Diet & Cancer

Diet and physical activity’s impact Dietary factors are estimated to account for approximately 30% of cancers, making unhealthy diet second only to tobacco as a preventable cause of cancer. Obesity is a killer. This proportion is thought to be about 20% in developing countries and is projected to grow. As developing countries become urbanized, patterns of cancer, particularly those most strongly associated with diet and physical activity, tend to shift towards the patterns of economically developed countries. Cancer rates also change as populations move between countries and adopt different dietary patterns. The relative importance of cancers as a cause of death is increasing. The incidence of lung cancer and cancers of the colon and rectum, breast and prostate, generally increases in parallel with economic development, as stomach cancer declines. Cancer is also strongly associated with social and economic status. Cancer risk factors are highest in groups with the least education. In addition, patients in the lower socioeconomic classes have consistently poorer survival rates than those in higher strata. In recent years, substantial evidence has pointed to the link from overweight and obesity, to many types of cancer such as esophagus, colorectal, breast, endometrium and kidney. The composition of the diet is also important since fruit and vegetables may have a protective effect by decreasing the risk for some cancer types such as oral, esophageal, gastric and colorectal cancer. High intake of preserved meat or red meat might be associated with increased risk of colorectal cancer. Another aspect of diet clearly related to cancer risk is the high consumption of alcoholic beverages, which convincingly increases the risk of the oral cavity, pharynx, larynx, esophagus, liver and breast cancers. Regular physical activity has also been seen to have a protective effect in reducing the risk of breast and colorectal cancer. What can be done? The wealth of knowledge that already exists about cancer risk factors provides obvious and ample scope for action to reduce the cancer burden of all countries. After tobacco, overweight and obesity seems to be the most important avoidable cause of cancer. Given that poor nutrition, physical inactivity, obesity, tobacco and alcohol, are risk factors common to other chronic diseases, such as Cardio-vascular Disease (CVD), type 2 diabetes, and respiratory diseases, conducting a cancer prevention program within the context of an integrated chronic disease prevention program would be an effective national strategy. Dietary factors that convincingly increase risk are:

• Overweight and obesity,
•  Excess alcohol consumption (more than 2 units a day)
•  Some forms of salting and fermenting fish
•  Very hot (thermally) salty drinks and food
•  Aflatoxins (fungal contaminants sometimes found on foods such as grains, peanuts, tree nuts, and cottonseed meal.

Eat well

Feel better Food tips for people with Cancer ‘You are what you eat’, was never truer than in the connection between food and cancer. Cancer has increasingly been identified as a “life-style’ disease. Scientists are agreed that cancers are linked to where you live, to what you eat and drink, and breathe and smoke. Cumulative impacts of the toxins in our systems lead to, or impact, diseases such as cancer. Eating healthy food is important when you are well. It is even more important when you are receiving treatment for cancer. There are no special foods you must eat or must avoid, but these suggestions will possibly help you to overcome problems connected with side effects of treatment. Cancer cannot be cured by diet alone, and there is insufficient evidence to prove that ‘special’ diets are beneficial. Some of these extreme diets may be harmful and interfere with the success of your treatment. If you are considering drastic changes, please discus them with your treating doctor. It is vital that you eat well to feel well and have more energy; get the best benefit from your treatment, with fewer side effects; improve your body’s ability to heal and keep body-weight at a healthy level. You need to eat energy generating foods, which help you maintain body weight. You need protein to maintain and renew the body’s tissues. You need vitamins and minerals to help the body assimilate the food you have eaten.

Side effects and how to deal with them:

It is quite common for people to have temporary problems such as loss of appetite during cancer treatment. Ideally, you should stay at the same weight as before cancer. Losing weight during treatment is not recommended. The normal ‘food pyramid’ does not apply in cancer patients. The best foods now will depend on the treatment he receives. So please do talk to your doctor/dietician about your special needs. Here are some tips you may find helpful:

1. Eat more frequent, but smaller meals. There is no rule, which says a patient should eat at “regular” meal times, or in “regular” quantities.
2. Very often, taste changes after chemotherapy. Make sure the meal looks appetizing, tempting the patient to eat.
3. Baby foods often work. Strained & pureed foods are easier to eat. You may want to add a teaspoon of non-fat dry milk (Powder) to soups or pureed foods.
4. Ice cream is a great option. So too milk shakes with fresh fruit. Jelly made with fruit juice or even soup is easily taken.
5. Dahi/lassi is easier to digest than full milk foods.
6. Please offer fruit whose skin is discarded – banana, mango, papaya, apple etc. Skin if fruit like grapes has residue of pesticides, which does not wash off completely.
7. Small amounts of meat in a broth or puree after cooking can be offered.
8. Grilled fish is excellent.
9. All vegetables can be cooked with light spice and pureed. /strained.
10. Offer plenty of fluids – water, juice, soups, and milk shakes; but especially water.

Above all, please speak up about changes have happened in your taste. You may want extra salt, extra masala, and extra sugar. Ask the family to give it to you. If you cannot tolerate milk products, (try dahi), ask your doctor about lactose free products available. If you have diabetes, high cholesterol, please ask the doctor for advice. Avoid foods that gives gas or which bring on diarrhea. You have already recognised the importance of a good diet in better prognosis for your recovery. Do call or email should you need more info. Our Cancer Sahyog volunteers visit hospitals regularly. If you want someone to visit, please let us know. Cancer Helpline: 24311010 Preventing Nausea: Hunger prolongs nausea. Eat small, frequent meals. Enjoy snacks between meals. Keep up fluid intake – sip your drink slowly. You may find it helpful to freeze limejuice or other juice, and suck on the frozen bits. Once the worst of nausea has passed, try a ginger ale, weak tea or green tea, Popsicles, clear broth and soup.

Other useful tips:

1. If you are likely to have a long wait, on a journey, or visit to the clinic, take a nourishing drink or small snack. Even a toffee in your pocket will do.
2. Chop your food into bite-sized pieces to make eating easier.
3. Eat your main meal at whatever time of day suits you.
4. Eat your favourite foods.
5. Choose foods that do not have strong smell, which could set up nausea.
6. Choose foods, which are quickly and easily digested.
7. Avoid fried or fatty foods.
8. Choose fluids that provide some energy – milk, juice, soup.
9. Eat & drink slowly
10. Chew foods well. Relax before meals. Anxiety affects the appetite.
11. Rest after eating.
12. Eat with family or friends; eat while watching TV or reading your appetite will improve between treatments. Eat well while you can. Taste & Smell Changes your treatment may cause your sense of taste or smell may change temporarily.
You may not like foods you previously enjoyed. Here are a few suggestions, which may help:
1. Eat foods, which do not have a strong smell. Cold foods may go down better.
2. Experiment with flavouring and extras like chutneys, pickles, chocolates, cheeses etc.
3. Feel free to add salt to food you find too sweet, or sugar to food which is too acidic or salty.
4. Add fruit or fruit puree to ice cream or gelatine desserts.
5. Stay away from the kitchen if cooking smells put you off.

You may have a sore mouth or difficulty in swallowing food:

1. Stew small pieces of meat or chicken in gravy.
2. Try smooth or blended foods, or creamy consistency.
3. Avoid foods that sting your mouth like acidic fruit (pineapple), or spicy and salty foods.
4. Avoid rough crunchy foods like hard toast and nuts.
5. Try drinking through a straw.
6. Pay special attention to mouth hygiene to prevent infection and tooth decay.

Use a gentle mouthwash after meals:

a) For a Dry Mouth:

1. Take fluids with your meal.
2. Suck on chips of ice. They also stimulate flow of saliva.
3. Add gravy or sauce, cream or custard to make foods moist. Bowel Troubles You may experience changes in bowel function as a result of your treatment. These are generally short –term, but unpleasant while they last. Make sure your doctor knows about them.

b) Constipation:

1. Eat regular meals. In particular, try not to miss breakfast.
2. Drink at least 8 cups/glasses of fluid every day. If you can tolerate it, drink 2 glasses of water on an empty stomach first thing in the morning.
3. Add extra fibre to your meal. Bran flakes, oat bran, dalia, can all be added to your meal in many ways. Get creative!
4. Remember to increase fibre and fluid simultaneously!
5. Eat some fruit and vegetable daily. Stewed apple or figs are very good. Avoid vegetables which give flatulence and gas. (Peas, cucumber, onion)
6. Prune juice is a good mild laxative. (A mix of pureed apple, softened prunes and bran moistened with prune juice will do the trick)
7. Eat slowly, chew your food well. Drink slowly too, avoid swallowing air.

c) Diarrhea:

1. Drink fluids between meals to prevent dehydration. Aim for 8 glasses of fluid a day.
2. Eat small, light and frequent meals.
3. Avoid coarse, indigestible foods – skin/seed of fruit, vegetables).
4. You may find yourself unable to digest milk during treatment.
Try hard cheese or curd, or try soya milk drinks. If you have severe diarrhea, please omit all fruit and vegetables, and eat a low residue diet for a few days. Low residue diet.
1. Drink plenty of fluids. Drink slowly. Avoid coffee or strong tea. A light green tea may help. Avoiding milk will also help.
2. Avoid all fruit/vegetable, except potato at first.
3. Gradually introduce foods as you tolerate them.
4. Cream crackers and other light biscuits, white bread, may help.
5. Rice, corn flakes, etc are light on the digestion.
6. Avoid pepper, strong curry with spices, and fatty foods.
7. Add foods one at a time. Once you can tolerate them, add the next, and so on. HAPPY EATING!