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Tips to boost nutritional intake during chemotherapy

Alicia Romano, MS, RD a registered dietitian at Tufts Medical Center. Maintaining a good nutritional status is an important part of cancer treatment; however this is sometimes easier said than done due to to unwanted side effects such as nausea, diarrhea and poor appetite.  That's why Alicia Romano, MS, RD, a registered dietitian at the Tufts Cancer Center in Boston has provided a few tips to help you boost your nutrition and hydration during chemotherapy while offsetting side effects.

1. Try eating small frequent meals and snacks

If having nausea and poor appetite, try eating small frequent meals and snacks, every 2-3 hours rather than eating 3 large meals.  Choose finger foods & other snack-sized food items that appeal to you.  Add calorie booster foods to your meals and snacks to get the most bang for your buck- this can include nut butters or nuts, oils or butter, honey, ripe avocado, whole fat Greek yogurt, sour cream, etc.

2. Stay hydrated

Chemotherapy can be very dehydrating.  Do the best you can to keep up your fluid intake. Keep a water bottle on hand and sip frequently throughout the day.  Add a squeeze of lemon or other citrus to make your water more palatable.  Sip on drinks at the temperature that appeals to you most (for example, warm beverages such as tea or hot water with lemon may be more soothing).  Include beverages with calories such as juice, milk, decaf tea with honey and oral nutrition supplements (Boost, Ensure).  If having diarrhea, trial G2 (Gatorade 2) or pedialyte to replace electrolytes. Remember, any food that is liquid at room temperature is considered a liquid- include items such as popsicles, fruit ice, ice cubes, etc in your diet to increase fluid intake.

3. Go for foods that are easy on the stomach and that appeal to your sense of smell

If you are having nausea, vomiting or an “upset stomach” go for foods that are easy on the stomach and that appeal to your sense of smell. Trial bland foods such as toast, dry cereal & dry crackers. Sip on ginger ale or tea with honey. Avoid strong smelling foods and heavy/fried/greasy foods, which may exacerbate your symptoms. Trial foods that are served cold or at room temperature. Again, focus on small frequent feedings and most importantly, do not force yourself to eat if you’re feeling nauseous.  Focus on eating the best when you are feeling the best.

4. Increase your fiber intake

You may experience diarrhea or constipation as a side effect of your chemo.  If having diarrhea, increase the amount of soluble fiber in your diet.  This includes rice, bananas, bread, cereals, oats, potatoes & applesauce.  Limit roughage, sugar free candies & gas forming foods & beverages (such as soda, cruciferous vegetables, beans & lentils and chewing gum).  Keep up with your fluid intake- include 1 additional glass of fluid after each bowel movement.  If experiencing constipation, increase the amount of fiber in your diet, buy increasing fruits, vegetables and whole grains and maintain adequate hydration.

5. Don’t be afraid to ask for help.

Between fatigue, nausea and poor appetite, the desire to cook and prepare food may not be at the top of your list.  Ask family members or friends to help prepare foods that you desire.  Keep convenience foods on hand that require little preparation- this can include yogurt, cottage cheese, fruit cups, toast, nut butters, soup and broth and ready to drink nutrition supplements (Ensure, Boost, Carnation Instant Breakfast).

Sometimes your side effects may not be managed by your food choices alone.  Make sure to communicate with your medical team regarding specific symptoms you are experiencing.  There may be medications & other remedies that will maximize the management of these symptoms and make you more comfortable.

If you are experiencing any difficulty eating during your treatment, ask to speak to a Registered Dietitian. He/she will be able to make specific recommendations to help you manage these symptoms and maintain your nutrition.

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