Diet and Nutritional Supplements

Cancer and its treatments can lead to unintentional weight loss, reduced appetite, difficulties with eating, or changes in the way the body uses nutrients. In addition, some treatments may cause symptoms such as nausea, changes in taste, swallowing difficulties, diarrhoea or fatigue, which can make it more challenging to maintain an adequate diet.

In some people, particularly in advanced stages of the disease, cancer cachexia may develop. This syndrome is characterised by weight loss, loss of muscle mass and reduced physical strength, and cannot always be corrected simply by increasing food intake. For this reason, it is important to identify nutritional problems early and seek specialist advice.

If you are losing weight unintentionally, inform your healthcare team. Maintaining good nutritional status can help to:

  • Maintain strength and muscle mass.
  • Tolerate treatments more effectively.
  • Support recovery.
  • Reduce complications.
  • Improve quality of life.

Increasing Energy and Protein Intake

When there is a risk of malnutrition or weight loss, the main goal is to increase energy and protein intake without requiring excessively large meals.

A registered dietitian or healthcare professional may recommend strategies such as:

  • Eating 5 to 6 small meals a day.
  • Including protein-rich foods at every meal.
  • Adding energy-dense ingredients to everyday meals.
  • Using oral nutritional supplements when necessary.

Protein-Rich Foods

Protein helps maintain and repair body tissues and preserve muscle mass.

It is recommended to regularly include:

  • Fish.
  • Eggs.
  • Lean meat.
  • Chicken or turkey.
  • Pulses.
  • Milk, yoghurt and cheese.
  • Protein-fortified plant-based drinks, where appropriate.
  • Nuts and nut butters.

How to Enrich Meals

If your appetite is poor, it may be helpful to increase the nutritional value of small portions of food:

  • Add extra virgin olive oil to mashed dishes, vegetables and soups.
  • Add grated cheese to soups, creamy dishes or pasta.
  • Add powdered milk to mashed dishes, yoghurts or smoothies.
  • Use nut butters (such as almond, peanut or hazelnut butter) where appropriate.
  • Prepare enriched smoothies using milk, yoghurt or soft cheese.

Oral Nutritional Supplements

When a normal diet does not meet nutritional requirements, your healthcare team may recommend specific oral nutritional supplements.

These products usually provide:

  • Energy (calories).
  • Protein.
  • Vitamins and minerals.

They may be available in the form of:

  • Milkshakes or nutritional drinks.
  • Dessert-style supplements.
  • Dairy-based drinks.
  • Fortified fruit juices.
  • Powders that can be added to food.

Nutritional supplements should be used under professional supervision and should not replace a balanced diet unless specifically recommended by a healthcare professional.

The Emotional Impact of Weight Loss

Weight loss and changes in appearance can affect body image, self-esteem and personal relationships.

It is normal to experience worry, frustration or sadness when your physical appearance changes. Talking about these feelings with family members, carers or healthcare professionals can be helpful.

If physical changes are causing significant distress, specialist psychological support may be beneficial.

Advice for Family Members and Carers

Caring for someone with cancer who has a poor appetite or is losing weight can be worrying. It is important to remember that pressuring someone to eat often creates stress and, in many cases, does not improve food intake.

Practical Tips

  • Take advantage of times of day when appetite is at its best.
  • Offer small, frequent meals instead of three large meals.
  • Keep meal times flexible.
  • Create a calm and pleasant eating environment.
  • Offer small portions initially and allow second helpings if desired.
  • Keep nutritious snacks readily available.
  • Respect food preferences, which may change during treatment.

If Taste or Smell Changes Occur

Some treatments may affect the perception of taste and smell.

The following strategies may help:

  • Serve foods cold or at room temperature.
  • Use plastic cutlery if foods have a metallic taste.
  • Choose foods with mild flavours or those that are better tolerated.
  • Avoid strong cooking smells during food preparation.
  • Keep the kitchen well ventilated.

If You Experience Nausea

The following measures may be helpful:

  • Eat slowly.
  • Avoid very fatty foods and foods with strong smells.
  • Eat small amounts frequently.
  • Maintain good hydration.
  • Follow any medication advice provided by your healthcare team.

Food Safety

Some people with cancer may have a weakened immune system, particularly during certain treatments.

In these situations, it is important to:

  • Wash your hands thoroughly before handling food.
  • Wash fruit and vegetables carefully.
  • Cook meat, fish and eggs thoroughly.
  • Avoid foods made with unpasteurised milk.
  • Store chilled foods correctly.
  • Observe use-by and expiry dates.

Alcohol and Appetite Stimulation

Current recommendations do not support the use of alcoholic beverages to stimulate appetite. Alcohol may interact with certain treatments, worsen some symptoms and increase the risk of other health problems. Any alcohol consumption should be discussed with your healthcare team beforehand.