Thursday 17 January 2019

Cancer: Eating well before, during & after

We are bombarded with misleading information about diet and cancer, which is why you really need to know the facts. Registered dietitian Fiona Roulston answers your queries

Eat a wide variety of fruit and vegetables
Eat a wide variety of fruit and vegetables
Fiona Roulston, Dietitian manager

There are many myths out there about diet and cancer, and unfortunately much of the information we read and hear simply isn't true.

What is true is that cancer prevention research has shown that as well as improving general health and well-being, a healthy diet and regular physical activity can help reduce the risk of cancer.

The World Cancer Research Fund recommends maintaining a healthy body weight, being physically active and eating a balanced diet rich in wholegrains, fruit, vegetables and pulses. There is scientific evidence to show that alcohol causes several types of cancers including liver, oesophageal, and throat cancer.

How can I reduce my risk of developing cancer?

Fiona Roulston, Dietitian manager
Fiona Roulston, Dietitian manager

1. Keep your weight as low as you can within the healthy range.

2. Be physically active for at least 30 minutes every day and sit less.

3. Limit high calorie foods (particularly processed foods high in fat or added sugar, or low in fibre) and avoid sugary drinks.

4.Eat a wide variety of wholegrains, vegetables, fruit and pulses, such as beans and lentils.

5. Eat no more than 500g (cooked) a week of red meat such as beef, pork and lamb. Eat little, if any, processed meat such as ham and bacon.

6. For cancer prevention, it's best not to drink alcohol. If you do, limit alcoholic drinks and follow national guidelines.

7. Limit your salt intake to less than 6g salt a day.

8. Eat a balanced diet rather than relying on supplements to protect against cancer.

I've been diagnosed with cancer. What should I be eating?

Eating well during cancer treatment generally means eating a diet rich in wholegrains, vegetables, fruit and pulses, with lean meat, fish and dairy products. This can help maintain a healthy weight, provide enough energy for everyday activities and help to deal with treatments.

It's important to remember that the goal of nutrition is not to treat the cancer, but to maintain the person and keep them strong so they can withstand their cancer treatment.

For some people with cancer, a regular balanced diet may not always be suitable. Research shows that weight loss, especially loss of muscle, during cancer treatment can reduce survival. Cancer patients who experience unintentional weight loss should see a registered dietitian for individualised dietary advice.

Cancer treatments can have different effects for each person and the side effects of treatments can vary. Chemotherapy side effects can depend on the individual drugs. Radiation therapy mainly affects the area of the body being treated.

Here are some of the side effects of treatment and tips on how to cope with them:

I've lost my appetite due to treatment. WHat can I do?

Eat little and often. Choose small, nourishing meals and snacks. High protein snacks include yoghurts, crackers and cheese, pitta bread and hummus, nuts and seeds.

• Eat your biggest meal when your appetite is best.

• Limit drinks before and during meals as they can make you feel full.

I'm exhausted and too tired to cook

• Stock up on tinned foods and ready meals for days when you don't feel like cooking.

• When you do feel like cooking, make extra portions and freeze them.

• Ask family and friends to help.

Chemo has made me nauseous. Are there any foods that will help?

• Avoid greasy, spicy or strong-smelling foods. Choose plain, soft, easy-to-digest foods instead.

• Try dry foods, eg crackers, toast or foods or drinks made with ginger.

• Eat little and often, as an empty stomach can worsen nausea.

my food tastes funny after chemo

• Rinse your mouth regularly with water and baking powder solution

•Suck on pineapple chunks before meals.

• Add extra seasonings or flavourings to your food. If meat tastes unpleasant, choose other sources of protein such as poultry, fish, eggs, dairy products or beans.

My mouth is sore and very dry

• Avoid very hot, spicy, acidic or salty foods, and alcohol.

• Choose soft, moist foods, or puree your foods if you need to.

• Avoid rough, textured or dry foods.

• Keep your mouth clean.

• Sip fluids regularly.

• Try sucking on hard-boiled sweets, pastilles or sugar-free gum to stimulate saliva.

Treatment has affected my digestive system

• If you have diarrhoea, stay hydrated. Avoid spicy foods, alcohol and caffeine.

• If wind is a problem, limit beans, cabbage, sprouts, onions, and fizzy drinks.

• If you're constipated, choose wholegrain bread and cereals and plenty of fruit and vegetables.

• Drink at least 8-10 cups of fluid a day.

• Try drinking a small glass of prune juice.

I'm worried about getting an infection. How can I ensure my food is safe?

Treatments such as chemotherapy can cause a fall in the number of white cells in the blood and when this happens there is a higher risk of infection or food poisoning. Therefore, it is important to practice good food hygiene.

• Wash your hands when you prepare food and make sure all utensils and surfaces are clean. Wash all fruits and salad vegetables.

• Ensure your food is always cooked properly. Avoid undercooked meat, poultry, fish and eggs. Avoid unpasteurised dairy products.

• Check use-by dates and do not use foods that are out of date.

Fiona Roulston is a CORU registered dietitian with a BSc (Hons) in Human Nutrition & Dietetics and is a member of INDI, the professional body for regulated dietitians in Ireland. She works as a dietitian manager in radiation oncology.


How can I access help after treatment?

After cancer treatment, cancer survivors should follow the cancer prevention recommendations opposite to help prevent cancer recurrence. However, some side effects of treatment can linger and if cancer treatment has affected the ability to eat or digest some foods, it's best to get specialist advice from a dietitian, doctor or specialist nurse.

A referral to a registered dietitian can be organised by an oncologist, specialist nurse or GP. Alternatively, to book an appointment with a freelance registered dietitian, details can be found at:

Irish Nutrition & Dietetic Institute,

Self Employed Dietitians of Ireland,

The biggest myths busted

Misinformation about nutrition and cancer is rife and can have devastating consequences for people with cancer. It is understandable that a person diagnosed with cancer would consider trying anything that might help make them better and give them a greater sense of control. However extreme 'cancer diets' can be harmful. Some of the common diet myths include:

• Whether it be an alkaline diet, a vegan diet or juice diet - remember there is no proof that diet can treat or cure cancer. These diets can be restrictive and can result in nutrient deficiencies.

• Cutting out sugar and carbohydrates to 'starve the tumour' - this idea oversimplifies a complicated process. All cells in the body use a type of sugar called glucose as a source of fuel. As cancer cells divide more rapidly than normal cells they use more glucose. However the body tightly regulates the glucose level in the blood and there is no scientific evidence that cutting out sugar or carbohydrate foods starves a tumour of glucose.

• High doses of supplements - high-dose anti-oxidant supplements may interact with cancer treatments and drugs so are not recommended.

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