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Dietary Management
  • To meet the increased metabolic demands of the disease and prevent catabolism as much as possible.
  • To alleviate symptoms resulting from the disease and its treatment through adaptation of food and feeding processes.
Energy
  • To prevent excessive weight loss and to meet increased metabolic demands, the total energy value of diet must be increased.
  • Calorie density should be sufficient to counter catabolic or hypermetabolic state promote anabolism.
  • For an adult with good nutritional status about 2000 kcal would provide sustenance.
  • Malnourished patient 3000 – 4000 kcal depending on the degree of malnutrition.
Protein
  • Additional protein is required to provide essential amino acids and nitrogen necessary for tissue regeneration, healing and rehabilitation.
  • An adult patient with good nutritional status will need about  80 – 100 g to meet maintenance needs and ensure anabolism.
  • A malnourished patient would need more to replenish tissues and to ensure positive nitrogen balance.
Carbohydrates
  • Adequate amount of carbohydrates need to be given to meet energy requirements and for the protein sparing action.
  • Consumption of simple carbohydrates, juices, jelly, custard, etc
  • Should be encouraged as they are energy dense and would help in meeting energy demands as the patient is unable to consume large quantities due to anorexia.
Fluid
  • Fluids are increased to compensate losses from gastrointestinal problems as well as additional loss caused by infections and fever.
  • A sufficient fluid intake is necessary to help kidneys function efficiently and help break down products from destroyed cancer cells and drugs themselves.
  • Increased fluid also helps to protect the urinary tract from irritation and inflammation
Vitamins and Minerals

Optimal intake of vitamins and minerals atleast at RDA and frequently augmented with supplements according to nutritional status.
Side effects of cancer Suggested Dietary Management
Nausea and Vomiting Clear, cold & carbonated beverages with added polycose; Sipping beverages, small frequent meals low in fat. Dry crackers or toast at arising and tart and salty foods and liquids 30 - 60 mins before eating
Dry Mouth Drinking atleast 2 quarts of liquid daily. High calorie beverages are preferable to water. Sauces, gravies, broth to moisten foods to make swallowing easier. Chewing sugar free gum or candy to increase salivation.
Taste Alterations Experimentations with different seasonings and flavours. Substitution of red meat with lean meat.
Loss of Appetite Small, Frequent feedings, high calorie, high protein snacks and beverages
Sore Mouth and Throat Soft, non-acid foods, blended or liquefied foods. Food and beverages at room temperature using straws with liquids
Swallowing problem Avoiding highly seasoned food. Liquid feeding, pureed, finely chopped or frequent feedings. Tube feedings. Adding butter or sauces
Early Satiety Small and frequent meals. Chewing foods well and eating slowly. Avoiding foods in excessively high in fat. Liquids 30 – 60 mins before meals not during meals.
Dietary Tips
  • Oral diet amplified with nutrient supplement for increased protein, kilocalories, vitamins and minerals
  • Normal ingestion of food is most desirable. But based on nutritional assessment a personal food plan can be developed incorporating all food groups.
  • Adjustments should be made in texture temperature, amount, timing, taste, appearance, and form of food to alleviate symptoms.
  • With support family can build a positive attitude towards diet.
  • Food should be nutrient dense.
  • Small and frequent meals and a heavy breakfast should be emphasized.
  • Mild exercise should be encouraged to improve appetite and mood.
  • Zinc supplementation to improve taste and appetite is also advised.
 
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