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The Issue
At OncoveryCare, we often get questions about how to incorporate healthful lifestyle strategies into one’s routine - especially when it comes to nutrition. Figuring out the best approach to nutrition and eating after a cancer diagnosis can feel challenging. There is a lot of information out there, and it can be difficult to figure out fact from fiction when it comes to what to eat. Furthermore, cancer treatments can often impact appetite, our body’s overall nutritional status, and weight management. We also find that folks have many different starting points when it comes to their nutritional needs.
Regardless of where you find yourself, our take home message for all survivors is that nutrition should be viewed as one of many tools to support overall wellness during and after treatment. This is a really key part of our philosophy - the foods we eat are just one of many decisions (along with things like exercise, mental health, sleep, and stress reduction) that work together to contribute to our health.
If you are struggling with nutrition you are NOT alone. This is an incredibly common issue in survivorship, and we are here to guide you through some next steps to put together a plan that’s sustainable and feels right for you.
So, what do we know?
Big picture - if you take nothing else from this overview, just remember that when it comes to nutrition, balance is key. This means that the right strategy for you is likely the one where you are supporting your body with healthful and nutritious foods, addressing any challenges that arise from your treatment, and incorporating foods that bring you joy when you need them!
There’s an old saying that the best diet is the one you are able to follow every day. If you’re not sure where to start, keep reading! We looked at the science, teamed up with expert dietitian, Peter Adintori, and we talked to our community of survivors to bring you the best recommendations from the experts and the folks on the ground.
What the research says
Here’s the advice on nutrition from the American Cancer Society (ACS):The full list of recommendations can be found online (1), but here are the general guidelines from the ACS: Try to eat a variety of vegetables—dark green, red, and orange, fiber-rich legumes (beans and peas), and others.Include fruits, especially those with a variety of colors in your diet. Eat plenty of high-fiber foods, like whole-grain breads and cereals.
- Avoid or limit your intake of red (beef, pork, or lamb) and processed meats. Studies have linked eating large amounts of red meat and processed meats (like bacon, hot dogs, and deli meats) with increased risk of colorectal and some other cancers.
- Avoid or limit sugar-sweetened beverages and refined grain products.
- Choose low-fat milk and dairy products or plant-based dairy alternatives.
What foods are considered “nutritious?”, and what kinds of foods should you minimize?
Generally speaking, the approach should focus on incorporating a variety of “whole foods” including vegetables, fruits, whole grains, healthy fats, and lean proteins. Importantly, you should try to limit highly processed products like processed meats, frozen meals , and fast foods.
So what are “whole foods” and which foods are “highly processed”, and how do you balance them?
What are “whole foods?” Whole foods are types of foods in their natural or unprocessed state. You can think of them as produce you might buy in the fruits and vegetable section of the grocery store or proteins at the fish and meat counter. Another simple way to think about this, is to eat mostly plants. Whole foods have not been altered with additives, artificial flavors or preservatives. They’re typically dense with nutrients to help our body function well. The majority of our food choices should be from these whole foods.
Whole foods include:
- Fruits and vegetables
- Whole grains like 100% whole wheat pasta/bread, quinoa, barley, oats
- Nuts and seeds
- Lean proteins like fish, chicken, turkey, tofu, and beans
- Herbs and spices like garlic, ginger, turmeric, cilantro, basil
What are processed foods?
These are foods that have been altered from their original form and processed together with other foods. This isn’t necessarily a bad thing! Most of the food we eat has been processed to some degree, and processed foods should not be avoided altogether. The important thing is to try to minimize “highly processed” foods like fast foods or pre-packaged foods. While generally speaking they are often delicious, they also often contain added substances to improve either flavor, texture, shelf life, or often all three. These foods tend to be much higher in less healthful fat sources, salt, and sugar than our body needs for overall health.
Processed foods include:
- Refined grains like white bread, pasta, cereals
- Packaged snacks like potato chips, cookies, candy
- Canned foods
- Deli meats
- Fast foods (with some exceptions!)
What the experts say
Here is what we learned from oncology dietitian, Peter Adintori, MS, RD, CSO, CDN, CNSC who shared his professional wisdom with us:
We sat down with Peter for his take, and asked him the question, “What is your philosophy when it comes to advising cancer survivors on how to approach food and nutrition?”
"During treatment, many symptoms may arise, which can drastically affect people’s relationship with food. I begin my sessions with survivors addressing this issue head-on. It’s important to acknowledge that these circumstances are individualized and everyone has their own experience with nutrition during treatment. Survivors should incorporate nutrition as a tool for health and also a source of enjoyment and celebration, as we know food can serve so many purposes in our lives.
Available data show that incorporating more plant-based whole foods such as fresh fruits, vegetables, beans, nuts, seeds, and whole grains is beneficial not just for cancer risk reduction but for many chronic diseases. So, I always encourage my patients to think of opportunities to include more of these foods in their eating choices throughout the week, while prioritizing the inclusion of foods that are important to them personally and culturally.
We also know that sugar is the elephant in the room during these conversations, so we asked Peter, “what is your professional opinion when it comes to sugar for cancer survivors?” Sugar is always at the front of mind of patients and survivors as a source of confusion and concern.
However, when it comes to foods, so many of them have sugars in one form or another.
So, it is nearly impossible to avoid all sugar, and that sugar is so important for our body to move, think, breathe, and process the food we eat. So, what we know is that it is likely a good idea to limit or avoid sources of added sugar, such as sodas, juices, candy, desserts, and alcohol. However, as I always tell my patients, having these foods once in a while will not immediately cause harm or increase one’s risk of chronic disease. These diseases develop overtime, and an overall balanced, healthful lifestyle makes a big difference in lowering one’s risk for disease."
What the community says
If you’re searching for strategies to try out when it comes to nutrition, we asked our survivors what has worked for them and collected it all in one place.
- Prioritize Nutrient-Dense Foods: Focus on incorporating nutrient-dense foods into your diet. These include fruits, vegetables, whole grains, lean proteins, and healthy fats. We realize this can be hard to do on a budget, so think about things like:
- Location of local farms or farmers markets
- Finding cost-conscious meal delivery services with nutrient dense foods
- Reaching out to your local grocery stores; some may have free dietician services to help you get started
- Eat the rainbow! (a Variety of Colors): Make your plate look as fun and colorful as possible. Aim to include a colorful variety of fruits and vegetables in your meals- these foods have different nutrient profiles and can help you get the right vitamins, minerals, and antioxidants.
- Looking for a hack? You can blend berries, spinach, kale, carrots, and other colorful ingredients into a smoothie to create a vibrant and nutrient-packed beverage.
- Check labels: As a good rule of thumb, if there are more than ten ingredients, it’s probably approaching highly processed. Again, this doesn’t mean you can’t eat and enjoy it, it just means you should balance it out with a more nutritious option for your next meal.
- Stay Hydrated: Proper hydration is crucial for overall health. Regardless of where you are at with your overall nutrition, drinking more water is a simple and important change you can make for your health.
- Meal Planning and Preparation: Planning and preparing your meals in advance can help you make healthier choices and save time. You can set aside specific days for grocery shopping and meal prepping, like Saturday/Sunday. Plan your meals to include a balance of macronutrients (carbohydrates, proteins, and fats) and have healthy snacks readily available to avoid reaching for less nutritious options.
In Summary
Cancer survivors have a really unique set of needs and considerations when it comes to nutrition. There is a lot of mixed information, fad diets, non-evidence based strategies and conflicting advice about how to use nutrition as a tool for overall wellness and cancer risk reduction, but the most important thing is to maintain a sense of balance, and appreciate that nutrition is one tool in a larger toolbox of health. The main goal is to strike a balance between nourishing your body with healthful foods and allowing yourself to enjoy the foods that bring you joy. If you are still feeling unsure about where to go from here, consider these tips as a take home message: Eat a variety of colors, mostly plant-based! Drink at least 3L of water daily Try to limit processed foods with more than 5-10 ingredients to no more than once a day
Resources
Here are a few more OncoveryCare approved resources to support you:
Free nutrition consultation for all cancer types: Leukemia and Lymphoma Society
Recipes we love
Frequently asked questions: Oncology Nutrition, a Dietetic Practice Group of the Academy of Nutrition and Dietetics
Grocery Lists, via MD Anderson
Food as medicine meal delivery service
