Maintaining weight and proper nutritional status is a significant challenge during cancer treatment. Weight loss is a common side effect, often resulting from the cancer itself and aggressive treatments like chemotherapy and radiation. The body needs sufficient calories and protein to maintain muscle mass, repair tissues, and support immune function. Focusing on practical, high-density nutrition strategies helps ensure the body has the energy reserves needed to tolerate therapy and improve quality of life.
Understanding Cancer-Related Weight Loss
Weight loss in cancer is a complex biological issue that goes beyond a reduced appetite. This condition, termed cancer cachexia, is a metabolic syndrome characterized by an involuntary loss of muscle mass. It differs from typical starvation because the disease fundamentally alters the body’s energy use.
Tumors release inflammatory chemicals called cytokines, which interfere with the normal metabolism of proteins, carbohydrates, and fats. This inflammatory state causes the body to break down muscle tissue at an accelerated rate, creating a catabolic environment. This metabolic dysfunction explains why specialized dietary approaches focusing on high-density nutrients are necessary.
Maximizing Calorie and Nutrient Intake
The most effective strategy for weight gain is to increase the energy density of the food consumed, maximizing calories and protein in small volumes. Food fortification involves adding calorie- and protein-rich ingredients to existing meals without significantly increasing the portion size. For example, powdered milk can be stirred into soups or sauces, and butter or olive oil can be generously added to vegetables, rice, pasta, and potatoes.
Prioritizing Density
Prioritizing fats and proteins is essential for maximizing density. Full-fat dairy products, such as cream cheese, cottage cheese, and whole milk, provide a calorie boost compared to low-fat alternatives. High-calorie snacks like nuts, seeds, avocados, nut butters, and dried fruit offer concentrated energy. These items should be kept readily available for grazing throughout the day.
Strategic Eating Patterns
Strategic eating involves shifting from three large meals to small, frequent meals or snacks consumed every two to three hours. This approach is often better tolerated, especially when appetite is low or early fullness occurs. Liquid nutrition, such as homemade smoothies or commercial oral nutrition supplements, can be particularly helpful. Drinking liquids requires less effort than chewing and swallowing, and they can be fortified further with ingredients like protein powder or nut butter.
Practical Tips for Managing Eating Obstacles
Treatment side effects often create physical barriers to consumption, requiring distinct management techniques to maintain adequate intake.
Nausea and Vomiting
Nausea can be eased by avoiding foods with strong odors, as warm foods tend to release more smells that trigger discomfort. Eating bland, low-fat, easy-to-digest items, such as toast, crackers, or plain yogurt, helps keep something in the stomach. Eat small amounts slowly and drink liquids at least 30 minutes before or after a meal, rather than with it, to prevent feeling overly full.
Taste Changes (Dysgeusia)
Changes in taste and smell, known as dysgeusia, are common and can make previously favorite foods unappealing. If a metallic taste is present, using plastic utensils instead of metal can help reduce the sensation. Marinating meats in sweet or tart sauces, or trying strong flavors like citrus (if tolerated), may help stimulate the taste buds.
Dry Mouth and Sore Throat (Mucositis)
Dry mouth and sore throat, or mucositis, necessitate a focus on soft, moist foods that are easier to swallow. Using gravies, sauces, and melted butter can moisten dry foods like meat and bread. Avoid acidic, very salty, or spicy foods, as these can irritate a tender mouth or throat lining.
Consulting Your Healthcare Team
A generalized approach to nutrition is rarely sufficient, underscoring the need for professional oversight. The oncology team, including the doctor and nurse, can assess for underlying medical causes of poor intake and manage symptoms like pain and nausea. In some cases, they may prescribe appetite stimulants, such as megestrol acetate or low-dose olanzapine, to help improve appetite and promote weight gain.
The Role of the Registered Dietitian
A Registered Dietitian (RD) specializing in oncology is a necessary resource for creating a personalized nutrition plan. An RD calculates specific calorie and protein needs, typically ranging from 25 to 30 kcal/kg of body weight and 1.0 to 1.5 g/kg of protein per day. They adjust the plan based on the type of cancer and stage of treatment. This expert guidance ensures that nutritional interventions are safe and align with the patient’s clinical status.
Oral Nutrition Supplements
Oral Nutrition Supplements (ONS) are pre-packaged, high-calorie, and high-protein liquids that an RD may recommend to bridge nutritional gaps. While ONS provide a concentrated source of energy, they should be used under professional guidance as part of a comprehensive strategy. The overall goal is to integrate medical interventions, symptom management, and a highly dense diet to proactively maintain strength throughout the cancer journey.