Nutritional Guidelines for Sarcoma Patients: Debunking Myths, Addressing Challenges

Nutrition For the Sarcoma Patient
Rebecca Perez, RDN, CSO, LD, CNSC
Sunday July 22, 2018
Objectives
 
Review some common cancer food myths
Review tips for the 5 most common nutrition
challenges during treatment
Review the plant based eating plan
Debunking the Cancer Food Myths
 
The Myth: Sugar Feeds Cancer
The Myth: Cancer Cells Cannot Survive in an Alkaline
Environment
The Myth: Herbal Supplements Help Fight Cancer
The Myth: Artificial Sweeteners Cause Cancer
 
 
 
5 Most Common Nutrition Challenges During
Treatment
 
 
Tips for Coping with Nausea/Vomiting
Tips for Coping with Decreased Appetite/Early Satiety
Tips for Coping with Altered Taste
Tips for Coping with Diarrhea
Tips for Coping with Constipation
Tips for Coping with Nausea/Vomiting
 
Take you anti-nausea medications as instructed!
Eat 5 - 6 small meals a day instead of three large meals.
Drink clear liquids as often as possible after vomiting to prevent
dehydration
Freshen your mouth with a homemade mouth rinse of 1 teaspoon of
baking soda, 1 teaspoon of salt, in a quart of water.  Swish and spit.
Eat bland foods, instead of foods that are very sweet, fatty, greasy, or
spicy.
Eat dry foods (such as crackers, toast, dry cereal, or bread sticks) when you
wake up and every few hours during the day when you are taking
medications or when you feel nauseated.
Tips for Coping with Decreased Appetite/Early
Satiety
 
Eat 5 or 6 small meals instead of 3 large meals.  Eat by the clock. Try to eat
something every 2-3 hours.
Keep your pantry and freezer well stocked with foods that make quick and
easy meals and snacks, tuna fish, sardines, peanut butter, soups, crackers,
cheese, cottage cheese, hard boiled eggs.
Eat a bedtime snack. This will give you extra calories without affecting
your appetite at your next meal.
Make every bite count by choosing protein rich foods.
Drink liquids throughout the day even when you do not feel like eating.
Choose liquids that add calories and other nutrients.
Drink only a small amount of liquids when you are eating meals. Many
people feel too full if they eat and drink at the same time
Tips For Coping with Altered Taste
 
Choose foods with tart flavors, such as lemon wedges, lemonade, citrus
fruits, vinegar, and pickled foods. (Caution: avoid these acidic foods if you
have a sore mouth or throat.)
Marinate foods in a balsamic vinaigrette salad dressing.
Season foods with herbs, spices, and other seasonings, such as onion,
garlic, chili powder, basil, oregano, rosemary, tarragon, barbecue sauce,
mustard, ketchup, or mint.  Try Mrs. Dash seasonings.
Eat frozen fruits, such as whole grapes and mandarin orange slices, or
chopped cantaloupe or watermelon.
Before eating, rinse your mouth with the homemade mouth rinse, 1
teaspoon salt, and 1 teaspoon baking soda in a quart of water.  Rinse and
spit.
If you have a metallic taste, try using plastic flatware and glass cups. Avoid
canned vegetables, fruits and soups.
Tips for Coping with Diarrhea
 
Avoid high fat and spicy foods
Choose low fiber, bland foods
Sip on broth, tomato juice, V-8 and electrolyte replacement
drinks to help replenish electrolytes
Add foods with soluble fiber to help thicken stool (banana,
applesauce, oats, white rice, white pasta)
Limit lactose, sugar and sorbitol
Limit hot, caffeinated beverages
Watch for medications containing magnesium
Tips for Coping with Constipation
 
Eat at about the same times each day
Drink plenty of liquids (at least 8 cups daily)
For variety, drink water, prune juice, warm fruit or vegetable juices,
decaffeinated teas, or hot water with added lemon juice and honey.
Fluids also include foods that are liquid at room temperature, like
frozen ice pops, gelatin, or ice cream.
Eat foods high in fiber
 Work up to 25-38 grams of fiber a day. Be sure to increase fiber
slowly.  Increase the amount of fiber you eat by no more than 5 grams
each day.
Eating Well Using a Plant Based Eating Plan
 
Recommended by the American Cancer Society (ACS)
and the American Institute for Cancer Research
(AICR).
Plant based eating provides antioxidants and
phytonutrients/phytochemicals that help “
fight
cancer cells and scavenge free radicals in the body.
Plant based eating helps reduce inflammation
throughout the body
.
Phytonutrients/Phytochemicals
 
They provide plants with color, odor and
flavor.
Not one single food has all the phytonutrients
in it.
Research has shown that phytonutrients work
better together so variety is the message.
Eat By Color To Include a Variety of
Phytonutrients/Phytochemicals
 
Red
: tomatoes, bell peppers, cranberries, cherries,
raspberries, onions, apples
Orange
: carrots, pumpkin, sweet potato, turmeric
Yellow
: ginger, pineapple, summer squash, pear, apple
Green
: broccoli, kale, green tea, spinach, Brussel
sprouts
Purple
: blueberries, figs, grapes, blackberries, eggplant
Tan/White: coffee, garlic, mushrooms, nuts, onions,
seeds, soy, tea, whole grains
Plate Method
Vegetables
 
Aim for 4 or more servings per day.    (1cup raw leafy,
½ cup cooked/raw for all others)
When cooking vegetables, they should be slightly
cooked.
Steam, bake, stir-fry, roast, or lightly sauté or raw.
   (No deep fried)
Drizzle 1tsp. Olive oil on vegetables for greater
phytonutrient absorption!
Fruits
 
Aim for 2 – 3 servings per day. (1 medium or ½
cup cut up raw or canned, approx. 12 grapes)
Choose fresh when in season or canned in
their own juice or frozen with no added sugar.
Avoid drinking 
ALL
 fruit juices!
Whole Grains
Aim for 3 servings per day.
Brown and Wild Rice
Oatmeal
Quinoa
Barley
100% whole wheat bread/English muffin
Whole grain cereal
Whole wheat pasta
Corn Tortillas
Corn, sweet potato, pumpkin, winter squash (acorn,
butternut) – these are considered grains on your plate not
vegetables.
Lean Protein Choices
 
Dried Beans, Peas & Lentils: 3 – 4 servings per
week
Fish: 3 – 4 servings per week (not fried)
Chicken and Turkey breast meat no skin
Veggie Burgers
Eggs – no more than 3 or 4 yolks per week
Tofu
Tempeh
Soybeans/Edamame
Dairy & Dairy Alternatives
Aim for 2 – 3 servings per day.
Skim or 1% milk
Non Fat Greek Yogurt
Low Fat Cottage Cheese
2% or Low Fat Cheese
Skim Soy Milk
Skim Lactaid
Almond Milk, Oat Milk, Rice Milk needs to be
fortified with calcium and does not contain
significant amounts of protein.
Healthy Fats
1 – 2 servings per day.
Nuts and Nut Butters (Peanut Butter, Almond Butter,
Cashew Butter)
Seeds: Flaxseed, Pumpkin Seed, Sesame Seed, Sunflower
Seeds, Chia Seeds
Oils: Canola oil, Olive oil, Peanut oil, Flaxseed oil, Grape
Seed oil, Safflower oil, Sesame oil, Sunflower oil
Avocados
Olives
Where to Find More Information
American Cancer Society: cancer.org
   1-800-227-2345
American Institute of Cancer Research (AICR) aicr.org: 1-800-
843-8114
Books:
American Cancer Society Complete Guide to Nutrition for
Cancer Survivors: Eating Well, Staying Well During and
After Cancer, 2
nd
 Edition
What to Eat During Cancer Treatment
American Cancer Society’s Eating Healthy Cookbook, 3
rd
Edition
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Explore debunked cancer food myths such as the impact of sugar, alkaline environments, herbal supplements, and artificial sweeteners. Learn strategies for coping with common nutrition challenges during treatment, including nausea, decreased appetite, altered taste, diarrhea, and constipation. Discover tips on maintaining a balanced diet with small meals, proper hydration, and managing taste alterations. Enhance your understanding of plant-based eating plans for optimal health.

  • Sarcoma
  • Cancer Myths
  • Nutrition Challenges
  • Plant-Based Eating
  • Coping Strategies

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  1. Nutrition For the Sarcoma Patient Rebecca Perez, RDN, CSO, LD, CNSC Sunday July 22, 2018

  2. Objectives Review some common cancer food myths Review tips for the 5 most common nutrition challenges during treatment Review the plant based eating plan

  3. Debunking the Cancer Food Myths The Myth: Sugar Feeds Cancer The Myth: Cancer Cells Cannot Survive in an Alkaline Environment The Myth: Herbal Supplements Help Fight Cancer The Myth: Artificial Sweeteners Cause Cancer

  4. 5 Most Common Nutrition Challenges During Treatment Tips for Coping with Nausea/Vomiting Tips for Coping with Decreased Appetite/Early Satiety Tips for Coping with Altered Taste Tips for Coping with Diarrhea Tips for Coping with Constipation

  5. Tips for Coping with Nausea/Vomiting Take you anti-nausea medications as instructed! Eat 5 - 6 small meals a day instead of three large meals. Drink clear liquids as often as possible after vomiting to prevent dehydration Freshen your mouth with a homemade mouth rinse of 1 teaspoon of baking soda, 1 teaspoon of salt, in a quart of water. Swish and spit. Eat bland foods, instead of foods that are very sweet, fatty, greasy, or spicy. Eat dry foods (such as crackers, toast, dry cereal, or bread sticks) when you wake up and every few hours during the day when you are taking medications or when you feel nauseated.

  6. Tips for Coping with Decreased Appetite/Early Satiety Eat 5 or 6 small meals instead of 3 large meals. Eat by the clock. Try to eat something every 2-3 hours. Keep your pantry and freezer well stocked with foods that make quick and easy meals and snacks, tuna fish, sardines, peanut butter, soups, crackers, cheese, cottage cheese, hard boiled eggs. Eat a bedtime snack. This will give you extra calories without affecting your appetite at your next meal. Make every bite count by choosing protein rich foods. Drink liquids throughout the day even when you do not feel like eating. Choose liquids that add calories and other nutrients. Drink only a small amount of liquids when you are eating meals. Many people feel too full if they eat and drink at the same time

  7. Tips For Coping with Altered Taste Choose foods with tart flavors, such as lemon wedges, lemonade, citrus fruits, vinegar, and pickled foods. (Caution: avoid these acidic foods if you have a sore mouth or throat.) Marinate foods in a balsamic vinaigrette salad dressing. Season foods with herbs, spices, and other seasonings, such as onion, garlic, chili powder, basil, oregano, rosemary, tarragon, barbecue sauce, mustard, ketchup, or mint. Try Mrs. Dash seasonings. Eat frozen fruits, such as whole grapes and mandarin orange slices, or chopped cantaloupe or watermelon. Before eating, rinse your mouth with the homemade mouth rinse, 1 teaspoon salt, and 1 teaspoon baking soda in a quart of water. Rinse and spit. If you have a metallic taste, try using plastic flatware and glass cups. Avoid canned vegetables, fruits and soups.

  8. Tips for Coping with Diarrhea Avoid high fat and spicy foods Choose low fiber, bland foods Sip on broth, tomato juice, V-8 and electrolyte replacement drinks to help replenish electrolytes Add foods with soluble fiber to help thicken stool (banana, applesauce, oats, white rice, white pasta) Limit lactose, sugar and sorbitol Limit hot, caffeinated beverages Watch for medications containing magnesium

  9. Tips for Coping with Constipation Eat at about the same times each day Drink plenty of liquids (at least 8 cups daily) For variety, drink water, prune juice, warm fruit or vegetable juices, decaffeinated teas, or hot water with added lemon juice and honey. Fluids also include foods that are liquid at room temperature, like frozen ice pops, gelatin, or ice cream. Eat foods high in fiber Work up to 25-38 grams of fiber a day. Be sure to increase fiber slowly. Increase the amount of fiber you eat by no more than 5 grams each day.

  10. Eating Well Using a Plant Based Eating Plan Recommended by the American Cancer Society (ACS) and the American Institute for Cancer Research (AICR). Plant based eating provides antioxidants and phytonutrients/phytochemicals that help fight cancer cells and scavenge free radicals in the body. Plant based eating helps reduce inflammation throughout the body.

  11. Phytonutrients/Phytochemicals They provide plants with color, odor and flavor. Not one single food has all the phytonutrients in it. Research has shown that phytonutrients work better together so variety is the message.

  12. Eat By Color To Include a Variety of Phytonutrients/Phytochemicals Red: tomatoes, bell peppers, cranberries, cherries, raspberries, onions, apples Orange: carrots, pumpkin, sweet potato, turmeric Yellow: ginger, pineapple, summer squash, pear, apple Green: broccoli, kale, green tea, spinach, Brussel sprouts Purple: blueberries, figs, grapes, blackberries, eggplant Tan/White: coffee, garlic, mushrooms, nuts, onions, seeds, soy, tea, whole grains

  13. Plate Method

  14. Vegetables Aim for 4 or more servings per day. (1cup raw leafy, cup cooked/raw for all others) When cooking vegetables, they should be slightly cooked. Steam, bake, stir-fry, roast, or lightly saut or raw. (No deep fried) Drizzle 1tsp. Olive oil on vegetables for greater phytonutrient absorption!

  15. Fruits Aim for 2 3 servings per day. (1 medium or cup cut up raw or canned, approx. 12 grapes) Choose fresh when in season or canned in their own juice or frozen with no added sugar. Avoid drinking ALL fruit juices!

  16. Whole Grains Aim for 3 servings per day. Brown and Wild Rice Oatmeal Quinoa Barley 100% whole wheat bread/English muffin Whole grain cereal Whole wheat pasta Corn Tortillas Corn, sweet potato, pumpkin, winter squash (acorn, butternut) these are considered grains on your plate not vegetables.

  17. Lean Protein Choices Dried Beans, Peas & Lentils: 3 4 servings per week Fish: 3 4 servings per week (not fried) Chicken and Turkey breast meat no skin Veggie Burgers Eggs no more than 3 or 4 yolks per week Tofu Tempeh Soybeans/Edamame

  18. Dairy & Dairy Alternatives Aim for 2 3 servings per day. Skim or 1% milk Non Fat Greek Yogurt Low Fat Cottage Cheese 2% or Low Fat Cheese Skim Soy Milk Skim Lactaid Almond Milk, Oat Milk, Rice Milk needs to be fortified with calcium and does not contain significant amounts of protein.

  19. Healthy Fats 1 2 servings per day. Nuts and Nut Butters (Peanut Butter, Almond Butter, Cashew Butter) Seeds: Flaxseed, Pumpkin Seed, Sesame Seed, Sunflower Seeds, Chia Seeds Oils: Canola oil, Olive oil, Peanut oil, Flaxseed oil, Grape Seed oil, Safflower oil, Sesame oil, Sunflower oil Avocados Olives

  20. Where to Find More Information American Cancer Society: cancer.org 1-800-227-2345 American Institute of Cancer Research (AICR) aicr.org: 1-800- 843-8114 Books: American Cancer Society Complete Guide to Nutrition for Cancer Survivors: Eating Well, Staying Well During and After Cancer, 2ndEdition What to Eat During Cancer Treatment American Cancer Society s Eating Healthy Cookbook, 3rd Edition

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