eaten
throughout the day can be helpful to keep track of everything you have
consumed. Another helpful reminder to eat
frequently throughout the day is to have a relative or friend call every three hours or set a clock or
timer to go off every two to three hours to
remind you it’s time to eat. When taste changes occur, it’s time to get
creative with the foods you are trying. Something you may have thought was too sweet, bland or sour may taste just right now.
When you find a food that works continue to use it and modify it’s flavoring to continue to
have it taste good to you. Some patients have found it helpful to keep a list of
foods that have tasted good. What foods no longer are appealing and foods you have yet to try. This can help you get new ideas if you are not feeling hungry at meal times. Sometimes the type of medicine or
treatment you are receiving may cause you to begin to gain weight. It is best to maintain your weight
during treatment unless you are underweight. If weight gain becomes a problem for you
during treatment, try to monitor the types of food you are taking in. You may need to cut back on added fat and focus on low calorie and nutrient dense foods, such as fruits and vegetables. Or choose smaller serving sizes at meals. Another thing to focus on is fluid
intake. Fluid is important during treatment and you will often hear your health care provider reminding you to drink enough fluids. Dehydration can cause fatigue or
increased mucus formation. Drink 8 to 12 cups of fluid a day unless a doctor says otherwise. Now let’s talk about some commonly
asked questions that the nurses, doctors and myself are asked by patients. Hopefully I can clear up some of the confusion and anxiety you may have regarding eating and cancer. You may have read that sugar can feed cancer. This causes a lot of anxiety
for patients as they feel they have to avoid eating all foods with sugar. Sugar is a
glucose-fructose structure and a carbohydrate. Carbohydrates are energy sources for our body. Both cancer and healthy cells require them to funtion properly. When glucose is consumed without fiber
protein or fat, it can lead to increased insulin production, which will in turn cause cell growth for cancer in healthy cells. There is nothing in particular about sugar
that feeds cancer cells any more than it feeds all the cells in our body to function. Sugar itself it’s not bad and you don’t have to avoid all sugar in your diet the most important thing to do is
consume sugar with protein fiber or fat to decrease the instant spike in cell growth. If you’re feeling well and not having
problems with your dietary intake, then have dessert in moderation and limit
simple sugars, such as soda, candy and fruit juice. If foods with
high sugar content, such as ice cream, are the only food that
you’re able to tolerate continue to consume them, as malnutrition
can be a serious problem and may cause a delay in your treatment. Next, are soy products safety? Soy is
rich in phytoestrogens, which can help increase cancer
prevention compounds, but may also enhance cancer development for women with
hormone-sensitive cancers if eaten in large quantities. A lot of
research has been done and as of now moderate amounts of soy is considered safe. This means up to three servings a day. High doses of concentrated sources of soy, such as that found in soy powders and
isoflavones supplements, are not recommended due to the potential estrogen like
effects and lack of safety data. Another common question I get asked is
should I buy organic food. Limiting pesticides may be beneficial, but it’s important to look at your diet as a whole first. Choosing organic cookies over
regular fruits or vegetables may not be beneficial. If you have the resources and interest in organic foods, you can start by planting a garden, choosing local fruits and vegetables or buying organic versions of the
fruits and vegetables known to have high pesticide loads. The dirty dozen is a list done by
the Environmental Working Group that lists the cleanest and dirtiest
fruits and vegetables in terms of pesticides after they are rinsed off. The list can be found online. Now what
about dietary supplements. There isn’t a lot of information
available on dietary supplement use during cancer treatment, so use them conservatively. The first
thing to remember is it’s always favorable to get nutrients from
the whole food versus a pill. High doses of some dietary supplements
can actually be dangerous and some commonly used herbal and dietary supplements can interfere
with chemo and radiation. Even antioxidant supplements may not be
recommended as they may be protecting the cancer cells while our treatment is trying to break them
down. Make sure to always share any herbal supplements or vitamins you are
taking with your doctor as they may be contraindicated with some medicines you
have been prescribed. If you do choose to take a dietary
supplement during treatment look for a USP symbol on the bottle, as these products have
been chosen to be voluntary tested for quality. If you have more questions about a
particular supplement, visit the cancer library computers and use the Natural Medicine
Comprehensive database to look up specific information on the supplement
you’re interested in. Now let’s talk about what to do after
your treatment. Eating well and staying active may help keep your cancer from
returning. Maintaining a healthy weight should be
your first goal as obesity can increase the risk of certain cancers. When your energy level has returned try
exercising 30 minutes a day for at least five days a week. It is important to fit exercise into
your daily routine as it is needed to build muscle and bone mass. You may enjoy walking, gardening, yoga, weightlifting, running or going to the gym. Any exercise will benefit your body. Next,
it’s important to look at the food you’re taking in. As side effects go away and you have
more foods that are appealing to you, it is time to focus on healthy eating. The American Institute for Cancer
Research recommends having two-thirds of your plate filled with plant-based foods, such as grains, beans, nuts, fruits and vegetables, and one-third your
plate from meat and dairy products. Choose whole grain breads, whole wheat noodles and brown rice instead a refined grains or processed
grains. Also, focus on your fruit and vegetable intake. The recommendation is to consumed five or more servings of fruits and vegetables a
day. Remember, a serving of vegetable is half a cup cooked or one cup raw and a serving of fruit is one cup of
berries, grapes or melon or about the size of a tennis ball
for round fruit like apples and oranges. Lastly, choose lean meats, fish or
vegetable protein, such as beans, tofu, soy or nuts as your protein source most nights of the week. Red meats are okay to have occasionally, but try to get a lean cut and make sure to
watch a serving size and have no more than three ounces a day. Lastly, you should limit your alcohol consumption. Thank you for listening and good luck
throughout your treatment. If you would like further nutrition tips or
recommendations based on your individual goals and challenges, or if you have a question that was not
discussed in this video, please ask your care provider to schedule an appointment with a dietitian at any time. The physicians, nurses, dietitians and staff
at the HealthPartners Cancer Care Center are here to help you along your journey.
Have a great day.