Nutrition Therapy during Cancer Treatment

Transcription

1 Christ Hospital Nutrition Therapy during Cancer Treatment Outpatient Nutrition Counseling Carepoint Health-Christ Hospital Main Building 176 Palisade Ave. Jersey City, NJ (Please leave a message and we will return your call to make an appointment.)

2 Table of Contents Importance and benefits of good nutrition therapy during treatment...3 What are my nutritional needs?...4 How should I eat during treatment?...5 Side effects that may occur from chemotherapy and radiation...7 Loss of appetite...8 Taste changes...9 Nausea...10 Constipation...11 Diarrhea...12 Dehydration...13 Low white blood cell count and risk of infections...14 Sore mouth or throat...15 Dry mouth...16 Recipes...17 References...18

3 Importance and benefits of good nutrition therapy during treatment Good nutritional status is an important goal while patients are receiving treatment for cancer. Good nutrition can help patients stay stronger and will help patients tolerate treatments and side effects. Maintaining adequate intake of calories and protein will prevent weight loss, help regain strength, and rebuild healthy tissues. Goals of Nutrition Therapy During Cancer Treatment: Help patients tolerate treatments Prevent and minimize weight loss and muscle wasting Minimize nutrition related side effects Prevent nutrient deficiencies Maintain healthy immune system, decreasing the risk of infection Maintain strength Help the body recover and heal 3

4 What are my nutritional needs? During treatment you need extra calories and protein. Extra calories and protein help keep up strength, rebuild tissues, and improve how you feel. Calorie needs: Consume enough energy (calories) to maintain a healthy weight. During treatment calorie needs are calories per kilogram of body weight. With one pound being 2.2 times one kilogram, a 130-pound female will require about calories per day and a 175-pound male will require about calories per day. If you experience weight loss increase caloric intake. Protein needs: The current Recommended Daily Allowance for protein is grams per day. During treatment more protein is needed. You can discuss how much more you need with your outpatient dietitian. Protein rich foods include: lean meats, poultry, fish, eggs, cheese, and yogurt. Fluid needs: Drinking 8 12 cups of fluid per day will help keep you hydrated and prevent dehydration. Carbohydrate: Carbohydrates will help supply the body with calories it needs. Foods high in carbohydrates include whole grain breads, pasta, brown rice, hot cereal, beans, potatoes, sweet potatoes, and fruits. Fat: Fats helps supply the body with the calories it needs. Good sources of fat include: olive oil, nuts, and seeds. Multivitamin: Taking a daily multivitamin will ensure you re meeting all your needs. 4

5 How should I eat during treatment? It can be a real challenge to eat healthy when you are dealing with cancer and treatment. Side effects from treatment may vary from day to day. Managing side effects of treatment will help maintain good nutritional status. Stock up on foods that need little or no cooking. Try to cook foods ahead of time. Eat when you have the biggest appetite such as first thing in the morning. Drink plenty of liquids: 8 12 cups per day (keep a water bottle close by.) Eat at least 2 ½ cups of fruits and vegetables per day. Plant based foods provide natural health-promoting substances. Include protein rich foods: 1. cheese 2. milk 3. yogurt 4. lean meat 5. poultry 6. fish 7. eggs 8. nuts 9. seeds 10. peanut butter 11. beans and lentils Include whole grain breads, oats, brown rice, and pasta. 5

6 How should I eat during treatment? (continued) Focus on healthy fats. Healthy fats are generally plant-based rather than animal-based Examples are: Nuts/nut butters Avocado Coconut Olives/Olive Oil Seeds/Seed Oil Vegetable Oil Fish/Fish Oil Include protein rich snacks: 1. yogurt 2. cereal and milk 3. sandwich 4. soup 5. cheese and crackers Multivitamin to ensure you are getting all the vitamins and minerals you need. 6

7 Side effects that may occur from chemotherapy and radiation The following are the most common side effects caused from chemotherapy and radiation. Loss of appetite Taste changes Nausea Constipation Diarrhea Dehydration Low white blood cell count and risk of infections Sore mouth or throat Dry mouth 7

8 Loss of appetite It is normal to experience loss of appetite during chemotherapy or radiation treatment. Aim for 3 5 small, frequent meals of high calorie and high protein foods. Taking a few bites of high calorie high protein foods every hour can make a difference in maintaining a healthy weight. Make every bite count! Try adding these high calorie high protein foods to your meals: Butter and olive oil: Add to potatoes, hot cereals, Rice, noodles, soups, meat, chicken, turkey, and fish Whole milk: Add to mashed potatoes, puddings, cereal, pasta, and hot chocolate Cheese: Add to potatoes, vegetables, omelets, grilled cheese sandwiches, pizza Ice cream: Add to milkshakes, cereal, pies, cookies, waffles Eggs: Increase egg whites to pancakes, French toast, omelets Peanut butter: Add to milkshakes, bread, muffins, crackers, waffles Meat, chicken, turkey, fish: Add to soups, meat sauce, stews, casseroles, and mini sandwiches Nuts and seeds: Add to pancakes, muffins, waffles, fruit, cereal, ice cream, yogurt, vegetables and salads Beans and lentils: Add to soup, pastas, rice, and cheese Whole milk yogurt or Greek yogurt: Add to granola, cereals, fruit, waffles, cookies, pancakes Notes: Make a list of foods that helped with loss of appetite and those that didn t for easy reference. What Worked: What Didn t Work: 8

9 Taste changes Taste changes may be caused from chemotherapy and radiation treatment. A sudden dislike of foods may occur. Continue to try new foods to manage taste changes. Treatment: Avoid foods with strong odors Choose chicken, fish, eggs, and cheese for protein without strong odors Try mints, lemon drops, and chewing gum to reduce bad taste Flavor foods with garlic, onion, ketchup, mustard, barbecue sauce, basil, chili powder Have drinks with a straw or cover drinks to avoid odors Rinse your mouth before eating to clear taste buds with tea, salted water, water with baking soda, or ginger ale Serve foods cold or at room temperature Season foods with tart flavors: lemon, citrus fruits, lemonade (avoid with sore mouth) Adding sugar to foods may reduce bitter or acidic tastes Try using plastic utensils if metallic taste is present Notes: Make a list of foods that helped with taste changes and those that didn t for easy reference. What Worked: What Didn t Work: 9

10 Nausea Nausea can be brought on by treatment and can be triggered by cooking odors, smells, and certain flavors. Try eating more frequent meals slowly. Treatment: Try eating 1 2 hours before treatment Offer 6 8 small meals per day Include easy to digest foods: crackers and plain toast, yogurt, oatmeal, baked or broiled chicken, soft fruits, and vegetables Offer sips of water, broth, ices, Jell-O, fruit drinks Avoid fatty, fried foods, hot and spicy foods Rest after eating Suck on ice chips, sugar-free candy or ice-pops Avoid foods with strong cooking odors or smells Offer dry toast and crackers in the morning if morning nausea is a problem You may ask your doctor for medication to control nausea Ginger is also known to help alleviate nausea Notes: Make a list of foods that helped with nausea and those that didn t for easy reference. What Worked: What Didn t Work: 10

11 Constipation Constipation may occur during treatment. Below are recommendations to help relieve this symptom. Treatment: Eat fiber rich foods: whole grain breads and cereals, beans and lentils, brown rice Drink 8 12 cups of fluid each day Exercise regularly Have a hot beverage Eat dried fruits such as raisins and prunes Include raw fruits and vegetables: apples, pears, oranges, peas, berries Add wheat bran to homemade breads Recommended fiber intake is grams of fiber per day Ask your doctor about over-the-counter treatments if necessary Beverages such as prune juice, warm juices, lemonade, decaffeinated teas may be helpful Notes: Make a list of foods that helped with constipation and those that didn t for easy reference. What Worked: What Didn t Work: 11

12 Diarrhea Diarrhea is defined as having three loose bowel movements in a 24-hour period. Uncontrolled diarrhea can lead to dehydration. Treatment: Offer small frequent meals throughout the day Drink plenty of fluids throughout the day Include foods that are low in fiber and high in calories and protein: farina, cream of wheat, hard boiled eggs, yogurt without fruit, bananas, baked chicken or turkey without skin, fish, lean beef, noodles, rice Avoid fried or fatty foods Avoid raw fruits and vegetables Avoid milk products Limit high-sugar foods, carbonated beverages, and caffeinated beverages Offer foods with sodium and potassium: fat free broths, sports drinks, bananas and mashed potatoes Avoid very hot and very cold foods Avoid strong spices such as curry and hot pepper Notes: Make a list of foods that helped with diarrhea and those that didn t for easy reference. What Worked: What Didn t Work: 12

13 Dehydration Dehydration may occur from losing too much fluid (vomiting and diarrhea) or not drinking enough fluids. Signs of dehydration include: dry mouth, irritability, fatigue, dizziness, extreme thirst, dark colored urine, and confusion. Treatment: Drink 8 12 cups of liquid a day Sip water, ice chips, sports drinks during the day Include foods with liquid in them: soups, ice pops, gelatins, and flavored ices Avoid drinks with caffeine including coffee and tea Drink most liquids between meals Drink even when you are not thirsty Ask your doctor about an anti-emetic (medication to help with nausea) Notes: Make a list of foods that helped with dehydration and those that didn t for easy reference. What Worked: What Didn t Work: 13

14 Low white blood cell count and risk of infections Low white blood cell count can be caused by chemotherapy, radiation, or the cancer itself. Low white blood cell count leads to an increased risk of potentially life-threatening infections. Good hygiene, handwashing, and food safety are extremely important in preventing infections. Treatment: Use antibacterial soap, scrubbing hands seconds several times per day especially before eating Avoid raw or lightly cooked fish and eggs (lox, sushi, shellfish, sashimi, poached eggs, soft boiled eggs, sunny side up, Caesar dressing, and cookie dough) Avoid raw nuts or fresh nut butters Wash fruits and vegetables well under running water Cook meats, poultry, and fish well done until they are no longer pink and the juices run clear Do not thaw meat, poultry, and fish at room temperature; thaw in the microwave or refrigerator Refrigerate groceries immediately Use different utensils for tasting and stirring foods Refrigerate foods at or below 40 degrees Avoid purchasing produce that has been cut at the grocery store, for example, melon Notes: Make a list of foods that decreased overall risk of contamination, and those that may have increased risk of contamination for easy reference. What Worked: What Didn t Work: 14

15 Sore mouth or throat Chemotherapy and radiation often cause mouth sores which can bleed, become infected, and cause pain making it difficult to eat. Treatment: Eat foods that are easy to chew and swallow: scrambled eggs, oatmeal, cream of wheat, puddings, ice cream, yogurt, and bananas Use a straw for drinking Eat foods cold or at room temperature Avoid salty, citrus, spicy, seasoned foods Add bland sauces or gravies to moisten foods Rinse mouth often with water Add high calorie high protein drinks such as Ensure or Boost Avoid dry course foods: dry toast, crackers, raw vegetables Avoid very hot or cold foods Use a blender to make foods smooth Notes: Make a list of foods that helped with sore mouth or throat and those that didn t for easy reference. What Worked: What Didn t Work: 15

16 Dry mouth Dry mouth is often a result of radiation therapy to the head or neck. May affect taste and the ability to swallow food. Treatment: Keep water available at all times to moisten the mouth Increase fluids Include moist foods with sauces, gravies, and salad dressings for easier swallowing Suck on sugar-free mints and candy Ice chips and ice pops can help produce more saliva Offer pureed and soft foods Keep lips moist with lip balm Include foods that are sweet and tart such as lemonade to produce saliva (avoid if you have a sore mouth) Avoid hot or spicy foods Drink fruit nectar instead of juice Notes: Make a list of foods that helped with dry mouth and those that didn t for easy reference. What Worked: What Didn t Work: 16

17 Recipes These quick and easy recipes are a great source of calories, protein, and potassium. Strawberry Banana Smoothie: ½ cup of milk 1¼ cup of strawberries 1½ medium bananas ½ cup of plain whole-milk Greek yogurt 2 teaspoons of honey 3 drops of vanilla extract 4 cubes of ice 465 calories 10 grams of protein Protein Fortified Milk: 4 cups of whole milk 1 cup of nonfat instant dry milk Pour milk into bowl. Add dry milk and beat until dissolved. Refrigerate and serve cold. 1 cup: 211 calories 14 grams of protein High Protein Milkshake: 1 cup of protein fortified milk 2 Tbsp. of chocolate sauce ½ cup of ice cream ½ tsp. vanilla extract Put all ingredients in blender at low speed for 10 seconds 1½ cups: 425 calories 17 grams of protein 17

18 References 1. Modern Nutrition in Health and Disease 10th Edition. Nutrition Support and the Patient with Cancer Cancer.org available at website: Accessed on November 1, Nutrition caremanual.org available at website: Accessed on November 1, Mskcc.org at website: Accessed November 15, Cancer.gov available at website: Accessed on November 15, Cancer.gov at website: Accessed on November 30, 2016 Christ Hospital Outpatient Nutrition Counseling Carepoint Health-Christ Hospital Main Building 176 Palisade Ave. Jersey City, NJ (Please leave a message and we will return your call to make an appointment.) If you want a specialized one-on-one consultation with a dietitian to help you meet your nutritional needs during this time, we highly recommend scheduling an appointment with the outpatient dietitian. 18