Optimizing Nutrition During Treatment for Brain Tumors. Nikki Spurgeon, MS, RDN, LMNT, CNSC

Transcription

1 Optimizing Nutrition During Treatment for Brain Tumors Nikki Spurgeon, MS, RDN, LMNT, CNSC

2 Objectives: Benefits of eating well throughout treatment Common nutritional side effects seen with tumors and with treatment Strategies to help manage side effects Answers to commonly asked questions Resources

3 Nutrition Services Dietitian is available in the inpatient and outpatient settings: Available during hospital stay or via phone, , face to face in clinic, radiation or during infusions Am available upon patient request or when consulted

4 Benefits of eating well through treatment Helps to maintain strength Decreases loss of muscle mass Helps to optimize immune system Promotes healing following treatment Helps to prevent treatment delays or dosereductions

5 Influences that may impact nutritional intake: Nutrition resources can be very confusing! Nutrition in cancer prevention vs treatment Advice from loved ones, people you know Research on the internet Media Stress Energy levels Depression

6 Barriers to receiving adequate nutritional intake Tumor-related: Neurological Symptoms Nausea/Vomiting Fatigue SIADH-?Fluid restriction Treatment-related: Inflammation/steroid use Nausea/vomiting Fatigue Diarrhea/constipation Mouth sores

7 Strategies to aid with nutritional intake Decreased Appetite Small and frequent meals, regular meal/snack times Add a bedtime snack Calorie-containing fluids Nutrient-dense foods Fluids between meals?nutritional drink supplements (ie Ensure, Boost, Carnation Breakfast, etc) or make your own (whey protein and milk or juice, yogurt smoothie) Take medications with caloriecontaining fluids as able Nausea and Vomiting Limit odors CHO-containing foods Small and frequent meals Bland foods (cereal, potatoes, cheese sticks, hard boiled eggs, yogurts, applesauce) Avoid overly spicy, greasy or sweetened foods and fluids Try ginger (ginger tea, ginger soda, crystalized ginger) Stay upright >30 mins after eating *Avoid oral nutrition supplements if nausea is an issue **Optimize nausea medications if needed

8 Strategies to aid with nutritional intake Diarrhea Small and frequent meals often are easiest to tolerate BRATY diet (Bananas, Rice, Applesauce, Toast, Yogurt) Bland foods avoid greasy, fatty or fried foods Drink plenty of fluids (non-carbonated and caffeine-free) Constipation Drink plenty of fluids, try prune juice (noncarbonated); Try drinking a warm beverage Bowel regimen Activity Gradually adding fiber to diet as tolerated If bloated, avoid gasforming foods (beans, broccoli, cauliflower, onions, garlic, etc.)

9 Strategies to aid with nutritional intake Fatigue Make meal prep easier temporarily (convenience food items, frozen meals, prep extra meals when feeling well) Have ready-to-eat snacks available (trail mix, string cheese, dried fruits, pudding, peanut butter/crackers) Use of oral nutritional shakes may be of benefit Be physically active as appropriate Sore mouth Cool or room-temperature foods often easier to tolerate than warm Soft, tender foods Use a straw Non-acidic foods and fluids Avoid alcohol-containing mouth rinses but practice good oral hygiene May consider use of mouth numbing rinses prior to eating Some things to try: applesauce, cottage cheese, mashed vegetables, nutritional or milk shakes, smoothies, cooked cereals

10 Recommendations Nutritional recommendations which are evidence-based Maximize foods that you are able to eat to maintain your strength Goal is to maintain a healthy weight Try to incorporate all food groups in your diet especially when feeling well

11 Commonly Asked Questions

12 Sugar and Cancer: All cells in your body require glucose as fuel Eating sugar has not been linked to cancer growing faster Avoiding dietary sugar will not prevent your body from making the glucose it needs Will break down protein and fats if needed to provide needed nutrients Can lead to unintended weight loss, fatigue, decreased immune function Unwarranted dietary restrictions can also lead to unnecessary anxiety and stress

13 Organic versus Non-organic A personal choice Conventional produce pesticide exposure has been found to be at safe levels Eating fruits and vegetables is important for health reduces risk for heart disease, cancer, obesity, diabetes

14 Vitamin/Mineral Supplements Goal of cancer treatment: Cancer cells to be destroyed Antioxidant supplement use has been found to protect cancer cells IT IS BEST TO OBTAIN NUTRIENTS FROM FOOD AND NOT PILLS Synergistic affect of nutrients in foods provides most benefit If take supplements, it is recommended to not take >100% Daily Value of the nutrient- discuss with doctor or dietitian

15 Resources: Oncologynutrition.org Cancerdietitian.com Cancer.org ABTA.org AICR.com Cancer.gov Quackwatch.com Nccih.nih.gov