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  • CANCER: MANAGING EATING PROBLEMS AND DIET AFTER CHEMOTHERAPY

A balanced nutrition is a  very important part of cancer treatment, survivorship and prevention.

Chemotherapy treatment places its own burden on the nutrition system in addition to the cancer itself. A healthful diet is needed to rebuild body cells and energy levels especially in chemotherapy and radiation treatments.

When undergoing chemotherapy, the patient needs to stay healthy and comfortable as possible. What you eat during treatment can make a big difference in helping you achieve that goal. The following tips will help patients manage their nutrition after chemotherapy.

  • Keep food tasty: Chemotherapy can do a lot of things on the taste buds, making certain foods and drinks taste metallic or unpleasant. Water and meat are the two most common item that become distasteful during chemotherapy. If it becomes difficult to drink plain water, try drinking flavoured mineral water or add sliced lemon to water. If certain meats become difficult to enjoy, try other sources of protein such as eggs, beans and fish.
  • Fight constipation: Keeping hydrated is important to help prevent constipation. Getting some exercise -even just a 20 minute walk can be a powerful intestinal stimulant.
  • Manage weight gain: low fat meals, snacks and lots of vegetables are recommended.
  • Improve your appetite: patient’s appetite suffer after chemotherapy. Therefore eating carbohydrates which are well digested in the form of blended soups, yoghurt, toast with peanut butter is recommended .
  • Ease Diarrhea: Avoid greasy and fried foods, caffeine, sugary drinks and fruit juices, if experiencing diarrhea. Foods that are generally well tolerated include oatmeal, most fruits without skin and sweet potatoes.
  • Keep a food and symptom diary: writing down what you eat and drink and the symptoms you experience daily, will help you identify what you are eating that is causing nausea, constipation or diarrhea. This way, medication and other dietary suggestions can be tried before problems escalate.
  • Stay Hydrated: Drink plenty of water to avoid dehydration.
  • Control Nausea: Eat cool foods, avoid greasy and fried foods as well as foods with strong odour.
  • Relieve Mouth Sores : Avoid spicy foods, alcohol, hot temperature foods. Drink plenty if fluids throughout the day.
  • Eat Mini Meals: Eating smaller, more frequent meals will help with nausea and tends to be better tolerated during the chemotherapy process.
  • Avoid Alcohol: During chemotherapy, the liver should receive some love by avoiding alcohol because it helps to metabolize all the potential toxins in the bloodstream. Alcohol can also worsen nausea and may interact with other drugs that are given in conjuction with chemotherapy.

Since every patient is unique and have their own set of needs, we encourage everyone who is undergoing cancer treatment to meet one-on-one with our Nutritionist to develop an individualized eating plan. This plan will meet the patients goals and needs, while taking into account the treatments side effects and other diseases for which the patient is receiving care.

QUICK TIPS ON NUTRITION IN RENAL DISEASES

The kidneys’ job is to keep the body’s fluids, electrolytes, and organic solutes in a healthy balance. Their functional units are the million or so nephrons in the renal cortex which filter most constituents of the blood other than red blood cells and protein,  reabsorb needed substances, secrete hydrogen ions to maintain acid-base balance, and secrete wastes.

Urine formation consists of three basic processes: glomerular filtration, tubular secretion, and tubular reabsorption. Several disease conditions can interfere with these functions. Urinary tract infections and kidney stones can interfere with normal drainage, causing further infection and tissue damage. Circulatory disorders, such as hypertension, can damage the small renal arteries. Other diseases, such as diabetes, gout, and urinary tract abnormalities can lead to impaired function, infection, or obstruction. Toxic agents such as insecticides, solvents, and certain drugs may also harm renal tissue.

Nutrition plays a very active role in the management of renal diseases and its treatment effects. Let’s have a quick look at the role of diet in some renal issues.

ACUTE RENAL FAILURE

Acute renal failure, manifested by oliguria or anuria, usually occurs suddenly and is often reversible. It is marked by a reduction in the glomerular filtration rate and a modification in the kidneys ability to excrete metabolic waste

Diet in Acute Renal Failure

Diet plays a critical role in the care of patients with acute renal failure. Nutritionists should plan diets with an eye toward the possibility of uremia, metabolic acidosis, fluid and electrolyte imbalances, infection, and tissue destruction.

Protein: A low-protein diet is recommended initially. Protein may be increased in the diet as the glomerular filtration rate increases to normal. If dialysis is initiated, the protein level may be increased if necessary to compensate for protein losses in the dialysate.

Calories: Calorie needs are generally elevated in order to provide positive nitrogen balance under stressful conditions. As protein is usually quite restricted, calorie needs may be met by providing greater amounts of carbohydrate and fat in the diet.

CHRONIC RENAL FAILURE

Approximately 90 percent of cases of end-stage renal disease are attributable to diabetes mellitus, glomerulonephritis, or hypertension. Kidney failure results in fluid and electrolyte imbalances, the buildup of nitrogenous wastes, and reduced ability to produce renal hormones.

Diet in Chronic Renal Failure

Low-protein diets may slow the progression of mild and moderate renal insufficiency. Therapeutic diets using plant sources of protein are more effective in delaying the progression of renal insufficiency, compared to those using animal sources.

NUTRITION & DIALYSIS

Dialysis changes dietary needs. Patients undergoing typical hemodialysis, involving about three treatments per week, follow diets that are restricted in protein, sodium, potassium, phosphorus, and fluid.

Sodium: Sodium intake must be modified to prevent hypertension, congestive heart failure, and pulmonary edema. Limiting intake will help avoid thirst and maintain acceptable fluid balance. Major salt sources should be limited.

Fluid: Fluid consumption should be controlled to avoid congestive heart failure, pulmonary edema, hypertension, and swelling of the legs and feet. Fluid allowances are 1,000-1,5000 ml/day and are based on urine output and type of dialysis.

Protein: Protein requirements vary depending on the type of dialysis used and the patient’s nutritional status. It is important to ensure sufficient protein to maintain visceral protein stores, but to avoid excesses that could lead the accumulation of nitrogenous waste products in the blood.

KIDNEY STONES

Stones usually result from the crystallization of calcium (which originally came in foods or supplements) and oxalate, a part of many plant foods. Some people have a tendency to lose excessive amounts of calcium or oxalate through their kidneys, and they have a greater likelihood of a stone. Kidney stones can also form from uric acid, which is a breakdown product of protein.

Here are simple nutrition tips to help patients with kidney stones.

Water. Water dilutes the urine and keeps calcium, oxalates, and uric acid in solution. In research studies, total fluid intake (from all sources) over 24 hours of roughly 2.5 liters, is recommended. (They do not need to drink 2.5 liters of water per day; rather this is the total fluid consumption, including juices, soups, etc.)

High-Potassium Foods. Studies have shown that a high potassium intake can cut the risk of kidney stones in half. Potassium helps the kidneys retain calcium, rather than sending it out into the urine. Potassium supplements are not generally necessary. Rather, a diet including regular servings of fruits, vegetables, and beans supplies plenty of potassium.

Calcium. Although most stones contain calcium, the calcium in foods does not necessarily contribute to stones. Calcium supplements taken between meals may increase the risk of stones, because about 8 percent of any extra dietary calcium passes into the urine. On the other hand, calcium consumed with meals has the opposite effect, reducing the risk of stones. Follow the notes below:

  1. Encourage patients to drink plenty of water or other fluids, staying ahead of their thirst.
  2. Diets including generous amounts of vegetables, fruits, and beans are rich in potassium and very low in sodium.
  3. Encourage patients to avoid animal products. Their proteins and sodium content increase the risk of stones.
  4. Patients should keep salt and sugar use modest.