What is nutrition like in cancer patients?
During the approach to cancer, it is important to consider the well-being of the person; And for this, a key aspect within the approach and treatment is good nutrition in cancer patients.
What is the diet of the cancer patient like?
Undoubtedly, food, physical exercise, mood and social environment are part of the elements that intervene positively or negatively in the recovery of a cancer patient.
In this sense, it is convenient to know that cancer patients have difficulties in being able to eat well, this being an important aspect to take care of during three moments:
In the prevention stage.
In the healing or treatment process.
In the palliative period.
In fact, to understand the true relevance of good nutrition in cancer patients, it is necessary to know some changes that occur in their body:
Protein metabolism. There is an increase in body protein exchange, consumption of body proteins, decrease in branched-chain amino acids in plasma.
Carbohydrate metabolism. Glucose intolerance, insulin resistance, abnormal insulin secretion are present.
Lipid metabolism. Decrease in body fat compared to proteins, decrease in free fatty acids, hyperlipidemia, decrease in lipoprotein lipase activity.
All this shows that the metabolic condition of the cancer patient is altered during the development of their disease.
Also, thanks to the discomfort that occurs, they tend to decrease the intake and tolerance of a wide variety of foods.
Importance of Good Nutrition in Cancer Patients
Following this approach, nutrition influences all stages of cancer, therefore, maintaining a good nutritional status generates benefits for the patient at all stages of their treatment.
For this reason, during the clinical follow-up of the cancer patient, nutrition is one of the values that is kept under permanent monitoring; using some of the following protocols:
Alteration of the BRCA1 gene
Periodic assessment of food intake, weight changes, and body mass index (BMI); starting with the diagnosis of cancer and repeating constantly depending on the physical condition of the patient.
General and quantitative assessment of nutritional intake, symptoms of malnutrition, physical performance, and the degree of systemic inflammation.
Nutritional requirements in cancer patients
From the results of some nutritional studies, it has been possible to know the benefits of auxiliary nutritional treatment.
An example of this is antioxidant supplementation in women diagnosed with cervical cancer, especially during their radiotherapy and chemotherapy treatments; which decreases oxidative stress (mainly at the protein level), maintains hemoglobin levels and avoids the application of blood transfusions.
In particular, in cancer patients, the distribution of macronutrients should be the same as in the general population; But when they are losing weight, a lipid intake of 35-50% of the total caloric value is recommended, especially from omega-3 polyunsaturated fatty acids.
Likewise, the protein level should be higher than 1g/kg/day and the caloric expenditure greater than that of a healthy person; oscillating around 25-30 kcal/kg/day.
During the nutritional approach of cancer patients, it is advisable to increase oral intake and maintain a good diet as long as they are able to eat.
When oral feeding is insufficient, enteral feeding is the recommended option.
If oral intake has been decreasing significantly for a long period of time, enteral or parenteral nutrition should be increased slowly over several days and caution should be taken to avoid refeeding syndrome.
Recommended Nutrition During Cancer Treatment
Obviously, the cancer patient must follow a balanced diet that covers the various types of foods; attending to the taste and tolerance of the patient, without neglecting the consumption of sufficient quantities to help cover their nutritional needs.
That is why, to ensure a good food intake during the disease, it is important to follow the following recommendations:
Good atmosphere and company. As well as the type of food that is going to be presented, the place and company are important details to make the meal a pleasant moment. In this particular, try to choose a pleasant environment, without noise or distractions and avoid the patient eating alone.
Personalized diet. Each patient has different reactions to cancer treatment, and although we all perceive flavors differently; The truth is that in some cases the disgust for something we eat is accentuated. That is why it is necessary to adapt the menus to meet the preferences and nutritional needs of the patient.
Plan meals. Treatment schedules should not interfere with the patient's meal times. They are generally known in advance and it is possible to establish weekly and even daily menus; however, you must be very attentive to any variation.
Less quantity and more times a day. It is advisable to establish portions that, in small quantities, you can make up to 6 - 10 in a day. It should also be ensured that the patient eats a little more at the times when they feel hungrier (for example, at breakfast time); and keep in mind that there are medications that affect appetite.
Better without fats. To facilitate digestion, it is recommended that food incorporates a minimum of fats into the diet. Grilled, boiled, steamed, oven, microwave preparations, among others; are some of the most recommended.
Hydrate a lot. The cancer patient must drink between 1.5 to 2 liters of water a day to recover the mineral salts lost during their treatment. To do this, the consumption of oral rehydration serums, vegetable smoothies, fruit juice, vegetable creams, whipped yogurt and infusions is recommended.
Bet on variety. Everyone should incorporate balanced meals into their daily diet, so that there is a representation of each type of food. However, in the case of cancer patients, monotony is much more harmful, as it can create resistance to certain tolerable foods.
Eat foods from all groups: It supplies easily digestible proteins, such as fish (hake, sole), white meat (chicken, turkey, rabbit) or cooked egg white. Skimmed melted cheese and carbohydrates such as bread, biscuits, pasta or rice are easily digestible and provide energy.
How does cancer affect the sense of taste?
Changes in taste function, including loss of the sense of taste, have been reported in up to 50% – 60% of cancer patients.
In fact, taste changes can manifest themselves in many ways, from the total absence of taste, decreased sensitivity (hypogeusia), increased sensitivity to some or all flavors (hypergeusia) or distortion/alteration of flavors (dysgeusia).
Alterations in the thresholds of perception and recognition of one or more of the basic tastes notoriously affect the quality of life of cancer patients and are one of the main factors in modifying eating habits.
There are multiple factors that influence dysgeusia, including the site of the tumor, stage, physiological state and habits of the patient, history of smoking, alcoholism, nutritional deficiencies and finally, the different treatments for cancer.
For this reason, it is common for cancer patients to have deficiencies in certain nutrients, including vitamin A, B6 and B12, iron, zinc and copper, related to taste alterations.
In this sense, zinc plays a role in the regeneration of taste bud cells, iron interacts in several enzyme systems and is linked to atrophy of the taste buds that contribute secondarily to hypogeusia.
On the other hand, patients who receive radiotherapy experience an early partial or complete loss of the sense of taste; a taste disorder caused by the cells of the taste corpuscles of the fungiform and circumvallate lingual papillae that are sensitive to radiation.
Consequently, patients undergoing chemotherapy may also develop direct neurotoxicity on taste cells and enhance xerostomia and infections; they even perceive an unpleasant taste related to the permeation of the drug through the oral tissue.
When a patient presents taste alterations, they may report the following symptoms:
Less pleasant taste of food after treatment.
Perception of all drinks and foods with identical taste.
A change in the sense of taste and smell that affects the ability to eat normally.
Loss of appetite.
Importance of avoiding malnutrition in cancer patients
Undoubtedly, cancer is a multifactorial disease with different treatments; But many patients come to share one negative factor in common: malnutrition.
Obviously, from this nutritional deficit, there is an alteration in the immune system and can cause levels of intolerance to neoplastic therapies.
That is why, to avoid possible malnutrition, you must comply with the following recommendations:
Eat five fruits or vegetables a day. If possible, try to make one of the vegetables in the form of a salad (raw).
Split meals. You can eat between six and ten meals a day. It is preferable to handle smaller portions and let the body digest the food.
Avoid consuming medications on an empty stomach. Unless there is a medical indication to do so, it is important that the drugs are administered with something in the stomach.
Eat more fish than red meat. Alternate oily fish (such as salmon) with white fish (hake). Reinforce the intake of legumes by combining fish with salads.
Vary the diet. Take different types of vegetables and modify the way you cook them.
Drink plenty of water. Two glasses between meals help you recover lost mineral salts.
What foods should cancer patients avoid?
Among the foods that should be avoided or their intake reduced to take care of nutrition in cancer patients, are:
Control alcohol consumption.
Foods high in saturated fats and processed meats.
Acids, fried foods, bitter, spicy, very salty or very spicy foods.
Carbonated drinks.
Vegetables that cause gas (broccoli, cauliflower, cabbage, beans, onions).
Whole nuts and seeds.
