Inflammatory and metabolic changes associated with cancer are a major cause of an appetite decrease. Anorexia is one of the most common problems associated with the treatment of cancer patients and the progressive loss of appetite may lead to weight loss, malnutrition and loss of muscle mass.
Cancer treatment, surgery, radiation therapy and chemotherapy can also affect the appetite and the ability to tolerate certain foods and nutrients. In addition to the disease itself, other factors such as a reduction or total lack of physical activity, pain or psychological alterations can contribute to the worsening of this condition.
Nutrition is an important part of cancer treatment. During treatment, patients should eat food rich in protein and micronutrients to help maintain nutrition and energy.
Guidelines for patients with the object of improving the ingestion of food:
1. Eating small portions of food slowly, in a pleasant atmosphere;
2. Having 5-6 meals daily. Opting for high energy food, preferably for breakfast when there is more appetite. Eating snacks often;
3. Drinking 6-8 glasses of water a day or any other liquid (infusions or tea), preferably between meals. For patients that have difficulty feeding themselves and need an extra intake of calories, a milkshake where four basic elements have been added is beneficial: fruit, yoghurt, cereal and dried fruit should be added to milk. Other liquids may also help: fresh fruit juice, soups and fruit smoothies;
4. Maintaining oral hygiene is of utmost importance;
5. Physical activity may also improve appetite, especially if practised 15 minutes before meals, with a rest period of 20 minutes after meals;
6. Preferring simple and easy-to-digest meals, during periods of poor appetite:
■ Carbohydrates: toast, biscuits, bread, rice, pasta or cereal
■ Vegetables: potatoes, pumpkin, onions, garlic and carrots
■ White meat: chicken, turkey, rabbit)
■ White fish (hake, sole, grouper, sea bream, sea bass and conger)
■ Desserts: yoghurt, ice cream, pudding or jam (apple, pear), banana
■ Fresh cheese, boiled or poached egg;
7. Avoiding places smelling strongly of food also helps;
8. Defining a set time daily for going to the toilet;
9. It is also important to check weight weekly, preferably in the morning.
When a diet is inadequate or not sufficient due to difficulty in eating solid food, it is necessary to change the diet by adding nutritional supplements, thereby increasing the intake of specific nutrients which are essential in the treatment of cancer.
Some studies have shown that after cancer treatment, the most effective form of oral supplements, with proven best results in terms of nutrition, are high protein supplements with added calories. These are available in various flavours. These supplements are added to the normal diet as a complement; they must not replace a meal.
Diet is part of the multidisciplinary treatment of a cancer patient and seeking advice from a dietitian during cancer treatment can help reduce treatment-related symptoms, improve appetite and quality of life.
By Soraia Santos
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Soraia Santos is a nutritionist working at the Hospital Particular do Algarve.
