Nutrition

Intro

Nutrition

“It’s about giving your body the nutrients it needs. Nutrition is important for everyone. When combined with exercising, eating well is a good way to help your body stay strong and healthy.”

Dr. Alex Bullock, PhD, RD, Trial Manager, Hull York Medical School

What is healthy eating?

Healthy eating means eating a variety of foods that give you the nutrients you need to maintain your health, feel good, and have energy. These nutrients include protein, carbohydrates, fat, water, vitamins, and minerals. A healthy diet contains a variety of foods from the following food groups: fruits and vegetables, whole grains, meat and beans, milk and dairy, and fats and oils.

Let’s dive into them! Click onto the next slide to continue

Food

Fruits and vegetables:

It's recommended that you eat at least 5 portions of a variety of fruit and veg every day. They can be fresh, frozen, canned, dried, or juiced. Fruit juice and smoothies should be limited to no more than a combined total of 150ml a day.

Starchy carbohydrates:

Starchy food should make up just over a third of the food we eat. Choose higher fibre or wholegrain varieties, such as whole wheat pasta and brown rice, or simply leave the skins on potatoes. There are also higher-fibre versions of white bread and pasta. Starchy foods are a good source of energy and the main source of a range of nutrients in our diet.

Try to include at least one starchy food with each main meal. Some people think starchy foods are fattening, but gram for gram, the carbohydrate they contain provides fewer than half the calories of fat.

Protein:

Fish, eggs, meats, dairy, beans, pulses, tofu, and soya are all good sources of protein. You need protein in your diet to help your body repair cells and make new ones. Eating enough protein can help you maintain your muscles and helps you build new muscle when you are doing strength training. It is important to get several sources of protein in your diet throughout the day. Try to have at least one serving of protein at each mealtime.

Fats:

You need some fat in your diet, but it's important to pay attention to the amount and type of fat you're eating.

There are two main types of fat: saturated and unsaturated. Too much saturated fat can increase the amount of cholesterol in the blood, which increases your risk of developing heart disease. Healthy sources of fats include vegetable oils (such as olive, sunflower, rapeseed, soy and corn), nuts, seeds and oily fish.

Foods and drinks that are high in fat, salt or sugar, such as sweet, crisps, chocolates, cakes and sugary drinks, can be enjoyed as part of a balanced diet. These foods can be high in calories and can be limited if you are trying to lose weight.

Food labelling:

Okay, we know it doesn’t necessarily fit with the food groups, but it is important to know that many pre-packaged foods have food labels on the front of the pack. These show the nutrition information per serving.

Food labels can help you choose between foods or pick foods that are lower in energy, fat, saturated fat, sugar and salt if you are looking to watch how much of these foods you are eating.

Where colour-coded labels are used, you can tell at a glance if they're high, medium or low in a particular nutrient. For some people, choosing products with more greens and ambers and fewer reds can help you manage your food choices.

For more information on healthy eating, visit: the NHS by clicking here!

For more information on healthy eating and cancer, visit: MacMillan by clicking here!

Low Appetite

Eating with a low appetite

The side effects of cancer and its treatment can affect your appetite and your ability to eat. You may not want to eat as much as normal or not have enough help with food shopping or preparing meals.

Speak to your GP, specialist nurse, or dietitian if you're having problems with eating enough. They can give you emotional support and practical help to eat a balanced diet.

Small amounts of exercise, such as a gentle walk before meals, can increase your appetite and eating at similar times each day will help to regulate your appetite. Adding herbs, spices, and seasonings can make food taste better and increase your appetite to eat. Alternatively, some plain foods, such as cereals, plain soups, or puddings, can be easier to manage if you have a low appetite. It can help to make large meals that can be divided into smaller portions, for example, soups, pies and bakes. Eating ‘little and often’ or trying nourishing drinks, such as smoothies or milkshakes, can also help.

Click onto the next slide to find some more resources and advice.

Eating problems after cancer

Eating problems after cancer treatment

Your diet is important in helping you recover from your cancer treatment. This includes eating a balanced diet, including enough protein to restore your body's strength, and staying hydrated. There are many good resources that can give you advice about following a balanced diet, including the Macmillan Healthy Eating and Cancer Booklet .

For some people, cancer treatment may have caused them to lose weight, which can make them feel tired and affect their energy levels and physical strength. Others may have experienced symptoms and side effects from their cancer treatment, such as nausea or poor appetite. Most side effects of treatment will go after your treatment ends, but some can last for some time. Below are some tips for managing any ongoing symptoms, as well as some resources to help with your diet;

Macmillan Recipes for People Affected by Cancer booklet contains ideas for recipes if you are experiencing problems with symptoms such as nausea, loss of sense of taste or smell, a sore mouth, difficulties chewing, or if you have lost weight during your treatment.

Making the Most of Every Bite provides extra recipes for those with a poor appetite, who are looking to regain weight, or who are trying to increase their calorie and protein intake.

After cancer treatment, some people want to improve their diet, however, there are many food myths which can cause people to restrict their diet unnecessarily. Cancer Research UK and the British Dietetic Association have fact-checked some of the more common food myths:

Cancer Research UK, Food Myths

British Dietetic Association, Challenging Cancer Diet Myths

Eating problems and cancer

People living with and beyond cancer may have different dietary needs. Some people will be able to eat normally. Other people may have symptoms, such as shortness of breath, a poor appetite, or poor digestion, which can affect what they are eating.

Some of the common side effects of treatments include; a loss of appetite, feeling sick (nausea), diarrhoea or constipation, a sore mouth, or changes to your tastes. Some people do not get any of these symptoms, other people may experience several of these symptoms.

Most side effects of treatment will go after your treatment ends, but some can last for some time. Below are some tips for managing any ongoing symptoms, as well as some resources to help with your diet;

- Advice to help with a poor appetite includes; making the most of the times of the day when your appetite is best, trying foods little and often, and making the most of nourishing drinks.

- Advice to help with sickness (nausea) includes; trying dry foods e.g., toast, crackers, and crispbreads, avoiding foods with a strong smell or taste, and avoiding large drinks with meals.

- Advice to help with constipation includes; drinking plenty of fluids, gentle exercise, and adding fibre to your meals

- Advice for diarrhoea includes; drinking plenty of fluids, avoiding alcohol and caffeine, eating small, frequent meals

- Advice for a sore mouth includes; choosing softer or moister foods, adding sauces or gravies to your meals, avoiding dry or sharp foods, and avoiding foods that are harder to swallow, such as very hot foods and drinks, very dry foods, or very spicy or salty foods.

- Advice for taste changes includes; using gentle mouthwashes before and after meals and changing the types of foods eaten depending on the type of taste changes.

- Advice for shortness of breath includes; taking smaller bites of food, avoiding very hot or very cold foods as these can catch your breath, and avoiding very chewy foods. Some people may need to eat higher-energy foods and drinks to get their energy needs in with as little effort as possible.

The below resources provide more information on how to help manage these problems:

Macmillan Eating Problems and Cancer

Making the Most of Every Bite

Macmillan Recipes for People Affected by Cancer

After your cancer treatment for colorectal cancer, you might find that you cannot eat the same foods as normal. You may have experienced symptoms after your cancer treatment, such as diarrhoea or constipation, or may have a stoma and be experiencing wind or loose stools. Changes to your diet can help manage these symptoms.

Fibre

A diet rich in fibre (whole grains, pulses, vegetables and fruit) is important for bowel health, as it helps move food more quickly through the bowel. Fibre also keeps you feeling full for longer, and so can help you control your weight and appetite. Increase fibre gradually and drink plenty of fluids to avoid wind, bloating and stomach cramps.

How much fibre?

Healthy adults should aim to eat at least 30g of fibre a day. Your healthcare team will explain how much fibre you need to include in your diet, depending on which treatment you’ve had. If you have any problems and find that you can’t cope with high-fibre foods, speak to your dietitian or healthcare team.

Low fibre diets

After treatment, you may be advised to follow a low-fibre diet. This means you may find you can no longer eat high-fibre foods such as bran, nuts or seeds. If this is the case, you could try foods containing gentler soluble fibre like oats and pulses. Cooking fruit and vegetables and removing the skins can also make fibre easier to digest. Over time, you may be able to gradually increase the amount of fibre you eat.

You may need to follow a low-fibre diet, for example, before and after treatment, but make sure you ask your healthcare team how long you should follow this diet.

Adding fibre to your diet

It is important to increase fibre gradually to avoid wind, bloating and stomach cramps. For example, you could add an extra portion of fruit or vegetables to your diet every few days. Fibre attracts water, so it’s important to drink plenty of fluids.

Eating with a colostomy

Many people with colostomy are able to eat a healthy, balanced diet. But if you had constipation or diarrhoea before having a colostomy, you may find that you continue to have these symptoms.

Whether you have constipation or diarrhoea, it is important to stay hydrated and drink two to three litres of liquid a day. All drinks count (water, tea, coffee, squash, milk) except for alcohol-containing drinks.

If you have constipation, make sure you’re eating enough fibre and have at least five portions of vegetables and fruit each day. Eating meals at regular times and high-fibre foods can help to relieve constipation.

If you have diarrhoea, see your GP or stoma nurse. They may give you medicine to slow the movement of food through your bowel and thicken the output. Foods that may thicken output include very ripe bananas, boiled rice, porridge, smooth peanut butter, white bread or pasta. Make sure you drink enough fluids.

Eating with an ileostomy

When you first have an ileostomy, you may find that some types of food are harder to digest. Chew your food well and introduce fibre gradually. You can eat vegetables and fruit as part of a healthy, balanced diet, but chew them well to reduce the risk of blockages. If you have problems eating these foods, you could try taking off the skin and removing the seeds or eating tinned vegetables and fruit.

Seek medical advice from your GP, stoma nurse or dietitian if you have ongoing problems with your stoma.

For more information, visit Bowel Cancer UK here.

Eating well

Eating well and spending less

Healthy eating, or changing your diet to help manage your symptoms or regain weight, does not need to be expensive.

Here are some tips to help you spend less when shopping for food, and tips for cooking to help reduce food waste.

To help you spend less when you go shopping:

1. Check what you already have at home. This may help you to avoid buying things you do not need

2. Make a meal plan, and write a shopping list before going shopping

3. Try to avoid shopping when you are hungry. This can make us want to buy more, Consider shopping after you have eaten

4. Special offers and packaged foods (such as bagged fruits and vegetables) may not be the cheapest options. Buying loose fruits and vegetables may be cheaper, and mean you can buy as much or as little as you need to help prevent food waste.

Fruits and vegetables on a budget:

1. Eating seasonally can save you money in your food shop. Fruits and vegetables that are in season tend to be less expensive as they are more widely available. For more information on eating seasonally: Seasonal fruit and veg – a handy guide | British Dietetic Association (BDA)

2. Frozen and tinned fruits and vegetables are often cheaper than their fresh counterparts. Buying frozen fruits and vegetables can also help prevent food waste as they can be stored for much longer.

3. Many fruits and vegetables can be eaten with their skins on. Alternatively, vegetable peels can be added to soups and stews to help reduce food waste.

For more information, including on how to read food labels and compare prices, and for ideas on budget meals: Eat well, spend less | British Dietetic Association (BDA)