Weight Management During Cancer

Weight loss is common among people with cancer. It may be the first visible sign of the disease. 40% of people complain about unexplained weight loss at the initial diagnosis with cancer. Weight loss associated with cancer may be different from other types of weight loss like increased metabolism, loss of skeletal muscle, fatigue, loss of appetite, and decreased quality of life.

The other symptoms associated with cancer are loss of energy, fatigue, and weakness ¹.

• Pain
• Nausea 
• Vomiting 
• Mouth sore 
• Depression 
• Loss of taste 
• Chewing difficulty 
• Swallowing difficulties 
• Diarrhoea 
• Constipation

Mitigate weight loss in cancer patients

Follow better eating habits

• A nutrition assessment helps evaluate the characteristics of malnutrition, which helps develop a plan for modifying or preventing the underlying factors like inadequate intake of calories and protein.
• The most helpful nutrition management strategy for dysphagia is altering food and drink and changing the food to soft, blended, moist foods from all food groups. It is also imperative to confirm the safety of oral intake by encouraging double swallows and verbalization after swallowing.
• Patients should concentrate on foods with high water content and maintain proper daily oral hygiene for dry mouth. Soft, non-acidic foods that are cold or room temperature may be well tolerated for oral mucositis; the use of a straw can aid swallowing and divert liquids to more minor painful areas of the mouth.
• To deal with taste and smell alterations, rule out mucositis and replace metal silverware with ceramic to avoid exacerbating the metallic taste. Sippy cups can divert odours from the patient’s nose. These patients often prefer tart, sour, and acidic foods.
• To deal with nausea and vomiting, confirm that patients take their anti-nausea medication as prescribed; changing the eating pattern toward small, frequent meals and bites and sips helps better digestion and improve appetite.
• Eating slowly and avoiding tight clothing and hot, stuffy atmospheres help overcome the problem. When feeling nauseated, they should avoid their favourite foods to prevent the development of new food aversions.
• Constipation can often be alleviated with a high-fibre diet, but limit the increase in fibre to ≤5 g/day and increase fluid concomitantly. Patients must maintain hydration and consume a low-fibre diet (< 13 g/day) for diarrhoea, with fibre slowly resumed once diarrhoea subsides.
• Early satiety can be managed by separating food and liquid intake. “Unless the patient requires liquids to swallow easily, limiting fluids with meals to half a cup and drinking other liquids 2 hours before or 2 hours after eating,”.
•  Eating in pleasant surroundings can also help with poor appetite. 

Eat a balanced diet to incorporate the six basic nutrients essential for good health

Carbohydrates, protein, fat, vitamins, minerals, water, and the adequacy of nutritional intake are the six essential nutrients necessary for maintaining good health. These are necessary for body tissue growth and repair, daily energy, fighting diseases and infections, and treatment and recovery ².

The dietary requirements differ from patient to patient and condition.

• Carbohydrates: Most calories are needed from healthy carbohydrate-containing foods like millets, vegetables, fruits, and whole grains. Good sources of healthful unsaturated fats include avocados, seeds, nuts and vegetable oils.
• Proteins: Patients may require proteins to 1.2-1.3 gm/Kg body weight to keep the immune system working well and support the repair of body tissue. Malnourished patients need to add extra protein by adding supplements, if necessary, dals, legumes, pulses, plant-based milk, A2 milk, nuts and seeds to their daily eating plan. 
• Fats: Good sources of fat include: olive oil and other cold-pressed oils, nuts, seeds, avocado, butter, fatty fish like salmon, tuna mackerel. Avoid trans fats like vanaspati.
• Vitamins and minerals: It helps in correct growth and development of our body’s cells. Eating a well-balanced diet with enough protein and calories usually contains plenty of vitamins and minerals. Eating a variety and choose foods from the many colours of the rainbow-like: tomatoes, watermelon, cherries, melon, carrots, sweet potatoes, oranges, apples, pears, broccoli, Brussels sprouts, edamame, garlic, onions, plums, blueberries, grapes, green tea, oatmeal, quinoa, barley, walnuts, almonds, etc.
• Water: Water is one of the essential nutrients in detoxifying our body and preventing cancer. This liquid is a foundational component of our body’s cells, providing nourishment to our whole body. Most of our bodily functions are supported by water, like maintaining a healthy body temperature, eliminating toxins, and joint health.

Also, water keeps things moving in your digestive tract. It helps push food through and promotes healthy digestion. Water flushes toxins out of the body, prevents buildup, and prevents many diseases of the colon or rectum, like colorectal cancer.

Drinking water and eating more water-heavy foods can also help promote the healthy growth, survival, and reproduction of the body’s cells. It protects your body’s organs like the colon, bladder, and breast tissue from developing cancer.

Exercise to improve appetite 

Exercises are done under a physiotherapist’s guidance to improve your quality of life and help you feel better. Regular exercise can reduce stress and give you more energy. Some of the benefits of doing regular activities include:

• reduce anxiety
• improve depression
• reduce fatigue
• improve quality of life during and after cancer treatment
• prevent or improve lymphoedema (a type of swelling caused by treatment to lymph nodes)
• improve general physical functioning

References

1. Cooper, C., Burden, S. T., Cheng, H., & Molassiotis, A. (2015). Understanding and managing cancer‐related weight loss and anorexia: insights from a systematic review of qualitative research. Journal of cachexia, sarcopenia and muscle, 6(1), 99-111. https://dx.doi.org/10.1002%2Fjcsm.12010

Skerrett, P. J., & Willett, W. C. (2010). Essentials of healthy eating: a guide. Journal of midwifery & women’s health, 55(6), 492-501. https://dx.doi.org/10.1016%2Fj.jmwh.2010.06.019