Anorexia and Poor Appetite

Why Nutrition Matters

Adequate nutrition is important during treatment as it provides your body with energy, decreases your feeling of tiredness, and prevents weight loss.

Maintaining your weight and eating well may help your body respond better to your treatment, decrease your risk of infections and may reduce your stay in the hospital.

Not feeling hungry is one of the problems that you may experience. Many people don't feel hungry or might feel full after eating small amounts of food.

How can you manage the decrease in appetite and the feeling of fullness?

1. Plan and prepare your daily meals ahead of time.
2. Choose times for eating, rather than waiting to be hungry.
3. Eat small amounts of food multiple times a day.
4. Keep high-calorie snacks on hand for when you are hungry like nuts, dried fruit, peanut butter cookies or cubed cheese.
5. Eat foods high in calories and protein. Try whole milk, pudding, cheese, cottage cheese, yogurt, peanut butter and cream soups.
6. Increase the calories and protein content of your food by adding cheese, olive oil, avocado, nuts, sugar and butter to meals and snacks.
7. Drink high calorie fluids between meals such as yogurt, milkshake, and milk-based puddings. Liquids are digested faster than solids.
8. Avoid drinking liquids with meals. Drinking liquids with meals will make you feel full during meals.
9. Try new recipes for food items and desserts.

Change in Taste and Smell

Adequate Nutrition is important during treatment as it provides your body with energy, decreases your feeling of tiredness, and helps you from losing weight. Avoiding weight loss will make your body respond better, decrease your risk of infections and your stay in the hospital.

Some of the medications you are taking can cause taste changes. Food may taste different than before; some will taste too sweet or too salty, other types of food will taste bitter, metallic or even bland. These changes might affect what you like and your appetite.

How can you manage taste changes?

• Brush your teeth before and after meals and snacks. This will help control the bad taste.
• Use plastic instead of metal utensils for eating if you experience a metallic taste.
• Cold or room-temperature food such as sandwiches and cottage cheese may taste better. Hot foods give off a stronger flavor and odor.
• Exchange red meat with chicken, fish, eggs, cheese, and legumes, for example, lentils, chickpeas, and fava beans. Vegetarian dishes can also provide you with adequate amounts of protein.
• Have some sugar-free chewing gum, lemon or peppermint candies, if you experience a bitter or metallic taste.
• Add spices and seasonings (like basil, oregano, mint, rosemary, onion, garlic, mint) to enhance the flavor of your food.
• If your food tastes too sweet or bitter, season with tart flavors such as lemon wedges, citrus fruits, vinegar, and pickled foods.
• If your food feels too salty, add sugar and if your food feels too sweet, add salt.
• Consume frozen fruits like oranges, grapes, watermelon.
• Consume frozen homemade milk shakes and ice-creams.
• Rinse your mouth with baking soda, salt, and water mouthwash before eating.
  • Mix 1 teaspoon salt and 1 teaspoon baking soda in 4 cups of water. Shake well. Swish in your mouth and spit out.
• Ask your doctor or dietitian about zinc supplementation which might help in restoring the sense of taste and smell.

Dry Mouth

A dry mouth happens when there is not enough saliva or when the saliva is thick. This can be a side effect of the treatment or a result of dehydration. A dry mouth can make it difficult for you to eat and swallow food.

What are some of the nutrition tips that can help you eat better when you have mouth dryness?

• Drink fluids frequently to moisten your mouth, at least 8 cups a day.
• Avoid caffeine containing foods and beverages like coffee, tea, caffeinated soft drinks, and chocolate.
• Avoid rinsing your mouth with alcohol-containing mouthwash products.
• Use a straw to drink fluids. Sip liquids frequently during meals.
• Add sauces to foods to make them soft and moist. Try gravy, broth, sauce, yogurt or melted butter.
• Dip your sandwich, cookies or crackers in milk to soften them and make them easier to swallow.
• Try to cut food into small pieces and take a drink after each bite to moisten your mouth.
• Try sugarless chewing gum or lemon/mint candies to increase your saliva production.
• Consume frozen fruits or homemade milk shakes and ice-creams.
• Don't forget to add protein to your meals and snacks: Yogurt, cottage cheese, lentil soups, hummus, ice-cream and fruit smoothies (yogurt, fruit, avocado and ice) are protein rich soft and moist food that you can enjoy.

Mouth Ulcers

Adequate Nutrition is important during treatment as it provides your body with energy, decreases your feeling of tiredness, and helps you from losing weight. Avoiding weight loss will make your body respond better, decrease your risk of infections and your stay in the hospital.

Some types of treatment can damage the cells lining your mouth, throat and digestive system. This will lead to the development of ulcers which might make chewing and swallowing difficult, or even painful.

What are the diet modifications that can help with mouth and gum ulcers?

How can you manage with mouth and gum ulcers?

• Eat soft, moist, easy to chew and swallow foods.
• Cut food into small pieces. You can moisten your food with sauces, gravies, or soups.
• If mouth ulcers are preventing you from chewing or swallowing, try blending your food in the blender.
• Drink soups or other liquids from a straw or cup instead of a spoon to keep foods away from sore spots in your mouth.
• Eat the foods cold or at room temperature since hot foods or beverages can irritate your mouth.
• Maintain a good oral hygiene to avoid bacterial growth.
• Consume frozen homemade milk shakes and ice-creams. Suck on ice cubes or popsicles to help relieve the pain.
• Avoid alcohol, caffeine or smoking as they can increase the pain and irritation.

Drink soups or other liquids from a straw or cup instead of a spoon to keep foods away from sore spots in your mouth.

Nausea and Vomiting

Adequate Nutrition is important during treatment as it provides your body with energy, decreases your feeling of tiredness, and helps you from losing weight. Avoiding weight loss will make your body respond better, decrease your risk of infections and your stay in the hospital.

Nausea is when you feel sick and is sometimes followed by vomiting. Nausea and vomiting can be caused by certain medications or treatments, pain, constipation, viral or bacterial infections.

How can you manage nausea and vomiting?

• Eat dry foods when you wake up. Try dry, starchy, or salty food such as pretzels, plain crackers, dry cereal, or dry bread sticks.
• Eat small snacks during the day such as nuts, pretzels, smoothies, milkshakes, ice cream, yogurt, fruits or a cheese sandwich. Nausea is often worse on an empty stomach.
• Consume your meals at specific times and before feeling hungry, as the hunger sensation may increase your nausea.
• Try drinking lemonade as it may ease your symptoms. Try lemon or mint candies to get rid of undesirable mouth tastes.
• Do not lay down directly after eating, keep your head elevated for at least an hour.
• Try foods that have minimal smell and are soft and easy to digest. Avoid high fibers and gas producing food such as beans and lentils, onions and cabbage.
• Avoid foods with high fat content, or are fried or spicy as they take longer to digest and can cause discomfort.
• Food smells can trigger nausea. Avoid the kitchen while meals are cooked and eat in a comfortable room with good ventilation.
• Try cold or room temperature foods as this will decrease the smell of the food.
• Rinse your mouth before and after a meal.
• Cover fluids or beverages and drink it with a straw.
• Avoid wearing tight clothes.
• Vomiting leads to fluid loss from the body. Try to drink ½ a cup of apple or cranberry juice to replenish your body stores after vomiting.
• If you are unable to tolerate juice try to rehydrate with ice. Start with 1 teaspoon of ice every 10 minutes. Increase to 1 tablespoon every 20 minutes.
• Consult your doctor for prescription of medications to relief nausea and/or vomiting.

Diarrhea

Adequate Nutrition is important during treatment as it provides your body with energy, decreases your feeling of tiredness, and helps you from losing weight. Avoiding weight loss will make your body respond better, decrease your risk of infections and your stay in the hospital.

Diarrhea is when you pass loose or watery stools more than 3 times. This can happen as a result of an infection, after taking certain medications or after a stomach or bowel surgery.

How can you manage diarrhea?

• Increase your intake of fluids throughout the day to prevent dehydration. Try to drink at least 8 cups per day.
• Consume foods containing soluble fibers: cooked apples or peeled apples, bananas, oats, rice, tapioca, boiled potato without skin, melon without the seeds.
• Drink at least 1 cup of fluids after each bowel movement.
• Reduce your intake of milk and dairy products to 2 servings (or 2 cups) per day. You can also use lactose free milk.
• Foods to avoid:
  • Sugary drinks, carbonated beverages, pastries, and desserts
  • Caffeine containing foods or beverages such as: chocolate, coffee, carbonated soda beverages
  • High fat food, fried food, spicy food
  • High-fiber foods such as nuts, seeds, whole grains, legumes, dried fruits, and raw fruits and vegetables, popcorn
  • Sugar-free gum and candies made with sugar alcohol like sorbitol, mannitol, or xylitol

Constipation

Adequate Nutrition is important during treatment as it provides your body with energy, decreases your feeling of tiredness, and helps you from losing weight. Avoiding weight loss will make your body respond better, decrease your risk of infections and your stay in the hospital.

Constipation is when you are not able to pass stools for a few days and is defined by less than 3 bowel movements per week. Passing stools could also be difficult and painful. Some of the most common causes are lack of activity, pain medications, not taking enough liquids, not eating enough fibers.

What are some of the tips that can help relief constipation?

How can you manage constipation?

• Drink 8-12 cups of fluid per day such as water, juice or flavored beverages.
• Drink 1/2 to 1 cup of prune juice in the morning to stimulate a bowel movement.
• Maintain a regular exercise such as walking.
• Try to have a regular meal pattern with regular timings.
• Slowly increase the amount of fiber you eat by adding high fiber food to your meals.

High fiber sources are:

• Legumes (chickpeas, beans, lentils…etc.)
• Whole wheat or oats. Look for products with 100% whole wheat, rye, oats, or bran as the first or second ingredient.
• Foods baked with bran or whole wheat flour.
• Vegetables and fruits with peels:
  1. Berries, kiwi, dates, figs, dried prunes, raisins, apricots or prune juice
  2. Spinach, artichokes, okra, beets, kale
• Add flaxseed to foods. Start with 1 tablespoon ground flaxseed and increase gradually.
• Add 2 tablespoons of wheat bran to your food and drinks. Wheat bran should be taken with good amounts of fluids in order to be effective.
• Consult with your doctor if constipation continues.