Free Prescriptions All cancer patients undergoing treatment for cancer, the effects of cancer or the effects of cancer treatment can apply for an exemption certificate for a free prescription from their GP. How can I help reduce healthcare associated infections? Infection control is important to the well-being of our patients and for that reason we have infection control procedures in place. Keeping your hands clean is an effective way of preventing the spread of infections. We ask that you, and anyone visiting you, use the hand rub (special gel) available at the main entrance of the hospital and at the entrance to every ward before coming in to and after leaving the ward or hospital. In some situations hands may need to be washed at the sink using soap and water rather than using the hand rub. Staff will let you know if this is the case. www.buckshealthcare.nhs.uk Issued by: Date: Healthy eating for people with cancer Resource 1 Information for Patients This booklet is designed to give healthy eating advice for people who have cancer If you require a translation or an alternative format of this leaflet please ask for assistance Author: Macmillan Dietitians Issue date: May 2010 Reviewed: September 2016 Review date: September 2018 Leaflet code: CISS - 26 Version: 4
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Increase Your Activity Levels Gentle exercise helps you to maintain a healthy body weight to manage fatigue. It is recommended we do 30 minutes of exercise 5 days a week. This includes: walking swimming dancing cycling golf horse riding house work gardening Choose activities that you enjoy and fit in with your life. If you haven t done any exercise for a while it is important to gradually build up the amount you are doing. Introduction If you have any difficulties eating or have lost any weight we have more specific advice for you. Please ask for Resource 2 on Eating well with a small appetite. A referral to the Macmillan Dietitians may be appropriate. Main Aims: Enjoy your food. Eat a variety of food. Eat regular meals, never skip meals. Watch your intake of fatty or sugary foods. Watch your alcohol intake. Try to maintain a healthy body weight. Keep active Eating Well a balanced diet for every day 12 The Eatwell guide (see centre pages) shows the different types of foods and the proportion you need to eat them in to have a well-balanced and healthy diet. The guide represents how to eat over a day or a few days, not just one meal. By choosing a variety of foods from each group in the guide, your body will get a wide range of nutrients to help you stay healthy. Over the next few pages we will look at each component of the guide in more detail. 1
1. Fruit and Vegetables Eat lots! A third of your total food intake should be fruit and vegetables. Aim to have at least 5 portions per day. This could be either fresh, frozen, tinned or dried fruits and vegetables all count towards your 5-a-day and are good sources of vitamins and minerals. One portion is 80 grams, which is equivalent to: 1 apple / 1 banana / 1 orange. 2 small fruits i.e. kiwi fruit /Satsuma's /plums. 1 small glass (150 mls) of orange juice. 1 heaped tablespoon of dried fruit. 1 small bowl of fruit or fruit salad. Side salad or bowl of salad. 3 tablespoons of vegetables or pulses. Fruit juice and smoothies only count as maximum of one portion per day; this is due to the high free sugar content and lack of fibre. Nutrient imbalances and toxicities can occur when large doses are taken. If you have any queries about other supplements or food additives please discuss with your health care professional. Alternative Diets Some complementary or alternative diets claim to cure or control cancer using a diet and many patients are unsure whether to follow these or not. If you are thinking of following any of these diets, please discuss it with your health professional first. To date there is no scientific evidence to support claims made by alternative diets. These diets are potentially harmful because they are often low in energy (calories) and protein and/or tend to be bulky, making them very filling. Therefore they can cause weight loss in people who are already experiencing problems eating due to their cancer treatment. 2 11
Other foods and supplements Probiotics These good bacteria found in food products or supplements, may benefit our health by improving the types of bacteria in our gut (bowels). If you are healthy and well they have been found to be safe to take. However, if your immune system is not working properly or you are on chemotherapy, you should not take them. If you are unsure discuss with your healthcare professional. Vitamins and minerals Most people when they are well are able to get all of the nutrients that they need from a balanced and varied diet. There is one exception to this - Vitamin D. The main source of Vitamin D is sunlight, and although it is found in some foods (e.g. oily fish, red meat, liver, egg yolks, fortified cereals and spreads), it is difficult to get enough Vitamin D from diet alone. All adults and children over one year should consider taking a daily supplement of 10micrograms of Vitamin D, especially during autumn and winter. Some at risk groups (pregnant women/breastfeeding mothers, people over 65, people with darker skin tones, people who cover their skin outside, people who spend very little time outside in the summer) should consider taking a daily supplement of 10mcg Vitamin D all year round. If you wish to take a vitamin and mineral supplement as an insurance policy to ensure you are getting all of the nutrients you need, choose a general multi-vitamin and mineral supplement providing at least 15 nutrients less than 150% of the Recommended Daily Allowance (RDA). 10 2. Potatoes, bread, rice, pasta and other starchy carbohydrates Starchy foods are generally low in fat and you should base your meals around these foods to make up a third of the food you eat. Choose wholegrain or high fibre options as they contain more nutrients than white alternatives and will make you feel fuller for longer. These foods are good sources of soluble and insoluble fibre. Fibre rich foods help keep your bowel healthy and can help prevent bowel cancer. Soluble fibre can be partially digested and may help to reduce the amount of cholesterol in the blood and control blood sugars. Good sources of soluble fibre include oats and pulses such as beans and lentils. Insoluble fibre passes through the gut undigested and helps other food and waste products move through the gut more easily and so prevents constipation. Insoluble fibre is found in wholegrain bread, brown rice, wholegrain breakfast cereals and fruit and vegetables. To increase your fibre intake: Eat five portions of fruit and vegetables per day Eat plenty of bread, try wholemeal or multigrain Try eating more potatoes, particularly baked or boiled (with skins) Try high fibre cereals e.g. Weetabix, Shredded Wheat, Bran Flakes or porridge Add chick peas, beans and lentils to soups, stews or casseroles 3
4 3. Dairy and alternatives Aim to have 2-3 servings of these foods per day to help keep your bones and teeth strong and healthy. One portion equals one small pot of yoghurt, 1/3 pint of milk or a matchbox size piece of cheese. Choose low fat options where possible, as they contain less fat but similar amounts of calcium to their full fat versions. If you are using a dairy alternative, choose unsweetened, calcium-enriched options. 4. Beans, pulses, fish, eggs, meat and other proteins Choose a variety of protein rich foods and aim to have 2-3 servings per day. Protein is essential for the body to help repair itself and build muscle. Meat is a good source of iron, zinc and B vitamins. However, as meat can also be high in fat, choose lean options like turkey and chicken and aim to eat no more than 70g red meat (e.g. beef, pork, lamb) per day. Try to avoid processed meat (e.g. bacon, sausages, salami). Aim to include at least two portions of fish per week; one of which should be oily. As well as protein, fish also contains vitamins and minerals and oily fish is particularly rich in omega 3. Other good sources of protein include eggs, pulses (beans and lentils) and nuts. Pulses are good alternatives to meat as they are also naturally low in fat and contain fibre, vitamins and minerals. Alcohol Drinking alcohol has been linked to certain cancers as well as other health problems and, for cancer prevention, it is best to avoid alcohol completely. If you are trying to lose weight, remember alcohol contains a lot of calories. The current UK guidelines advise that men and women should not exceed 14 units of alcohol in a week and aim to spread consumption over at least three days. A unit calculator may be useful (have a look at Alcohol Concern s calculator https://www.alcoholconcern.org.uk/help-andadvice/help-and-advice-with-your-drinking/unit-calculator/ to help you see how much you are having). Alcohol unit guide: 1 pint of premium strength bitter/lager/cider 3 units 1 pint of ordinary strength beer/lager 2 units 1 standard glass of wine (175ml, ABV 12%) 2.1 units 1 large glass of wine (250ml, ABV 12%) 3 units 1 single shot of spirits (25ml, ABV 40%) 1 unit Food Labels Food labels can often be difficult to understand. Even low fat versions of foods may still be relatively high in fat. As a guide: Per 100g: High Low 22.5 g of sugars 5.0 g of sugars 17.5 g of fat 5.0 g of saturated fat 3.0 g of fat 1.5 g of saturated fat 3.0 g of fibre 0.5 g of fibre 1.5 g of salt 0.3 g of salt 9
6. Foods high in fat, salt and sugar Things like sweets, cake, biscuits, crisps, chocolate, sugary soft drinks and ice cream are not needed in our diet these foods should be eaten infrequently and in small amounts. Eating a lot of foods that contain added or free sugar can also contain lots of calories and contribute to weight gain. No more than 5% of your daily energy consumption should come from free sugars this is equal to 30g or 7 sugar cubes for adults. Try to reduce your sugar intake by: 7. Fluids Choose a low calorie or diet fizzy drinks or squash. Trying a sweetener instead of sugar in drinks. Buying fruit tinned in natural juice rather than syrup. Avoid buying sugar coated and honey coated breakfast cereals. Instead of cakes or biscuits, try having a currant bun, scone or some malt loaf with low-fat spread. Trying sugar free versions e.g. sugar free jelly / custard To ensure that you stay well hydrated, aim to have 6-8 glasses of fluid every day. This could be water, milk, tea/coffee or any type of low sugar drink. Make sure to limit fruit juice or smoothies to one 150ml glass per day as they are high in free sugars.. 5. Oils and spreads Fats are essential to our wellbeing. Choose unsaturated products and eat in small amounts only as they are also a major source of calories. Eating a diet high in fat, especially saturated fat can lead to raised cholesterol and an increased risk of heart disease. Ways to reduce your fat intake: Choose a low fat spread Choose skimmed or semi-skimmed milk instead of full cream milk. Try using low fat or diet yoghurts (check sugar content). Try using half fat hard cheese, or cottage cheese or have a small portion (1oz) of a strong flavour cheese. Avoid frying or roasting foods, try boiling, poaching, grilling or microwaving instead. Remove visible fat or skin from meat before cooking. Use more vegetables and beans and a bit less meat in stews and curries. Reduce the number of fatty takeaways (such as burgers, curries and kebabs). Avoid high fat snacks such as pastries, crisps, cakes and biscuits and chocolate. 8 5
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