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Food and Nutrition Facts No. 24 in a series providing the latest information for patients, caregivers and healthcare professionals www.LLS.org Information Specialist: 800.955.4572 Highlights ●● Rinse fruits and vegetables well, BEFORE peeling, so dirt and bacteria are not transferred onto the fruit or vegetable. ● Many nutrition professionals agree that eating Cut away any damaged or bruised areas before preparing different foods rich in nutrients is important to or eating. Throw away the outside leaves of a head of maintain and improve good health. lettuce or cabbage. ● Patients who eat well and keep or achieve a healthy ●● Use separate dishes, cutting boards or utensils when weight usually manage treatment side effects better. preparing raw or cooked meat, fish or poultry. Do not use the same serving dishes and utensils for meat, fish and ● Certain foods may cause a bad reaction with some poultry after they are cooked. of the drugs that are used to treat cancer. Members ●● Do not rinse raw meat and poultry before cooking because of your treatment team will tell you which foods bacteria can spread to the sink or countertops. to avoid. ● You may want to ask your doctor to refer you to a ●● Keep raw eggs, meat, poultry, seafood, and the juices of registered dietitian for specific nutrition advice all food that will be cooked away from foods that won’t be and guidance. cooked. ● Cancer research related to nutrition is still in its early ●● Thaw frozen items in the microwave or refrigerator, not stages. It may be hard to find truthful, honest advice on the kitchen counter. Thaw foods by using one of the because of the myths and misinformation about following methods: this subject. {{ Put the food item in the refrigerator 1 day before cooking {{ Use the defrost setting on a microwave. Cook right away. Introduction ●● Marinate food in the refrigerator. Eating well is important for everyone. The types and ●● Use a food thermometer to make sure that meat is amounts of foods that we eat affect our energy levels, our fully cooked. moods and how we feel about ourselves. A healthy lifestyle plays a key role in keeping the body strong, supporting the ●● Read the expiration dates on food products and look for immune system (the cells and proteins that defend the body signs of food spoilage. If in doubt, throw it out. Don’t against infection) and reducing risk for some diseases, such taste food that looks or smells “funny” or bad. Leftovers as certain kinds of heart disease and some types of cancer. should be used within one to four days depending on the food product. Refrigerate or freeze all cooked and perishable food within two hours of purchasing and Food Safety preparing. Refrigerate ready-to-eat food and leftovers right Handling food safely is important for everyone. People who after you eat. Take special care to quickly store rice and o are being treated for cancer can have weakened immune pasta below 40 F if you plan to re-use it. Grains, such systems, which increases their risk for illness caused by food. as rice and pasta, can contain bacterial spores that may Safe food handling includes the following guidelines: lead to food poisoning. Ideally use cooked rice and pasta within 24 hours. ●● Keep your hands, counters, dishes, cutting boards, sinks, ●● After grocery shopping, go directly home and put knives and utensils clean. perishable food into the refrigerator or freezer right away. ●● Wash dishtowels often. ●● If you need to make a stop after grocery shopping, ●● Wash sponges in the dishwasher regularly along with your place perishable foods in an insulated bag or cooler with dishes or boil the sponges for five minutes to remove bacteria. gel packs. FS24 Food and Nutrition Facts I page 1 February 2017 Food and Nutrition Facts Here is an easy way to remember food safety basics. A healthy diet limits saturated fats and trans fats (e.g. Clean – wash hands and surfaces often. butter) to less than 10 percent of all calories consumed each Separate – keep different types of foods apart. day. Consume less than 10 percent of calories per day from Cook – ensure food is cooked to proper temperatures. added sugars. Consume less than 2,300 mg of sodium (salt) Cooked food should be steaming hot all the way through. per day. Food can also be tested by a thermometer and should Drink water, tea and coffee to maintain hydration. Consider o maintain a temperature of 160 F for 2 minutes in the center decaffeinated beverages if you are experiencing diarrhea or of the thickest area. reflux, as caffeine may make these symptoms worse. Avoid Chill – refrigerate promptly. sugary drinks such as soda. The Partnership for Food Safety Education (PFSE) educates Discuss drinking alcohol with your doctor before the public about safe food-handling practices. The PFSE consumption. If you do drink, do so in moderation. This website offers additional information and also has fun ideas means having no more than 1 drink a day if you are a for children regarding food safety. woman and no more than 2 drinks a day if you are a man. Partnership for Food Safety Education (PFSE) One drink equals: (202) 220-0651 {{ www.fightbac.org 12 ounces of beer {{ 5 ounces of wine {{ Nutrition During and After Cancer 1.5 ounces of 80-proof liquor. Treatment For more information and resources to help plan a healthy Eating well helps people living with cancer feel better and diet see: www.cancer.gov/publications/patient-education/ stay stronger during and after cancer treatment. If you eat eating-hints or www.choosemyplate.gov. well and keep or achieve a healthy weight, you will usually In addition to good nutrition, a healthy lifestyle includes manage the side effects of treatment better. Good nutrition also helps the body replace blood cells and healthy tissues that ●● Maintaining or achieving a healthy weight are damaged as a result of cancer treatment. ●● Drinking enough fluid Many nutritionists agree that eating a variety of foods is ●● Exercise. This is an important part of a healthy lifestyle the best method to ensure intake of all the nutrients that and can reduce anxiety, fatigue and improve heart function the body requires. A healthy eating pattern includes a and feelings of self-esteem. Consult your doctor before combination of the following food groups to a calorie intake beginning a new exercise program. Gradually increasing level that maintains a healthy body weight. exercise levels, through low risk activities like short daily walks, can be the best method to start an exercise program. A healthy diet includes ●● Relaxation (managing stress) ●● A variety of vegetables including legumes (beans and ●● Getting enough sleep (for adults 7 to 9 hours sleep per peas). Approximately 50 percent of your plate should be night is recommended) vegetables not including potatoes. ●● Fruits, especially whole fruits. ●● Not using tobacco or abusing drugs, and limiting or not drinking alcohol. ●● Grains, half of which should be whole grains. Limit refined Foods cannot be used to treat cancer, but some things you eat grains like white rice and white bread. or drink and some actions you avoid can make a difference ●● Fat-free or low-fat dairy (e.g. milk, yogurt, cheese and/or in your health and how you feel. For example, it’s important fortified soy beverages). to know if what you eat is causing a bad reaction with your ●● A variety of protein foods including seafood, lean meats, medication. It’s also important to know how much you poultry, eggs, beans, nuts, seeds and soy products. should eat to achieve or maintain a healthy weight and also be aware of how much water you are drinking. ●● Oils. Use healthy oils like olive oil and canola oil for cooking and in salad dressings. FS24 Food and Nutrition Facts I page 2 Food and Nutrition Facts Cancer Drug Treatment and Nutrition Decreased appetite can be very challenging and distressing Certain foods may cause a bad reaction with some of especially when it results in weight loss. It can be difficult the drugs that are used to treat cancer. Members of your for patients and families to cope with changes in food likes treatment team will tell you which foods to avoid. and dislikes and eating behavior that is caused by decreased or changed appetite. If appetite continues to be poor, your When you begin a new treatment or start using a new drug, doctor may wish to try an appetite stimulant. it is a good idea to tell your doctor about any food allergies you The following nutrition tips can help you to get the most have and all vitamin and herbal supplements you are taking. nutrition out of each bite of food when decreased appetite is You should also ask the following questions: a problem: ●● Will I have any special nutritional needs while taking this ●● Eat small meals or snacks frequently throughout the day. medication? ●● Keep prepared snacks or small meals on hand and be sure ●● Do I need to take this medication with food or should I to take them with you when you will be away from home. take it without food? ●● Try high calorie liquids such as juices, soups or shakes if ●● Are there any known vitamins or drug supplements that I eating solid foods is a problem. shouldn’t take while undergoing this treatment? ●● For extra calories, add gravy, milk, butter or cream to your ●● Are there any foods or beverages I should avoid during this food whenever possible. treatment? ●● Do I need to drink extra water or other fluids while in ●● Use healthy fats like olive oil, avocado, and nut butters to treatment or while taking this medication? boost calories. ●● Can I drink alcoholic beverages, including beer and wine, ●● Choose soft foods or foods that can be cooked until tender. while in treatment or while taking this medication? ●● Try new foods and recipes to accommodate changes in taste ●● What if I vomit immediately after taking my medication? or smell. For other questions to ask your doctor about side effects, see the ●● When possible, take a walk before meals to improve appetite. free LLS publication Understanding Side Effects of Drug Therapy. ●● Eat with friends or family members when possible. ●● Make a list of your favorite foods and be sure to have these Your Appetite foods on hand. People living with cancer may have different nutrition goals ●● Try over the counter high calorie, high protein drinks like and challenges, depending on their Carnation Breakfast Essentials, Ensure, Boost, or Orgain. ●● Age ●● Keep snacks and desserts handy and visible. ●● Type of cancer ●● Keep a bottle of water with you and sip it throughout the day to prevent dehydration. ●● Stage of cancer ●● Accept help with food shopping and meal preparation. ●● Type of treatment ●● Sign up for cooking classes for people with cancer, which ●● Other medical conditions such as high blood pressure, heart are offered in many areas. Your LLS chapter may know of disease, diabetes or depression. classes that you can attend if you are interested. Your cancer and the treatment for it may increase your body’s ●● If water tastes unpleasant, try taking in liquids through need for calories and protein. Chemotherapy, certain other food, such as watermelon; flavor water with fresh cut fruit; drug therapies and radiation therapy create a need for more or try sports drinks, tea or milk. calories and protein. Side effects of your treatment, such as ●● If food tastes bland try seasoning it with spices. loss of appetite, nausea, mouth sores and taste changes, may also make it a challenge for you to take in enough calories ●● If your mouth is sore, try non-acidic, non-spicy foods. and protein. ●● If meat is not enjoyable try getting protein from other sources, such as eggs, cheese, nuts or high-protein smoothies. FS24 Food and Nutrition Facts I page 3 Food and Nutrition Facts Weight Gain Your treatment team may recommend liquids, such as broths For some patients, weight gain may occur as a result of or sports drinks—these can restore the body’s electrolyte increased appetite or fluid retention (“bloating”) associated balance. Electrolytes, such as sodium and potassium, have many with certain drug therapies. Weight-loss diets are not important functions in the body. Vomiting and diarrhea increase recommended without proper medical guidance. For help, your body’s loss of electrolytes. Check with your treatment team ask your oncologist to refer you to a dietitian who can design to see if you need extra help in keeping your body’s fluid in an appropriate diet for you. balance by drinking liquids that contain electrolytes. Obesity has been associated with an increased risk of being If water does not appeal to you, flavored fluids are fine. It is diagnosed with different types of cancer including blood best to avoid alcohol as this can increase your body’s fluid loss. cancers. Further research is required to assess whether obesity has a clear effect on treatment outcomes for cancer. Dental Health More information about diet in relation to cancer risk and Dental care is an important part of overall cancer care. prevention can be found at the National Cancer Institute Problems with the teeth, gums or mouth can interfere with (www.cancer.gov/about-cancer/causes-prevention/risk/ eating well. And poor nutrition can lead to dental problems. obesity/obesity-fact-sheet). Visit the dentist at least four weeks before treatment begins if possible, and Get Enough to Drink ●● Maintain good dental and oral hygiene to help prevent gum Certain cancer therapies, including chemotherapy, other disease and infection. drug therapies and radiation therapy can increase risk for ●● Brush teeth two to three times a day with a fluoride dehydration. Some side effects of treatment, such as diarrhea toothpaste with mild taste – flavorings can irritate the mouth. and vomiting, increase the need for more fluids. Fever can also increase the risk for dehydration. Signs of dehydration include: ●● Gently floss once a day. ●● Thirst ●● Rinse the mouth with a solution of water, salt and baking soda every 2 hours. ●● Dry or sticky mouth and/or swollen tongue ●● Use an antibacterial rinse two to four times a day to prevent ●● Dizziness and/or headaches gum disease. Avoid alcohol-based mouthwashes. ●● Nausea ●● Use a lip-care product to prevent your lips from drying and cracking. ●● Constipation ●● Brush dentures daily. ●● Dry skin ●● Avoid hot, spicy, highly acidic and crunchy foods that may ●● Weight loss irritate your mouth. ●● Dark urine. ●● Try soft texture and moist foods if your mouth is dry or sore. If you are taking medications by mouth, drink plenty of ●● Avoid sugary foods, such as candy or soda that can cause fluids throughout the day. Sipping even small amounts of cavities. liquids at regular intervals will help if that is all you can ●● Avoid alcohol and tobacco products. manage. Drinking large amounts of fluid at once may ●● Inspect your mouth daily to detect any problems with sores, cause vomiting. Do not wait until you feel dehydrated and ulcers or infection. thirsty to drink. Try and maintain your fluid levels before you become dehydrated. If you feel fatigued, make sure ●● Speak with your oncologist and dentist as soon as possible fluids are within easy reach. Fluid requirements are based on if you have any mouth, tooth or jaw pain—or any other several factors such as age (infants, children and older adults symptom of possible dental problems. have a greater risk of dehydration), activity level, climate ●● Ask your healthcare team for tips on how to keep your and medical treatment. Women and overweight or obese teeth and mouth clean, and for their suggestions on how to individuals are at greater risk for dehydration. Check with reduce dental discomfort. If needed, your oncologist may your treatment team for guidance on the amount of fluid you refer you to a dental oncologist (a dentist who is specially should have each day. trained to treat people with cancer). FS24 Food and Nutrition Facts I page 4
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