Eating Through Illness

There’s no denying it: Facing a chronic illness takes ample amounts of courage, patience, and strength. While no one is ever truly ready to face a battle of such intensity, there is some comfort in knowing nutrition can play a role in helping to aid the body in the healing process.

“Often, with a lot of chemotherapies, cells that are dividing quickly are hit pretty hard after treatment,” says Anthony Dissen, registered dietitian nutritionist (RDN) and instructor of health sciences at Stockton University in Galloway. “This especially applies to cells that line our GI tract—like our bowels and esophagus—which is why some people get mouth sores, stomach irritation, and inflammation, making eating and drinking challenging,” he says, adding it can be a further challenge if people are experiencing nausea, a common side effect of chemotherapy.

Because of this, every bite of food someone is able to take truly counts. “It’s important that food be as nutrient-dense and hydrating as possible, so that’s why broths or smoothies are helpful: because they’re easy to consume,” he says. “Salty foods can stimulate appetite, and sauces, dressings, and gravies can add both flavor and moisture.”

Dissen stresses that everyone’s experience with cancer and cancer treatment is highly individualized, and not everyone’s appetite is affected.

“One of the things I recommend to people is to talk to their oncology team about the type of chemotherapy they’ll be receiving and what the potential side effects are so they can prepare ahead of time,” he says, noting the importance of patients listening to their bodies. People undergoing treatment “may become averse to foods they used to love, become vegetarian, or begin eating meat,” Dissen says.

Their eating habits may change too. “Sometimes when people are going through treatment they may prefer to eat alone rather than with others or in a group—and that’s OK,” he says. “It’s important to allow them to share what’s working for them and what’s not. These changes won’t last forever, and old eating behaviors will likely return once they’re feeling stronger and healthier.”

But until then, planning ahead of time can also put someone ahead of the curve.

Fortunately, oncology nutrition has become ubiquitous with cancer treatment.

“Doctors and the oncology community are really understanding how nutrition care impacts our overall health and keeps our bodies strong in the face of illness like cancer,” says Christina Frescki, clinical nutritionist in radiation oncology at Robert Wood Johnson University Hospital in New Brunswick.

Frescki explains one of the major benefits that oncology nutritionists are able to give patients is to check in with them to monitor any diet or weight changes to be sure they’re able to get enough nutrition.

“If their diagnosis and treatment has anything to do with their head or neck, I try to meet with them as early as possible since radiation in those areas can cause dry mouth, thicker saliva, or can feel like their throat is sunburned—which obviously makes swallowing very difficult,” she says. “I also can guide them through taste or sensation changes and help them understand and manage them. Foods can sometimes taste woody or metallic after treatment, and I can show them ways to make [foods] taste better or have less strong of a taste so they’ll be easier to eat.”

A healthy, well-balanced diet is crucial for our body whether or not it’s faced with a chronic illness. But throughout cancer treatment, diet becomes vital.

“A good nutrition routine before someone starts treatment does play a role in how they respond and tolerate it,” says Danielle Kennedy, registered dietitian (RD) and certified diabetes and education specialist (CDCES) at the Diabetes Foundation in Hackensack, and previous oncology dietitian at the Cancer Treatment Center of America.

“If you have a poor nutritional status or pre-existing malnutrition, it can be more difficult to endure and thrive during treatment,” she says, noting that can mean considering adequate calorie and protein intake beforehand.

“Making sure people are maintaining lean body mass is especially important. You don’t want to necessarily gain weight, but you do want to maintain lean body mass and avoid weight loss prior to treatment,” she says, citing the importance of keeping up with protein. “Protein is going to directly support your body and lean muscle mass, and your calorie intake is going to support your weight,” she says, adding this includes lean animal protein like chicken and fish, or eggs, or plant-based protein like beans or nuts.

“FOOD IS CONNECTED TO JOY, PLEASURE, AND COMMUNITY, AND A LOT OF THIS IS TAKEN AWAY WHEN YOU GO THROUGH A CHRONIC DISEASE LIKE CANCER.”

Kennedy also explains that different types of cancers can affect your metabolism.

“While not fully understood, some tumors have been shown to have an increased metabolic rate and burn more calories,” she says. These tend to be tumors like pancreatic or upper GI tumors.

If one’s appetite is not affected and they’re able to eat, Kennedy recommends keeping up with fruits, vegetables, and whole grains.

“These foods are going to provide a lot of the vitamins and minerals your body needs that may have been depleted,” she says.

Fruits and vegetables contain flavonoids, which are phytochemical compounds that have additional benefits.

“These nutrients help reduce the risk of inflammation, and since cancer can be so inflammatory, eating foods that contain them can support the immune system by reducing inflammation,” she says, adding that one caveat is that if one is battling GI cancer, a fibrous diet should be avoided.

While nutrition can benefit some people pre- and post-chemo-therapy, Kennedy stresses it should only help support the healing process—not be used in place of medicine. That being said, nutrition is not the only importance of food.

“Food is connected to joy, pleasure, and community, and a lot of this is taken away when you go through a chronic disease like cancer,” says Kennedy. “It’s important to maintain what we can of this joy while also considering other factors that can help, like asking what someone needs or how you can be supportive in their journey,” she says. “These are factors that help nourish, too.” □

Importance of Nutritional Support for Cancer Patients
 

“Make sure that the nutrition box has been checked. One way to be sure that it will be part of your treatment planning is to ask if your program has been accredited by the Commission on Cancer (CoC). There are 1,600 of those hospitals around the country, and we’re very fortunate in that there are about 60 of these accredited hospitals here in New Jersey. One of the reasons we’ve seen a significant improvement in survival statistics for cancer patients is the real strong appreciation for nutritional support.” —Dr. Arnold Baskies, MD, FACS, chairman of the Global Health Advisory Council for the American Cancer Society, who serves on the Greater NYC and Philadelphia area boards

How Friends and Family Can Help During Cancer Treatment

Courtesy of Danielle Kennedy, registered dietitian (RD) and certified diabetes and education specialist (CDCES) at the Diabetes Foundation in Hackensack (previous oncology dietitian at the Cancer Treatment Center of America)

It’s always good to have friends and family help with treatment. Talk to the person impacted by cancer, see how can you can help, whether that helping is to cook meals or just to provide company. Ask them what foods are working for them and prepare small-portioned meals that can be frozen. Sometimes being in front of a large meal can just make people nauseated. It’s also good to have things that are easy to prepare. A lack of energy after chemo and radiation is a real thing. It knocks you down.

Here are some simple small snack ideas that are easy to prepare. (Adjust ingredients to suit individual needs.)

• Protein balls or bars—Combine protein powder, almond butter, chocolate chips, oats; add almonds or walnuts or cranberries; and add honey or maple syrup to bind ingredients together. Rolls into balls or spread into a pan, then cut into bars and freeze.
• Egg muffins—Mix up eggs with favorite vegetables and cheese and bake them in a muffin tin. These little protein-rich quiches are easy to freeze and reheat.
• Avocado toast
• Yogurt with fruit with nuts
• Variation of smoothies—Smoothies work well because they’re easy to eat and digest. Try adding nut butter, protein powder, spinach or kale, fruit (berries are especially high in phytonutrients), and add a protein-rich liquid like soy or almond milk. Add orange juice or honey if desired, and blend.

Also, if you can, encourage your friend or family member to either take a walk, walk in place, or stand up and sit down, if they are able. Simply moving the body is helpful for circulation, keeps nausea away, and can help preserve muscle mass.