We’d like to introduce you to the lovely Diane Nicolas, an experienced nutritionist currently working with cancer patients in the oncology department at one of the biggest hospitals inBeirut. She holds a Bachelor’s degree in Nutrition and Dietetic from USJ along with a Masters in Human Nutrition. Diane has also been involved in several nutritional awareness programs at schools, including teaching children about the importance of good nutrition.
Diane’s been working with breast cancer patients, and within the oncology department in general, for 7 months now and 1 out of 10 of her cancer patients is usually a breast cancer case.
We recently did a lengthy interview with Diane and she was kind enough to share some invaluable insight on the topic of nutrition as it relates to breast cancer patients (and cancer patients in general). To give each of her detailed answers their due attention, we’ll be sharing them in individual posts as part of a upcoming Q&A section of our website, starting with this one:
Question: Women undergoing chemotherapy tend to feel very tired due to the harsh chemicals in their bodies, as well as undergoing other symptoms relating to food in general. What are your recommendations for overcoming those side effects during treatment?
Diane’s Answer: Cancer treatment effects the eating behavior of patients and our job is to accommodate their diet during their treatment as it can cause nausea, vomiting, apotheosis, diarrhea or constipation. These are all gastrointestinal problems that require a specific dietetic approach. At certain periods during treatment, the patient’s immunity is weakened and it’s crucial to provide them with the proper nutritional education to prevent food contamination due to their heightened sensitivity.
In the case of any of the following reactions, the following is recommended:
a) Loss of Appetite
- Eating frequent meals and snacks that are easy to prepare.
- Liquid supplements may improve total energy intake and body function and may work well when eating solids is difficult.
- Other liquids that contain energy may also help, such as juices, soups, milk, shakes and fruit smoothies.
Types of foods recommended: cheese and crackers, muffins, puddings, nuts, chocolate, nutritional supplements, milkshakes, yogurt, ice cream, powdered milk or eggs added to foods such as puree, soups, or any other recipe that requires milk, and lastly, fruit cocktail that is low in added sugar.
b) Alterations to taste and/or smell
Alterations in taste can be related to chemotherapy, radiotherapy, dental problems, mucositis and infection (thrush) or medications. Rinsing the mouth before eating may help improve the taste of food.
- Use plastic utensils if foods taste metallic.
- Try eating your favorite foods.
- Have others prepare the meal.
- Substitute red meat with poultry, fish, eggs or cheese.
- A vegetarian diet could be useful, choose high-protein recipes.
- Use sugar-free lemon drops, gum, or mints when experiencing a metallic or bitter taste in the mouth.
- Add spices and sauces to foods.
- Eat meat with something sweet, such as applesauce.
c) Xerostomia (Dry Mouth)
- Drink plenty of liquids (25–30 ml/kg per day). Keep water handy at all times to moisten the mouth, and eat moist foods with extra sauces.
- Drink fruit nectar instead of juice.
- Use a straw to drink liquids.
- Eat hard candies, frozen desserts such as frozen grapes, chewing gum or flavored ice pops.
- Perform oral hygiene at least 4 times a day (after each meal and before bedtime). Avoid rinses containing alcohol.
- Consume very sweet or tart foods and beverages, which may stimulate saliva.
- Eat foods that are soft, easy to chew and swallow. Some conditions may require processing foods in a blender. Irritants may include acidic, spicy and salty foods.
- Eat foods cold or at room temperature; hot and warm foods can irritate a tender mouth.
- Practice good mouth care.
- Eat dry foods such as crackers, breadsticks, or toast, throughout the day.
- Eat bland, soft, easy-to-digest foods rather than heavy meals.
- Avoid cooking odors.
- Rinse out the mouth before and after eating.
- Suck on hard candies such as peppermints or lemon drops if the mouth has a bad taste.
- Soups, sports drinks, bananas, and canned fruits may be helpful for the replenishment of electrolytes.
- Diarrhea may worsen with greasy foods, hot or cold liquids, or caffeine.
- Limit milk to 2 cups or eliminate milk and milk products until the source of the problem is determined.
- Limit gas-forming foods and beverages such as soda, cruciferous vegetables, legumes and lentils and chewing gum.
- Limit the use of sugar-free candies or gum made with sugar alcohol (sorbitol).
- Eat more fiber-containing foods on a regular basis. The recommended fiber intake is 25 to 35 grams per day (beans, vegetables, whole cereals, vegetables, etc). Fiber should be gradually added to the diet, and adequate fluids must be consumed at the same time.
- Drink 8 to 10 cups of fluid each day; beverages such as water, prune juice and warm juices, decaffeinated teas, and lemonade can be particularly helpful.
- Take walks and exercise regularly (proper footwear is important).
To get in touch with Diane Nicolas for an appointment or other questions, feel free to email her on: firstname.lastname@example.org